Improvement of Gait after 4 Weeks of Wearable Focal Muscle Vibration Therapy for Individuals with Diabetic Peripheral Neuropathy.

Josiah Rippetoe,Matthew Beckner,Bethany Block,Hongwu Wang,Carol Dionne,Shirley A James

doi:10.3390/jcm9113767

Abstract

People with diabetic peripheral neuropathy (DPN) experience lower quality of life caused by associated balance, posture, and gait impairments. While focal muscle vibration (FMV) has been associated with improvements in gait performance in individuals with neurological disorders, little is known about its effectiveness in patients with DPN. The purpose of this study was to investigate the effect of FMV on gait outcomes in patients with DPN. The authors randomized 23 participants into three FMV intervention groups depending upon the delivery of vibration. Participants applied wearable FMV to the bilateral quadriceps, gastrocnemius, and tibialis anterior, 10 min per muscle, three times per week over a four-week period. Spatiotemporal, kinematic, and kinetic gait parameters at baseline and post-intervention were calculated and analyzed. Gait speed, cadence, stride time, left and right stance time, duration of double limb support, and left and right knee flexor moments significantly improved after four weeks of FMV. Trends toward significant improvements were noted in maximum left and right knee flexion. Results indicate that FMV therapy was associated with improvements in gait parameters in individuals with DPN, warranting expanded study of FMV therapy for long-term gait performance improvement in these individuals.

Highlights

Up to 30% of individuals diagnosed with Type I or Type II Diabetes Mellitus will develop diabetic peripheral neuropathy (DPN) [1]
Accounting for approximately 27% of the US annual healthcare cost of diabetes, [2] which was $327 billion in 2017, [3] people with DPN experience a decline in their quality of life caused by the balance, posture, and gait impairments associated with DPN [4,5,6]
Inclusion criteria included a medical diagnosis of diabetes of at least one-year duration, the presence of diabetic peripheral neuropathy as indicated by failing the ten-site 5.07 (10 g) monofilament sensory test [34], age of at least 18 years, ability to stand without the use of an assistive device, lack of other neurological or orthopedic diagnoses, normal vision, and English language proficiency

Summary

Introduction

Up to 30% of individuals diagnosed with Type I or Type II Diabetes Mellitus will develop diabetic peripheral neuropathy (DPN) [1]. Accounting for approximately 27% of the US annual healthcare cost of diabetes, [2] which was $327 billion in 2017, [3] people with DPN experience a decline in their quality of life caused by the balance, posture, and gait impairments associated with DPN [4,5,6]. DPN causes metabolic and microvascular alterations in the peripheral nerves supplying the lower extremities [7,8]. These alterations create sensorimotor changes in the hands, fingers, feet, and toes, accompanied by debilitating pain [7,8]. One study reported that while their participants with DPN experienced a two-fold increase in healthcare costs, $12,492, those with the additional complications of DPN experienced a fourfold increase, up to $30,755 [9]

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