Plantar vibration training for the treatment of diabetic peripheral neuropathy

NewsBot · Jun 10, 2017

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Positive effects of plantar vibration training for the treatment of diabetic peripheral neuropathy: A pilot study.
Stambolieva K et al
Somatosens Mot Res. 2017 Jun 9:1-5. doi: 10.1080/08990220.2017.1332585

PURPOSE:
To evaluate the effectiveness of 8-week low-frequency plantar vibration training on patients with sensorimotor diabetic peripheral neuropathy (DPN).
PARTICIPANTS:
Twelve patients took part in the investigation.
RESULTS:
An increase of the nerve conductive velocity of soral and peroneal nerves of feet, increased postural stability, and disappearance of the pain and tingling were observed.
CONCLUSION:
The obtained results provide evidence for beneficial effects of 8-week plantar vibration training in patients with DPN.
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Admin2 · Jun 10, 2017

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NewsBot · Mar 30, 2018

The effects of Vibro-medical insole on vibrotactile sensation in diabetic patients with mild-to-moderate peripheral neuropathy.
Bagherzadeh Cham M et al
Neurol Sci. 2018 Mar 28. doi: 10.1007/s10072-018-3318-1

Peripheral sensory neuropathy seems to be the main risk factor for diabetic foot ulceration. Previous studies demonstrated that stochastic resonance can improve the vibrotactile sensation of diabetic patients. The aim of this study was to evaluate the effects of Vibro-medical insole on pressure and vibration sensation in diabetic patients with mild-to-moderate peripheral neuropathy. A total of 20 patients with mild-to-moderate diabetic neuropathy were included in the pre-test and post-test clinical trial study. Vibro-medical insole consists of medical insole and vibratory system. Medical insole was made independently for each participant and vibratory system was inserted in it. Pressure and vibration sensation were evaluated before and after 30-min walking with Vibro-medical insole. Semmes-Weinstein monofilaments and tuning fork were used to evaluate pressure and vibration sensation, respectively. Pressure sensation showed significantly improvement using Vibro-medical insole at the heel, first and fifth metatarsophalangeal heads, and hallux of both feet in all participants (p < 0.001). Vibration sensation also improved at the big toe of both feet with 256 Hz tuning fork (p < 0.05) but no statistically significant effect was found with 128 Hz tuning fork (p > 0.05). Vibro-medical insole significantly improved pressure and vibration sensation of the foot in diabetic patients with mild-to-moderate peripheral neuropathy. The results suggest that Vibro-medical insole can be used for daily living activities to overcome sensory loss in diabetic neuropathy patients.
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NewsBot · Oct 20, 2018

Mechanical Noise Improves the Vibration Perception Threshold of the Foot in People With Diabetic Neuropathy.
Zwaferink JBJ et al
J Diabetes Sci Technol. 2018 Oct 17:1932296818804552.

BACKGROUND:
Mechanical noise may improve somatosensation at the dorsal side of the foot, but the effect at the plantar side of the foot, the side most at risk for foot ulceration, is unknown. Moreover, techniques used in research so far have several problems that limit applicability in daily practice. Piezoelectric actuators may provide mechanical noise with better clinical applicability. We assessed the effects of piezoelectric actuators generating mechanical noise on the vibration perception threshold (VPT) at the plantar side of the foot in people with diabetic neuropathy.

METHODS:
Double-blind within-subjects design in a controlled laboratory setting including participants with diabetic neuropathy (N = 40; 18 male; mean age 69.6 years; mean duration of diabetes 14.1 years; mean BMI 30.5). VPT was measured at three plantar foot locations with and without mechanical noise applied via piezoelectric actuators.

RESULTS:
Mechanical noise improved VPT at metatarsophalangeal joint (MTP) 1 (left 39.3V vs 43.5V; right 39.0 vs 42.6 V), MTP5 (left 37.5V vs 41.7V; right 34.5V vs 40.8V) and the heel (left 40.0V vs 44.0V; right 39.3V vs 41.0V), all P < .001.

