Intermittent pneumatic compression therapy improves functional and dynamic balance and neuropathy severity in neuropathic patients with type 2 diabetes
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Diabetic neuropathy is a common complication of diabetes which increases risk of falling. Reduction in neural blood flow is one proposed theory for this etiology of diabetic neuropathy. Intermittent pneumatic compression (IPC) is a treatment method that increases nutritional supplies for the peripheral nervous system. The current study aims at evaluating the effects of IPC therapy on two aspects of balance dysfunction as one of the most important clinical signs of diabetic neuropathy. This study is a single-blind, randomized, controlled clinical trial that involved 39 patients with diabetic peripheral neuropathy. In this analysis, patients aged 40–75 years (with a mean age of 58.82 years) were randomly divided into intervention (n = 20) and control groups (n = 19). In the first session, all tests of neuropathy severity (using Valk and Michigan diabetic neuropathy questionnaires) and stability (functional and dynamic balance) were performed for both groups. The subjects in intervention group underwent 10 sessions of IPC treatment. At last, balance and neuropathy examinations were carried out in the final session. P < 0.05 was chosen as statistical significance level. Implementation of IPC interventions for 10 sessions significantly decreased APSI and OSI of Biodex balance system in level 6 (P < 0.05). The subjects in intervention group showed significant increases in standing time with their eyes either open or closed by performing functional balance tests. Additionally, Valk and Michigan neuropathy screening scores significantly decreased after 10 sessions of IPC therapy. This study showed that IPC has a positive effect on diabetic neuropathy and balance.
KeywordsDiabetic neuropathy Instability Postural balance Intermittent pneumatic compression
We would thank Dr. Soghrat Faghih Zadeh for his advice on statistical analysis and Dr. Manouchehr Khan Nakhjavani, Endocrinologist, for his cooperation in performing the study. This study was extracted from a Master of Science in Physical Therapy project and supported by Tarbiat Modares University, Tehran, Iran. The ethical committees of Tarbiat Modares University approved the study protocol and informed consent that each patient signed prior to his or her participation. Patients were all informed of the purposes of the study.
Conflicts of interest
- 5.Ajimsha M, Paul J, Chithra S. Efficacy of stability trainer in improving balance in type II diabetic patients with distal sensory neuropathy. J Diabetol. 2011;1(6):1–6.Google Scholar
- 11.Tesfaye S. Epidemiology and etiology of diabetic peripheral neuropathy. Adv Stud Med. 2004;4(10):1014–21.Google Scholar
- 18.Lee HJ, Delisa JA. Manual of nerve conduction study and surface anatomy for needle electromyography. Philadelphia: LIPPINCOTT WILLIAMS & WILKINS; 2005.Google Scholar
- 22.Herman WH, Pop-Busui R, Braffett BH, Martin CL, Cleary PA, Albers JW, et al. Use of the Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in Type 1 diabetes: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications. Diabet Med. 2012;29(7):937–44.PubMedPubMedCentralCrossRefGoogle Scholar
- 37.Swenson RS. Review of clinical and functional neuroscience. Chapter 7. Hanover: Dartmouth Medical School; 2006.Google Scholar
- 38.Swenson RS. Review of clinical and functional neuroscience. Chapter 9. Hanover: Dartmouth Medical School; 2006.Google Scholar
- 39.Patton HD, Fuchs AF, Hille B, Scher AM, Steiner R (eds). Textbook of physiology. 21 ed. Philadelphia: W B Saunders Co; 1989.Google Scholar
- 40.Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2007.Google Scholar
- 47.Schmitz RJ, Arnold B. Intertester and intratester reliability of a dynamic balance protocol using the biodex stability system. J Sport Rehabil. 1998;7(2):95–101.Google Scholar