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ORIGINAL PAPER
Effects of neurodynamic exercises on the management of diabetic peripheral neuropathy of the upper limb: a case series
1
Sialkot College of Physical Therapy (UOS), Sialkot Pakistan
2
University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
3
Physical Therapy Department, Syed Medical Complex, Sialkot Pakistan
4
Physical Therapy Department, DHQ Hospital Pakpatan, Pakistan
Submission date: 2021-03-29
Acceptance date: 2021-10-19
Publication date: 2022-02-07
Physiother Quart. 2023;31(3):53-56
KEYWORDS
TOPICS
ABSTRACT
Introduction:
This study has been designed to find out the effectiveness of neurodynamic exercises in patients with diabetes mellitus having peripheral neuropathy in upper limb.
Methods:
This was a case series. Total 40 patients were selected in this study who had diabetes mellitus type II with peripheral neuropathy pain. Consecutive sampling technique was used. Standard Neurodynamic sliders’ techniques were applied for Radial, Ulnar and Median nerves in appropriate position by qualified physical therapist for 10 sec with 2 sec rest and 10 repetitions. TENS (80 Hz and 150µ sec) was applied for 20 minutes. Neuropathic pain questionnaire DN 4 was used to collect the data. Pretest and posttest value were calculated using this questionnaire. Paired sample T test was used to compare the pretest and posttest values.
Results:
There were 31 females and 8 males with peripheral neuropathy in this study. The mean age of the patients was 51.22 ± 6.712 years. The mean value of total pretest was 6.42 ± 1.152 and the mean of total posttest value was 3.68 ± 1.095.
Conclusion:
Neurodynamic exercises were effective in managing diabetic peripheral neuropathy pain. Neurodynamics techniques for Peripheral Nerve can reduce the diabetes associated peripheral neuropathy symptoms in upper limb.
This study has been designed to find out the effectiveness of neurodynamic exercises in patients with diabetes mellitus having peripheral neuropathy in upper limb.
Methods:
This was a case series. Total 40 patients were selected in this study who had diabetes mellitus type II with peripheral neuropathy pain. Consecutive sampling technique was used. Standard Neurodynamic sliders’ techniques were applied for Radial, Ulnar and Median nerves in appropriate position by qualified physical therapist for 10 sec with 2 sec rest and 10 repetitions. TENS (80 Hz and 150µ sec) was applied for 20 minutes. Neuropathic pain questionnaire DN 4 was used to collect the data. Pretest and posttest value were calculated using this questionnaire. Paired sample T test was used to compare the pretest and posttest values.
Results:
There were 31 females and 8 males with peripheral neuropathy in this study. The mean age of the patients was 51.22 ± 6.712 years. The mean value of total pretest was 6.42 ± 1.152 and the mean of total posttest value was 3.68 ± 1.095.
Conclusion:
Neurodynamic exercises were effective in managing diabetic peripheral neuropathy pain. Neurodynamics techniques for Peripheral Nerve can reduce the diabetes associated peripheral neuropathy symptoms in upper limb.
REFERENCES (27)
1.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(Suppl. 1):81–90; doi: 10.2337/dc14-S081.
2.
Argoff CE, Cole BE, Fishbain DA, Irving GA. Diabetic peripheral neuropathic pain: clinical and quality-of-life issues. Mayo Clin Proc. 2006;81(4 Suppl.):3–11; doi: 10.1016/S0025-6196(11)61474-2.
3.
Davies M, Brophy S, Williams R, Taylor A. The prevalence, severity, and impact of painful diabetic peripheral neuropathy in type 2 diabetes. Diabetes Care. 2006;29(7):1518–1522; doi: 10.2337/dc05-2228.
4.
Gordois A, Scuffham P, Shearer A, Oglesby A, Tobian JA. The health care costs of diabetic peripheral neuropathy in the US. Diabetes Care. 2003;26(6):1790–1795; doi: 10.2337/diacare.26.6.1790.
5.
Kidwai SS, Wahid L, Siddiqi SA, Khan RM, Ghauri I, Sheikh I. Upper limb musculoskeletal abnormalities in type 2 diabetic patients in low socioeconomic strata in Pakistan. BMC Res Notes. 2013;6(1):16; doi: 10.1186/1756-0500-6-16.
6.
Candrilli SD, Davis KL, Kan HJ, Lucero MA, Rousculp MD. Prevalence and the associated burden of illness of symptoms of diabetic peripheral neuropathy and diabetic retinopathy. J Diabetes Complications. 2007;21(5):306–314; doi: 10.1016/j.jdiacomp.2006.08.002.
7.
Tesfaye S, Selvarajah D. Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy. Diabetes Metab Res Rev. 2012;28(Suppl. 1):8–14; doi: 10.1002/dmrr.2239.
8.
