Using Plantar Electrical Stimulation to Improve Postural Balance and Plantar Sensation among Patients with Diabetic Peripheral Neuropathy: A Randomized Double Blinded Study

Bijan Najafi, Talal K. Talal, Gurtej Singh Grewal, Robert Menzies, David G Armstrong, Lawrence A. Lavery

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Objective: People with diabetic peripheral neuropathy (DPN) often exhibit deteriorations in motor-performance mainly due to lack of plantar-sensation. The study explored effectiveness of plantar electrical-stimulation therapy to enhance motor-performance among people with DPN. Design and methods: Using a double-blinded model, 28 volunteers with DPN (age: 57.8 ± 10.2 years) were recruited and randomized to either intervention (IG: n = 17) or control (CG: n = 11) group. Both groups received identical plantar-stimulation devices for six weeks of daily use at home; however, only the IG devices were set to deliver stimulation. Balance (ankle, hip, and center of mass [COM] sway) and gait (stride velocity [SV], stride time [ST], stride length [SL], and cadence) were measured using validated wearable sensors. Outcomes were assessed at baseline and at six-week. Clinical assessment including vascular as measured by ankle-brachial-index (ABI) and plantar-sensation as quantified by vibratory plantar threshold (VPT) were also measured at baseline and six weeks. Results: No difference were observed between groups for baseline characteristics (P >.050). Posttherapy, ankle and COM sway with eyes open were significantly improved (P <.05, Cohen's effect size d = 0.67-0.76) in the IG with no noticeable changes in CG. All gait parameters were significantly improved in the IG with highest effect size observed for cadence (d = 1.35, P =.000). Results revealed improvement in VPT (P =.004, d = 1.15) with significant correlation with stride velocity improvement (r =.56, P =.037). ABI was improved in the IG in particulate among those with ABI>1.20 (P =.041, d = 0.99) Conclusion: This study suggests that daily home use of plantar electrical-stimulation may be a practical means to enhance motor-performance and plantar-sensation in people with DPN.

Original languageEnglish (US)
Pages (from-to)693-701
Number of pages9
JournalJournal of diabetes science and technology
Volume11
Issue number4
DOIs
StatePublished - Jul 1 2017

Keywords

  • balance
  • diabetes
  • electrical stimulation
  • gait
  • intervention
  • peripheral neuropathy
  • skin perfusion
  • wearable

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Bioengineering
  • Medicine(all)
  • Biomedical Engineering

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