The Efficacy of Adding Electromagnetic Therapy or Laser Therapy to Medications in Patients With Diabetic Peripheral Neuropathy
Journal of Lasers in Medical Sciences,
Vol. 11 No. 1 (2020),
18 January 2020
,
Page 20-28
Abstract
Introduction: Diabetes mellitus (DM) is a common disease with a highly significant burden among the Saudi population. This study aimed to investigate the effects of adding either magnetic or laser therapy to medications in patients with diabetic peripheral neuropathy (DPN).
Methods: Seventy-one medically controlled diabetic patients were randomly assigned to 1) Magnetic group: 26 patients were exposed to magnetic therapy for 20 minutes/session, 2 sessions/week, for 3 months 2) Laser group: 25 patients were exposed to laser therapy with intensity 5.7 J/cm2 for 30 minutes/session, 2 times/week, for 3 months. 3) Drug group: 20 patients received only the regular medications for diabetic control and pain analgesia. Pain and neuropathy were assessed by the visual analog scale (VAS) and the Toronto Clinical Neuropath Scoring System (TRCNSS). Conduction velocities and amplitudes of peroneal and sural nerves were measured by electromyography.
Results: The results showed significant increases in conduction velocities and amplitudes in both magnetic and laser groups in parallel with significant reductions in TRCNSS. Non-significant changes were obtained only after using only medications (P > 0.05). The mean values of VAS reduced significantly in the three groups. The least significant differences showed significant changes among the three groups, whereas non-significant differences were obtained between both magnetic and laser groups.
Conclusion: There were non-significant differences between both magnetic and laser therapy groups. Addition of either magnetic or laser therapy to medications could bring extra positive benefits to patients with DPN. Both magnetic and laser therapy can be applied with medications for the treatment of patients with DPN.
- Neuropathic pain
- Laser therapy
- Conduction velocity
How to Cite
References
Maronesi CT, Cecagno-Zanini SC, de Oliveira LZ, Bavaresco SS, Leguisamo CP. Physical exercise in patients with diabetic neuropathy: systematic review and metaanalysis of randomized clinical trials. Fisioter Pesqui. 2016; 23(2):216-23. doi: 10.1590/1809-2950/14649323022016
Alqurashi KA, Aljabri KS, Bokhari SA. Prevalence of diabetes mellitus in a Saudi community. Ann Saudi Med. 2011;31(1):19-23. doi: 10.4103/0256-4947.75773.
Ahmad I, Hussain E, Singla D, Verma S, Ali K. Balance training in diabetic peripheral neuropathy: A Narrative Review. JSM Diabetol Manag. 2017;2(1):1002.
Yamany AA, Sayed HM. Effect of low level laser therapy on neurovascular function of diabetic peripheral neuropathy. J Adv Res. 2012;3(1):21-8. doi: 10.1016/j.jare.2011.02.009
Akbari M, Jafari H, Moshashaee A, Forugh B. Do diabetic neuropathy patients benefit from balance training? J Rehabil Res Dev. 2012;49(2):333-38. doi: 10.1682/jrrd.2010.10.0197
Kaku M, Vinik A, Simpson DM. Pathways in the diagnosis and management of diabetic polyneuropathy. Curr Diab Rep. 2015;15(6):609. doi: 10.1007/s11892-015-0609-2
Bril V, Perkins BA. Validation of the Toronto Clinical Scoring System for diabetic poly-neuropathy. Diabetes Care. 2002;25(11):2048-52. doi: 10.2337/diacare.25.11.2048
Dixit S, Maiya AG, Shastry BA. Effect of aerobic exercise on peripheral nerve functions of population with diabetic peripheral neuropathy in type 2 diabetes: A single blind, parallel group randomized controlled trial. J Diabetes Complications. 2014;28(3):332 9. doi: 10.1016/j. jdiacomp.2013.12.006.
Parminder K, Kushwash AS, Ravinderpal K. Current therapeutic strategy in diabetic neuropathy. Int Res J Pharm. 2012;3(3):22-9.