Boyd BS, Wanek L, Gray AT, Topp KS. Mechanosensitivity during lower extremity neurodynamic testing is diminished in individuals with type 2 diabetes mellitus and peripheral neuropathy: a cross sectional study. BMC Neurol. 2010;10(1):75; doi: 10.1186/1471-2377-10-75.
9.
Kumar SP, Adhikari P, Prabhu MM. Efficacy of tibial nerve neurodynamic mobilization for neuropathic pain in type II diabetes mellitus – a randomized controlled trial. Platform presentation, 4th Asia-West Pacific World Confederation for Physical Therapy (WCPT) Congress and 47th Annual Conference of Indian Association of Physiotherapists (IAP); 2009.
10.
Tabatabaei-Malazy O, Mohajeri-Tehrani MR, Madani SP, Heshmat R, Larijani B. The prevalence of diabetic peripheral neuropathy and related factors. Iran J Public Health. 2011;40(3):55–62.
11.
Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003;289(1):76–79; doi: 10.1001/jama.289.1.76.
12.
Day JM, Willoughby J, Pitts DG, McCallum M, Foister R, Uhl TL. Outcomes following the conservative management of patients with non-radicular peripheral neuropathic pain. J Hand Ther. 2014;27(3):192–200; doi: 10.1016/j.jht.2014.02.003.
13.
Balducci S, Iacobellis G, Parisi L, Di Biase N, Calandriello E, Leonetti F, et al. Exercise training can modify the natural history of diabetic peripheral neuropathy. J Diabetes Complications. 2006;20(4):216–223; doi: 10.1016/j.jdiacomp.2005.07.005.
14.
Anwar S, Malik AN, Amjad I. Effectiveness of neuromobilization in patients with cervical radiculopathy. Rawal Med J. 2015;40(1):34–36.
15.
Akhtar M, Karimi H, Gilani SA, Ahmad A. Effects of routine physiotherapy with and without neuromobilization in the management of internal shoulder impingement syndrome: a randomized controlled trial. Pak J Med Sci. 2020;36(4):596–602; doi: 10.12669/pjms.36.4.1545.
16.
Huijbregts PA. Orthopaedic manual physical therapy – history, development and future opportunities. J Phys Ther. 2010;1(1):11–24.
17.
Singh PP, Bindra S, Singh S, Aggarwal R, Singh J. Effect of nerve mobilization on vibration perception threshold in diabetic peripheral neuropathy. Indian J Physiother Occup Ther. 2012;6(3):189–195.
18.
Villafañe JH, Pillastrini P, Borboni A. Manual therapy and neurodynamic mobilization in a patient with peroneal nerve paralysis: a case report. J Chiropr Med. 2013;12(3):176–181; doi: 10.1016/j.jcm.2013.10.007.
19.
Boyd BS, Nee RJ, Smoot B. Safety of lower extremity neurodynamic exercises in adults with diabetes mellitus: a feasibility study. J Man Manip Ther. 2017;25(1):30–38; doi: 10.1080/10669817.2016.1180772.
20.
Cox T, Bischof T, Cassmeyer D, Lueders K, Pickett M. Effectiveness of neurodynamic mobilization in the treatment of patients presenting with lower extremity pathologies: a systematic review. In: Orthopaedic section poster presentations (abstracts OPO1–OPO236). J Orthop Sports Phys Ther. 2016;46(1):58–157; doi: 10.2519/jospt.2016.46.1.A58.
21.
Zusman M. Pain science and mobilisation of painful compressive neuropathies. Phys Ther Rev. 2009;14(4):285–289; doi: 10.1179/174328809X452935.
22.
Nasr AJ, Zafereo J. The effects of dry needling and neurodynamic exercise on idiopathic peripheral neuropathy: a case report. J Bodyw Mov Ther. 2019;23(2):306–310; doi: 10.1016/j.jbmt.2018.02.006.
23.
Spallone V, Morganti R, D’Amato C, Greco C, Cacciotti L, Marfia GA. Validation of DN4 as a screening tool for neuropathic pain in painful diabetic polyneuropathy. Diabet Med. 2012;29(5):578–585; doi: 10.1111/j.1464-5491.2011.03500.x.
25.
Somers DL, Somers MF. Treatment of neuropathic pain in a patient with diabetic neuropathy using transcutaneous electrical nerve stimulation applied to the skin of the lumbar region. Phys Ther. 1999;79(8):767–775; doi: 10.1093/ptj/79.8.767.
26.
Young MJ, Boulton AJ, MacLeod AF, Williams DR, Sonksen PH. A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia. 1993;36(2):150–154; doi: 10.1007/BF00400697.
27.
Stein C, Eibel B, Sbruzzi G, Lago PD, Plentz RDM. Electrical stimulation and electromagnetic field use in patients with diabetic neuropathy: systematic review and meta-analysis. Braz J Phys Ther. 2013;17(2):93–104; doi: 10.1590/S1413-35552012005000083.
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