Adel Alshahrani1, Mark Bussell2, Eric Johnson3, Bryan Tsao4, Khalid Bahjri5. 1. School of Allied Health Professions, Department of Physical Therapy, Loma Linda University, Loma Linda, CA. 2. East Campus Rehabilitation Services, Department of Physical Therapy, Loma Linda University Medical Center, Loma Linda, CA. 3. School of Allied Health Professions, Department of Physical Therapy, Loma Linda University, Loma Linda, CA. Electronic address: ejohnson@llu.edu. 4. Clinical Neurophysiology, Neurology Department, Loma Linda University School of Medicine, Loma Linda, CA. 5. School of Public Health, Department of Public Health, Loma Linda University, Loma Linda, CA.
Abstract
OBJECTIVE: To determine the effect of a novel therapeutic intervention called intraneural facilitation on balance measures and a neuropathy scale in patients with diabetic peripheral neuropathy. DESIGN: Prospective pre- and posttest, single group clinical trial. SETTING: Outpatient physical therapy clinic. PARTICIPANTS: Patients with diabetic peripheral neuropathy (N=13). INTERVENTION: Subjects received 10 sessions of intraneural facilitation. MAIN OUTCOME MEASURES: The modified Total Neuropathy Scale, the NeuroCom SMART Balance Master system computerized dynamic posturography (CDP) that includes the Sensory Organization Test (SOT) and the limits of stability (LOS), and the Activities-specific Balance and Confidence (ABC) scale. RESULTS: Subjects in this study showed significant improvement in the modified Total Neuropathy Scale, SOT, and 1 component in the LOS test (movement velocity). There were no significant differences in the ABC scale or in 4 components of the LOS test, which were reaction time, end point excursion, maximum excursion, and directional control. CONCLUSIONS: Intraneural facilitation improved objective balance measures and neuropathy symptoms in patients with diabetic peripheral neuropathy. Further study is needed to determine long-term benefits of this intervention.
OBJECTIVE: To determine the effect of a novel therapeutic intervention called intraneural facilitation on balance measures and a neuropathy scale in patients with diabetic peripheral neuropathy. DESIGN: Prospective pre- and posttest, single group clinical trial. SETTING:Outpatient physical therapy clinic. PARTICIPANTS: Patients with diabetic peripheral neuropathy (N=13). INTERVENTION: Subjects received 10 sessions of intraneural facilitation. MAIN OUTCOME MEASURES: The modified Total Neuropathy Scale, the NeuroCom SMART Balance Master system computerized dynamic posturography (CDP) that includes the Sensory Organization Test (SOT) and the limits of stability (LOS), and the Activities-specific Balance and Confidence (ABC) scale. RESULTS: Subjects in this study showed significant improvement in the modified Total Neuropathy Scale, SOT, and 1 component in the LOS test (movement velocity). There were no significant differences in the ABC scale or in 4 components of the LOS test, which were reaction time, end point excursion, maximum excursion, and directional control. CONCLUSIONS: Intraneural facilitation improved objective balance measures and neuropathy symptoms in patients with diabetic peripheral neuropathy. Further study is needed to determine long-term benefits of this intervention.