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Painful Diabetic Polyneuropathy pp 63–69Cite as

Physical Therapy for Painful Diabetic Neuropathy

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Abstract

For conservative treatment of diabetic PN different types of physical therapy are available. Therapeutic interventions focus on different symptoms like pain, reduced muscle strenght, impaired balance and physical functioning or feet ulcers. Also different pathogenetic mechanisms like impaired circulation and oxygenation, increased plantar pressure or reduced muscle mass and glycogen utilization are taken into account. A combined individualized treatment with focus on the major complaints is required and mostly consists of exercise therapy, medical training therapy, and electrotherapy. A multidisciplinary management of painful diabetic PN is most beneficial.

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References

  1. Galer BS, Gianas A, Jensen MP. Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes Res Clin Pract. 2000;47:123–8.

    Article  PubMed  CAS  Google Scholar 

  2. Wallace C, Reiber GE, LeMaster J, et al. Incidence of falls, risk factors for falls, and fall-related fractures in individuals with diabetes and a prior foot ulcer. Diabetes Care. 2002;25:1983–6.

    Article  PubMed  Google Scholar 

  3. Uccioli L, Giacomini PG, Monticone G, et al. Body sway in diabetic neuropathy. Diabetes Care. 1995;18:339–44.

    Article  PubMed  CAS  Google Scholar 

  4. Allet L, Armand S, Aminian K, et al. An exercise intervention to improve diabetic patients’ gait in a real-life environment. Gait Posture. 2010;32:185–90.

    Article  PubMed  CAS  Google Scholar 

  5. Sigal RJ, Kenny GP, Wasserman DH, et al. Physical activity/exercise and type 2 diabetes. Diabetes Care. 2004;27:2518–39.

    Article  PubMed  Google Scholar 

  6. Cheer K, Shearman C, Jude EB. Managing complications of the diabetic foot. BMJ. 2009;339:b4905.

    Article  PubMed  Google Scholar 

  7. Malik RA, Newrick PG, Sharma AK, et al. Microangiopathy in human diabetic neuropathy: relationship between capillary abnormalities and the severity of neuropathy. Diabetologia. 1989;32:92–102.

    Article  PubMed  CAS  Google Scholar 

  8. Fisher MA, Langbein WE, Collins EG, et al. Physiological improvement with moderate exercise in type II diabetic neuropathy. Electromyogr Clin Neurophysiol. 2007;47:23–8.

    PubMed  CAS  Google Scholar 

  9. Boulton AJ, Hardisty CA, Betts RP, et al. Dynamic foot pressure and other studies as diagnostic and management aids in diabetic neuropathy. Diabetes Care. 1983;6:26–33.

    Article  PubMed  CAS  Google Scholar 

  10. Abouaesha F, van Schie CH, Griffths GD, et al. Plantar tissue thickness is related to peak plantar pressure in the high-risk diabetic foot. Diabetes Care. 2001;24:1270–4.

    Article  PubMed  CAS  Google Scholar 

  11. Brink T. Induration of the diabetic foot pad: another risk factor for recurrent neuropathic plantar ulcers. Biomed Tech. 1995;40:205–9.

    Article  CAS  Google Scholar 

  12. Otterman NM, van Schie CH, van der Schaaf M, et al. An exercise programme for patients with diabetic complications: a study on feasibility and preliminary effectiveness. Diabet Med. 2011;28:212–7.

    Article  PubMed  CAS  Google Scholar 

  13. Song CH, Petrofsky JS, Lee SW, et al. Effects of an exercise program on balance and trunk proprioception in older adults with diabetic neuropathies. Diabetes Technol Ther. 2011;13:803–11.

    Article  PubMed  Google Scholar 

  14. Richardson JK, Sandman D, Vela S. A focused exercise regimen improves clinical measures of balance in patients with peripheral neuropathy. Arch Phys Med Rehabil. 2001;82:205–9.

