Ultrasound analysis of a novel therapeutic intervention for neuropathy: intraneural facilitation acute effects on idiopathic and chemotherapy induced peripheral neuropathy

Abstract

Intraneural Facilitation (INF) is a novel therapy for the treatment of various neuropathic pathologies. INF is an evidence‐based approach which utilizes physical‐therapy‐based “holds” to stretch and relax peripheral associated nerve areas and thus potentially allows for re‐establishment of blood supply (oxygen and nutrients) to damaged nerves.The acute efficacy of INF therapy to treat idiopathic or chemotherapy‐induced neuropathy remains undetermined. Therefore, in a pilot feasibility study, we examined the effects of acute changes by ultrasound assessment of the arterial pulsatility index and volume flow with pre‐ and post‐Intraneural Facilitation Treatment in patients with chemotherapy‐induced neuropathy and idiopathic peripheral neuropathy.PurposeTo determine the acute effect of a novel therapeutic intervention called intraneural facilitation on patients with idiopathic (IPN) and chemotherapy‐induced (CIN) peripheral neuropathies.MethodsThis is a prospective pre‐ and posttest, single group clinical pilot study in an outpatient physical therapy clinic. Participants are patients with peripheral idiopathic or chemotherapy‐induced neuropathy. Outcome measures were assessed with ultrasound measures 1) pulsatility index (PI), which is a measure of the variability of blood velocity in a vessel, equal to the difference between the peak systolic and minimum diastolic velocities divided by the mean velocity during the cardiac cycle, and 2) volume flow (VF), a measure of a cross‐sectional blood vessel area in a time‐averaged velocity.ResultsThere were 38 arterial ultrasound measurements in 13 patients diagnosed with either CIN or IDN for this pilot study. The PI showed significant improvement from pre‐ to post‐treatment in both neuropathy categories, CIN and IDN respectively (p < 0.05). The average total percent change in the 38 arterial measurements of PI was +1.32% and VF was −2.59%. The percent change in PI and VF in patients with IDN was +1.25% and −8.26% and CIN was +1.36% and +0.12%, respectively. Ultrasound measurements of the left radial artery showed a treatment efficacy with a significant change in PI (p = 0.0463).ConclusionThese preliminary pilot outcome results, using ultrasound assessment parameters PI and VF are clinically promising. Intraneural facilitation treatment improves objective PI and VF “markers” in patients with CIN and IDN. Overall, the average percent change of PI showed that there was a significant acute improvement in patients with both CIN and IDN. Greater frequency and chronicity of INF treatment is suggestive to be potentially efficacious in the resolution of the respective neuropathies. These promising pilot patient data suggests the need for further expansive prospective studies to expand a more comprehensive clinical understanding of this new novel treatment called, Intraneural Facilitation Treatment. These studies are currently in progress.Support or Funding InformationDepartmentalThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.