CONCLUSIONS:
Mechanical noise improves VPT at the plantar side of the foot in people with diabetic neuropathy. This is an important step for further development of insoles using mechanical noise that may have the potential to improve VPT and decrease the risk of foot ulceration.
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NewsBot · Apr 4, 2019

The Effect of Daily Use of Plantar Mechanical Stimulation Through Micro-Mobile Foot Compression Device Installed in Shoe Insoles on Vibration Perception, Gait, and Balance in People With Diabetic Peripheral Neuropathy
Gu Eon Kang, PhD, Mohsen Zahiri, PhD, Brian Lepow, DPM, ...
Journal of Diabetes Science and Technology April 3, 2019

Objective:
People with diabetic peripheral neuropathy (DPN) have impaired gait and balance performance. The aim of this study is to investigate therapeutic effectiveness of mechanical stimulation through a wearable foot compression device equipped in a shoe insole on vibration perception, balance control and gait performance in people with DPN.

Methods:
Using a single-arm 4-week intervention study design, we examined effectiveness of daily use of shoes equipped with the foot compression device (Footbeat™, AVEX, Grand Junction, CO, USA) on improving vibration perception threshold (VPTmax), skin perfusion pressure (SPP), ankle brachial index (ABI), lower extremities edema (circumferences in the calf and ankle), and motor performance (postural sway with eyes open and closed conditions, and gait performance during normal, dual-task and fast walking). Thirty people with type 2 diabetes and symptoms of PN completed the experimental protocol.

Results:
Improvements in VPTmax (before = 27.4 V, after = 23.3 V, P = .007, d = 0.33, where d denotes effect size), center-of-mass sway in the mediolateral direction with both eyes open and closed conditions (before = 0.94 cm, after = 0.76 cm, P = .020, d = 0.47; before = 1.10 cm, after = 0.83 cm, P = .033, d = 0.66, respectively), and stride velocity for normal walking, dual-task walking and fast walking tasks (before = 0.87 m/s, after = 0.96 m/s, P = .017, d = 0.41; before = 0.75 m/s, after = 0.91 m/s, P = .001, d = 0.77; before = 1.10 m/s, after = 1.20 m/s, P = .043, d = 0.33, respectively) were found post treatment. There was no significant improvement in SPP, ABI, and circumferences in the calf and ankle.

Conclusions:
Our findings suggest the wearable foot compression device may be effective for reducing neuropathic symptoms and enhancing motor performances in people with DPN.
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NewsBot · Jun 6, 2020

Whole body vibration improves symptoms of diabetic peripheral neuropathy
Nathan J. Kessler et al
Journal of Bodywork and Movement Therapies

Whole Body Vibration (WBV) is an innovative therapy that may be effective for reducing chronic pain associated with diabetic peripheral neuropathy (DPN), Current treatments for DPN pain have demonstrated questionable efficacy and significant risk of adverse events. Preliminary research has indicated that WBV may be effective for controlling chronic pain symptoms of DPN. METHODS: 20 participants (9 male, 11 female), 58.51 ± 10.69 years old, and BMI of 33.60 ± 8.20 kg/m2 were randomly assigned to a sham-treatment (n = 8) or WBV treatment (n = 12) group in a pre-post design. Pain was assessed with a 10-point verbal analog pain scale (VAS). Treatment consisted of three sessions/week with at least one day between sessions, 12 min/session (four bouts of 3 min), for four weeks. Control was established with a sham vibration protocol for two weeks in which the participants were blinded to the treatment. RESULTS: VAS scores of the treatment group decreased significantly at both 2 and 4 weeks (p = 0.019). The treatment group was found to have a significantly lower VAS score than the controls at two weeks (p = 0.033). After cessation of WBV vibration treatment, participants reported reduced DPN-related pain from 1 to 5 weeks later.
Conclusion
WBV is effective for reducing DPN-associated pain over a two- and four-week interval. This was the first study to demonstrate this using a sham vibration control. We further saw a persistence in pain reduction beyond the day of treatment, indicating a potential chronic effect of WBV treatment.
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NewsBot · Aug 30, 2021