    Article  PubMed  CAS  Google Scholar 

  15. Lemaster JW, Mueller MJ, Reiber GE, et al. Effect of weight-bearing activity on foot ulcer incidence in people with diabetic peripheral neuropathy: feet first randomized controlled trial. Phys Ther. 2008;88:1385–98.

    Article  PubMed  Google Scholar 

  16. Matjacic Z, Zupan A. Effects of dynamic balance training during standing and stepping in patients with hereditary sensory motor neuropathy. Disabil Rehabil. 2006;28:1455–9.

    Article  PubMed  Google Scholar 

  17. Balducci S, Iacobellis G, Parisi L, et al. Exercise training can modify the natural history of diabetic peripheral neuropathy. J Diabetes Complications. 2006;20:216–23.

    Article  PubMed  Google Scholar 

  18. Gilcreast DM, Stotts NA, Froelicher ES, et al. Effect of electrical stimulation on foot skin perfusion in persons with or at risk for diabetic foot ulcers. Wound Repair Regen. 1998;6:434–41.

    Article  PubMed  CAS  Google Scholar 

  19. Kaada B. Vasodilation induced by transcutaneous nerve stimulation in peripheral ischemia (Raynaud’s phenomenon and diabetic polyneuropathy). Eur Heart J. 1982;3:303–14.

    PubMed  CAS  Google Scholar 

  20. Martin TP, Stein RB, Hoeppner PH, et al. Influence of electrical stimulation on the morphological and metabolic properties of paralyzed muscle. J Appl Physiol. 1992;72:1401–6.

    PubMed  CAS  Google Scholar 

  21. Walker J. Relief from chronic pain by low power laser irradiation. Neurosci Lett. 1983;43:339–44.

    Article  PubMed  CAS  Google Scholar 

  22. Passarella S. He-Ne laser irradiation of isolated mitochondria. J Photochem Photobiol B. 1989;3:642–3.

    Article  PubMed  CAS  Google Scholar 

  23. Watkins ES, Koeze TH. Spinal cord stimulation and pain relief. BMJ. 1993;307:462.

    Article  PubMed  CAS  Google Scholar 

  24. Pieber K, Herceg M, Paternostro-Sluga T. Electrotherapy for the treatment of painful diabetic peripheral neuropathy: a review. J Rehabil Med. 2010;42:289–95.

    Article  PubMed  Google Scholar 

  25. Reichstein L, Labrenz S, Ziegler D, et al. Effective treatment of symptomatic diabetic polyneuropathy by high-frequency external muscle stimulation. Diabetologia. 2005;48:824–8.

    Article  PubMed  CAS  Google Scholar 

  26. Hopkins JT, McLoda TA, Seegmiller JG, et al. Low-level laser therapy facilitates superficial wound healing in humans: a triple-blind, sham-controlled study. J Athl Train. 2004;39:223–9.

    PubMed  Google Scholar 

  27. Oron A, Oron U, Streeter J, et al. Low-level laser therapy applied transcranially to mice ­following traumatic brain injury significantly reduces long-term neurological deficits. J Neurotrauma. 2007;24:651–6.

    Article  PubMed  Google Scholar 

  28. Huang YY, Chen AC, Carroll JD, et al. Biphasic dose response in low level light therapy. Dose Response. 2009;7:358–83.

    Article  PubMed  Google Scholar 

  29. Zinman LH, Ngo M, Ng ET, et al. Low-intensity laser therapy for painful symptoms of diabetic sensorimotor polyneuropathy: a controlled trial. Diabetes Care. 2004;27:921–4.

    Article  PubMed  Google Scholar 

  30. Khamseh ME, Kazemikho N, Aghili R, et al. Diabetic distal symmetric polyneuropathy: effect of low-intensity laser therapy. Lasers Med Sci. 2011;26:831–5.

    Article  PubMed  Google Scholar 

  31. Verdolini R, Bugatti L, Filosa G, et al. Old fashioned sodium bicarbonate baths for the treatment of psoriasis in the era of futuristic biologics: an old ally to be rescued. J Dermatolog Treat. 2005;16:26–30.

