Prolonged Mechanical Noise Restores Tactile Sense in Diabetic Neuropathic Patients

NewsBot · Jan 11, 2009

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Prolonged Mechanical Noise Restores Tactile Sense in Diabetic Neuropathic Patients.
Cloutier R, Horr S, Niemi JB, D' Andrea S, Lima C, Harry JD, Veves A.
Int J Low Extrem Wounds. 2009 Jan 6. [Epub ahead of print]

Acute application of stochastic resonance (SR), defined as a subsensory level of mechanical noise presented directly to sensory neurons, improves the vibration and tactile perception in diabetic patients with mild to moderate neuropathy. This study examined the effect of 1 hour of continuous SR stimulation on sensory nerve function. Twenty diabetic patients were studied. The effect of stimulation was measured at 2 time points, at the beginning and after 60 minutes of continual SR stimulation. This effect was measured using the vibration perception threshold (VPT) at the big toe under 2 conditions: a null (no SR) condition and active SR, defined as mechanical noise below the subject's own threshold of perception. The measurements under null and active conditions were done randomly and the examiner was blinded regarding the type of condition. Immediately after SR application, the VPT with SR in null condition was similar to baseline (32.2 +/- 13.1, P = nonsignificant) but was significantly lower during active SR (27.4 +/- 11.9) compared with both baseline (P = .018) and off position (P = .045). The 60 minutes VPT with active SR (28.7 +/- 11.1) reached significance comparing the baseline when one outlier was removed from the analysis (P = .031). It may be concluded that SR for a continuous 60-minute period can sustain the VPT improvement in diabetic patients with moderate to severe neuropathy. These results permit the conclusion that there is no short-term adaptation to the stimulation signal. Long-term application of this technique, perhaps in the form of a continually vibrating shoe insert, or insole, may result in sustained improvement of nerve function.
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amiya · Jan 15, 2009

Interesting finding. Although no reason is given behind this, an active integration (such as addition) of the SR and the actual sensory cue in a spatial scale is probably responsible.

Regarding 'the examiner was blinded', I wouldn't like to be an examiner, I don't want to lose my eyes! :)

NewsBot · Aug 25, 2018

The effects of vibro-medical insole on sensation and plantar pressure distribution in diabetic patients with mild-to-moderate peripheral neuropathy.
Bagherzadeh Cham et al
Clin Biomech (Bristol, Avon). 2018 Aug 18;59:34-39. doi:

BACKGROUND:
The first aim of this study was to determine the effect of a vibro-medical insole on pressure sensation and the second was to measure the effects of a vibro-medical insole with and without random noise on plantar pressure distribution in diabetic patients with mild-to-moderate peripheral neuropathy.

METHODS:
Twenty patients with mild-to-moderate diabetic neuropathy were recruited in the clinical trial pre-test, post-test study. A medical insole was made for each participant and a vibratory system was inserted into it. Pressure sensation was evaluated before and after the 30-min walk using the vibro-medical insole with added random noise by Semmes-Weinstein Monofilaments. Peak pressure data was measured before and after 30-min walking with a vibro-medical insole with and without random noise by the Pedar-x system.

FINDINGS:
Pressure sensations showed improvement after 30-min walking with the vibro-medical insole with added random noise at the heel, metatarsophalangeal heads and hallux of both feet in all participants (p < 0.05). Peak pressure decreased significantly in the heel, MTP2,3, MTP4,5 and hallux (p < 0.05) and increased in midfoot (p < 0.05) using the vibro-medical insole with and without random noise compared to the shoe only condition. Only the peak pressure of the heel region decreased using the vibro-medical insole with random noise compared to without random noise (p = 0.006).

INTERPRETATION:
Thirty minute walking with a vibro-medical insole seems to improve pressure sensation and alter peak pressure in diabetic patients with mild-to-moderate peripheral neuropathy. This work suggests that vibro-medical insoles can be used for daily living activities and possibly decreases the risk of ulceration in diabetic neuropathy patients.
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amiya Member

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