Immediate effects of footwear with vibration applied to the swing phase of the gait cycle on dynamic balance in patients with diabetic peripheral neuropathy
RoyaRavanbodNiloofarEslamiMohammedN.Ashtiani
Journal of Biomechanics 28 August 2021, 110710

Sensory and sub-sensory foot vibration have beneficial effects on the static and dynamic balance of patients with diabetic peripheral neuropathy (DPN). Previous foot vibration during walking was applied at sub-sensory threshold in both stance and swing phases of the gait cycle in DPN. This study aimed to investigate the effects of footwear with vibration above the sensory threshold applied to the swing phase of the gait cycle on the dynamic balance of DPN. Fifteen patients with DPN and 10 matched healthy control participants were enrolled in this study. Dynamic balance assessment was investigated by the sit to stand and turn tests while electromyography activity (root mean square, RMS) of the vastus lateralis (VL), tibialis anterior (TA), and peroneus longus (PL) muscles were recorded at baseline, after 10 minutes of wearing the vibratory sandal without vibration, and after 10 minutes of wearing the sandal with vibration. Repeated measure analysis of variance was conducted for data analysis. Wearing the vibratory sandal slightly increased the speed of weight transfer in both groups and COP sway in DPN (P>0.05), and close to significant decrease of turn sway (P=0.07) in both groups. There were significant differences of the PL RMS in turn test (P=0.03) in DPN and peak RMS of the PL after 10 minutes of wearing the sandal with vibration in both groups (P<0.05). The results of the present study demonstrated that PL activity was significantly influenced by the vibratory sandal as its tendon passing across the sole and in direct contact with the source of the vibration.
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NewsBot · Jan 19, 2022

Local plantar vibration for the treatment of diabetic neuropathy: a case report
Mahsa Sabziparvar et al
J Diabetes Metab Disord. 2021 Jul 24;20(2):2115-2119

Purpose: One of the most common and debilitating complications of diabetes is peripheral neuropathy. Physical modalities such as whole-body vibration are used to treat diabetic peripheral neuropathy (DPN), but there are limted studies on the effectiveness of local vibration for the treatment of PDN. In this study, we aimed to evaluate the effectiveness of local vibration in treating a patient with DPN.

Methods: The local vibration was applied on the plantar side of both feet. The patient received 10 min of local vibration with 62.5 Hz frequency for five sessions. We used brief BESTest for balance evaluation, Numerical Pain Rating Scale (NPRS) for pain assessment, monofilament examination score for protective sensation evaluation, vibration threshold, and skin temperature to evaluate the effects of local vibration, which were measured before the treatment, after one session of treatment, and after 5th session of treatment.

Results: There was a 62.5% reduction in pain severity after five sessions of treatment. Vibration threshold of both patient's feet and protective sensation of right foot returned to normal after treatment. Skin temperature was increased in all evaluated points of both patient's feet, brief BESTest score increased by six points after five treatment sessions, indicating improvements in the blood flow of feet and balance, respectively.

Conclusions: Local plantar vibration was effective in improving the symptoms of DPN.
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NewsBot · Oct 14, 2022

This clinical trial was juts registered:
Effects of Vibration Therapy in Addition to Routine Physical Therapy in Patients With Diabetic Neuropathy

The study is aimed to determine the effects of sole-foot vibration therapy on pain intensity, static and dynamic balance, functional status and satisfaction to the intervention applied on patients with peripheral neuropathy due to type 2 diabetes mellitus.
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NewsBot · Nov 30, 2023

White noise insole: an artificial evoked sensation device that can be expected to improve plantar sensation of diabetic foot
Yangzheng Jiang
Sci Rep. 2023 Nov 24;13(1):20687.