    Article  PubMed  CAS  Google Scholar 

  32. Wong AM, Lin YC, Chou SW, et al. Coordination exercise and postural stability in elderly people: effect of Tai Chi Chuan. Arch Phys Med Rehabil. 2001;82:608–12.

    Article  PubMed  CAS  Google Scholar 

  33. Taggart HM. Effects of Tai Chi exercise on balance, functional mobility, and fear of falling among older women. Appl Nurs Res. 2002;15:235–42.

    Article  PubMed  Google Scholar 

  34. Wang JS, Lan C, Wong MK. Tai Chi Chuan training to enhance microcirculatory function in healthy elderly men. Arch Phys Med Rehabil. 2001;82:1176–80.

    Article  PubMed  CAS  Google Scholar 

  35. Wang JS, Lan C, Chen SY, et al. Tai Chi Chuan training is associated with enhanced endothelium-dependent dilation in skin vasculature of healthy older men. J Am Geriatr Soc. 2002;50:1024–30.

    Article  PubMed  Google Scholar 

  36. Richerson S, Rosendale K. Does Tai Chi improve plantar sensory ability? A pilot study. Diabetes Technol Ther. 2007;9:276–86.

    Article  PubMed  Google Scholar 

  37. Jiang H, Shi K, Li X, et al. Clinical study on the wrist-ankle acupuncture treatment for 30 cases of diabetic peripheral neuritis. J Tradit Chin Med. 2006;26:8–12.

    PubMed  Google Scholar 

  38. Abuaisha BB, Costanzi JB, Boulton AJ. Acupuncture for the treatment of chronic painful peripheral diabetic neuropathy: a long-term study. Diabetes Res Clin Pract. 1998;39:115–21.

    Article  PubMed  CAS  Google Scholar 

  39. Zhang C, Ma YX, Yan Y. Clinical effects of acupuncture for diabetic peripheral neuropathy. J Tradit Chin Med. 2010;30:13–4.

    Article  PubMed  CAS  Google Scholar 

  40. Malhotra V, Singh S, Tandon OP, et al. Effect of Yoga asanas on nerve conduction in type 2 diabetes. Indian J Physiol Pharmacol. 2002;46:298–306.

    PubMed  Google Scholar 

  41. Head KA. Peripheral neuropathy: pathogenic mechanisms and alternative therapies. Altern Med Rev. 2006;11:294–329.

    PubMed  Google Scholar 

  42. Rains C, Bryson HM. Topical capsaicin. A review of its pharmacological properties and therapeutic potential in post-herpetic neuralgia, diabetic neuropathy and osteoarthritis. Drugs Aging. 1995;7:317–28.

    Article  PubMed  CAS  Google Scholar 

  43. Treatment of painful diabetic neuropathy with topical capsaicin. A multicenter, double-blind, vehicle-controlled study. The Capsaicin Study Group. Arch Intern Med. 1991;151:2225–9.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Medical University of Vienna, General Hospital of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Karin Pieber M.D., Malvina Herceg M.D. & Tatjana Paternostro-Sluga M.D.

Authors
  1. Karin Pieber M.D.
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  2. Malvina Herceg M.D.
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  3. Tatjana Paternostro-Sluga M.D.
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Corresponding author

Correspondence to Karin Pieber M.D. .

Editor information

Editors and Affiliations

  1. , Department of Anesthesiology, University of California San Diego, Campus Point Dr 9300, La Jolla, 92037, California, USA

    Erin Lawson

  2. , Department of Neurology, University of Wisconsin, Highland Avenue 1685, Madison, 53705-2281, Wisconsin, USA

    Miroslav "Misha" Backonja

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Pieber, K., Herceg, M., Paternostro-Sluga, T. (2013). Physical Therapy for Painful Diabetic Neuropathy. In: Lawson, E., Backonja, M. (eds) Painful Diabetic Polyneuropathy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6299-6_6

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  • DOI: https://doi.org/10.1007/978-1-4614-6299-6_6

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6298-9

  • Online ISBN: 978-1-4614-6299-6

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