Nervous System Diseases
Conditions
Interventions
High Power Laser Group
Sponsors
Faculty of Physical Therapy at Cairo University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Inclusion Criteria: 1-Patients with painful diabetic neuropathy. 2-The age of patients will range from 50- 60 years old. 3-Patients with moderate neuropathy according to neuropathy disability score (score range from 6 to 8). 4-Diagnosis of the type 2 DM is for at least 10 years. 5-Body mass index did not exceed 30 Kg/m2. 6-Controlled blood glucose level by the examination via Glycated Hemoglobin exam (9 % > HbA1c > 6.5 %)
Exclusion criteria
Exclusion criteria: Exclusion Criteria: 1. Patients with type 1 diabetes. 2. Lower extremity open wounds. 3. Obesity . 4. Pregnancy. 5. Patients who had history of any other neuropathy. 6. Unstable medical condition. 7. Other neurological disorders causing pain as lumbar plexopathy, spinal stenosis, and spinal nerve root compression. 8. History of central nervous system primary or metastatic malignancy.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Bilateral Sensory and motor nerve conduction study for sural nerve and peroneal nerve for measurement of Latency, Velocity, and amplitude Sural sensory study: The patient was side lying , the ground electrode at the lower leg between the recording and stimulating electrodes. The recording active electrode was placed posterior to the lateral malleolus and the reference recording electrode placed 3-4 cm distally , the stimulation site at the posterolateral calf directly over the sural nerve, with the cathode placed 14 cm from the proximal recording electrode. Sural nerve recordings used a standard antidromic technique Peroneal motor study: The patient was in supine lying position, a recording electrode is placed on the extensor digitorum brevis and a reference electrode at the base of the fifth metatarsal. The ground is placed on lateral or medial malleolus between stimulating and recording electrodes. Stimulation is performed at the ankle in between the extensor hallucis longus and extensor digitorum longus tendons, just below the fibular head and the lateral third of the popliteal crease at the knee. Measurements are taken from ankle to below fibula head and below to above fibula head | — |
Secondary
| Measure | Time frame |
|---|---|
| Visual analogue scale VAS Pain asessment: The VAS is a horizontal continuous scale,10 cm in length, ended with two verbal pain descriptors on either end one is “no pain” (score of 0) and “pain as bad as it could be” or “worst imaginable pain”(score of 10) on other end (Hawker et al., 2011).The patients will be asked to point the suitable score on the line that represent their pain intensity. ;Modified Neuropathy Disability Score: The Neuropathy Disability Score: It is the most widely used and accepted scoring system for diabetic neuropathy. It includes examination of vibration (using a 128-Hz tuning fork), sensation (pain and temperature), and ankle reflex. The score of vibration and sensation is ‘0’ if present and normal, and ‘1’ if absent, reduced, or uncertain. The ankle reflex scores ‘0’ if present and normal, and ‘2’ if absent, with a maximum total score of ‘10’. The grades of severity of neuropathy are classified as follows: mild (scores: 3–5), moderate (scores: 6–8), and severe (scores: 9–10) ;Neuropathy specific quality of life questionnaire The Neuropathy Specific Quality of life questionnaire (NeuroQoL) is an appropriate validated measure for neuropathic QoL. It has 27 items. Each question has a Likert scale of 1 to 5 for frequency of symptoms where 1 represents “never” and 5 represents NeuroQoL assesses diabetic neuropathy-related emotional and physical problems affecting diurnal life and well-being. NeuroQoL consists six subscales: painful symptoms, dependence on others, emotional distress, unsteadiness while walking or standing, restriction in daily activities, paresthesia, interpersonal problems, and decreased or lack of ability to feel the temperature. | — |
Countries
Egypt
Contacts
Public ContactNessrein Abdelrashid
Assistant Professor Department for Surgery Burn and Skin Disorders Faculty of Physical Therapy Cairo University.
Outcome results
None listed