Diabetic foot is a common severe complication of diabetes, and its main symptom is diabetic foot ulcer. The production of plantar diabetic foot ulcers is usually affected by two factors, namely neuropathy or vascular disease. While previous studies proved that stochastic resonance (SR) could effectively enhance the plantar touch of patients with diabetic feet, the potential impact of SR on neural circuit feedback, especially on the input of the tactile nerves of the lower limbs, is less clear. This study aims to explore the potential impact on the tactile threshold of the human foot when using vibrating insoles. We study a white noise vibration insole based on SR mechanism. We compare and analyze the tactile threshold voltage (TTV) triggered by an electrical stimulation device in three main plantar pressure-bearing areas (the second metatarsal (M2), the fourth metatarsal (M4), and the heel (H) area) of 8 participants using EEG and self-developed vibration insole. Significance found in M2 and M4 areas, white noise signal (WNS) lowered the tactile threshold in these areas, and had a potentially positive impact on patients with diabetic feet, especially in the M4 area. The influence of WNS on the plantar heel area was still controversial. This study showed that WNS applied to the sole could improve the plantar tactile sensing ability of patients with diabetic feet, but it did not cover all areas. The application of WNS showed better benefits for the forefoot area than for the hindfoot area, which was speculated that may be related to the difference in the distribution density of blood vessels in plantar areas. Due to the impaired natural touch in participants with diabetic foot, using artificial evoked sensation WNS intervention, would be a feasible approach to improve plantar sensation.
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NewsBot · Mar 28, 2024

Acute Effects of Vibrating Insoles on Dynamic Balance and Gait Quality in Individuals With Diabetic Peripheral Neuropathy: A Randomized Crossover Study
Giorgio Orlando et al
Diabetes Care. 2024 Mar 27:

Objective: This study investigated the effects of vibrating insoles on dynamic balance and gait quality during level and stair walking and explored the influence of vibration type and frequency in individuals with diabetic peripheral neuropathy (DPN).

Research design and methods: Twenty-two men with DPN were assessed for gait quality and postural and dynamic balance during walking and stair negotiation using a motion capture system and force plates across seven vibratory insole conditions (Vcs) versus a control (Ctrl) condition (insole without vibration). Vibration was applied during standing and walking tasks, and 15-min rest-stop periods without vibration were interposed between conditions. Repeated measures test conditions were randomized. The primary outcomes were gait speed and dynamic balance.

Results: Gait speed during walking significantly improved in all Vcs compared with Ctrl (P < 0.005), with Vc2, Vc4, and Vc6 identified as the most effective. Gait speed increased (reflecting faster walking) during stair ascent and descent in Vc2 (Ctrl vs. Vc2 for ascent 0.447 ± 0.180 vs. 0.517 ± 0.127 m/s; P = 0.037 and descent 0.394 ± 0.170 vs. 0.487 ± 0.125 m/s; P = 0.016), Vc4 (Ctrl vs. Vc4 for ascent 0.447 ± 0.180 vs. 0.482 ± 0.197 m/s; P = 0.047 and descent 0.394 ± 0.170 vs. 0.438 ± 0.181 m/s; P = 0.017), and Vc6 (Ctrl vs. Vc6 for ascent 0.447 ± 0.180 vs. 0.506 ± 0.179 m/s; P = 0.043 and descent 0.394 ± 0.170 vs. 0.463 ± 0.159 m/s; P = 0.026). Postural balance improved during quiet standing with eyes closed in Vc2, Vc4, Vc6, and Vc7 (P < 0.005).

Conclusions: Vibrating insoles are an effective acute strategy for improving postural balance and gait quality during level walking and stair descent in individuals with DPN. These benefits are particularly evident when the entire plantar foot surface is stimulated.
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