Callaghan BC, Little AA, Feldman EL, Hughes RA. Enhanced glucose control for preventing and treating diabetic neuropathy. Cochrane Database Syst Rev. 2012;
(6):1-60. doi: 10.1002/14651858.CD007543 11. Wong MC, Chung JW, Wong TK. Effects of treatments for symptoms of painful diabetic neuropathy: systematic review. Br Med J. 2007;335:(14):87-90. doi: 10.2147/IJGM. S64419
Dworkin RH, O’Connor AB, Backonja M, Farrar MF, Finnerup NB, Jensen TS. Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain. 2007;132 (3): 237-51. doi: 10.1016/j.pain.2007.08.033
Conti M, Peretti E, Cazzetta G, Galimberti G, Vermigli C, Pola R, et al. Frequency-modulated electromagnetic neural
stimulation enhances cutaneous microvascular flow in Patients with diabetic neuropathy. J Diabetes Complications. 2009;23(1):46-48. doi: 10.1016/j.jdiacomp.2008.02.004
Bril V, England J, Franklin GM, Backonja M, Cohen J, Del Toro D, et al. Evidence-based guideline: treatment of painful diabetic neuropathy: report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology. 2011;76:1758-65. doi: 10.1212/WNL.0b013e3182166ebe.
Lei T, Jing D, Xie K, Jiang M, Li F, Cai J. Therapeutic effects of 15 Hz pulsed electromagnetic field on diabetic peripheral neuropathy in streptozotocin-treated Rats. PLoS One. 2013; 8(4):e61414. doi: 10.1371/journal.pone.0061414
Graak V, Chaudhary S, Bal BS, Sandhu JS . Evaluation of the efficacy of pulsed electromagnetic field in the management of patients with diabetic poly-neuropathy. Int J Diabetes Dev Ctries. 2009;29(2):56-61. doi: 10.4103/0973-
53121
Filimban WA, El-Fiky AAR, Helal OF, Abdelaal AA. Effect of magnetic therapy on balance deficits in patients with
diabetic polyneuropathy: Randomized Controlled Trial. Jokull Journal. 2015; 65(3):187-96.
Wróbel MP , Szymborska-Kajanek A, Wystrychowski G, Biniszkiewicz T, Sieroń-Stołtny K, Sieroń A, et al. Impact of low frequency pulsed magnetic fields on pain intensity, quality of life and sleep disturbances in patients with painful diabetic poly-neuropathy. Diabetes Metab. 2008; 34(4):349-54. doi: 10.1016/j.diabet.2008.02.003
Alves AC, De Paula VR, Leal-Junior EC, Dos Santos SA, Ligeiro AP. Effect of low-level laser therapy on the expression of inflammatory mediators and on neutrophils and macrophages in acute joint inflammation. Arthritis Res Ther. 2013;15(5):R116. doi:10.1186/ar4296.000000
De Andrade AL, Bossini PS, Parizotto NA. Use of low level laser therapy to control neuropathic pain: a systematic
review. J Photochem Photobiol B. 2016;164:36-42. doi: 10.1016/j.jphotobiol.2016.08.025.
Peric Z, Cvetkovic B. Electrophysiological evaluation of low intensity laser therapy in patients with diabetic polyneuropathy. Facta Universitatis, Series: Medicine and Biology. 2006;13(1):11-14.
Khamseh ME, Kazemikho M, Aghili R, Forough B, Lajevardi M, Dabaghian HF. Diabetic distal symmetric
poly-neuropathy: Effect of low-intensity laser therapy. Lasers Med Sci. 2011;26(6):831-35. doi: 10.1007/s10103-
-0977-z.
Akyuz G, Kenis O. Physical therapy modalities and rehabilitation techniques in the treatment of neuropathic
pain. Int J Phys Med Rehabil. 2014;93(3):253-9. doi: 10.1097/PHM.0000000000000037.
Fallah A, Mirzaei A, Gutknecht N, Demneh AS . Clinical effectiveness of low-level laser treatment on peripheral
somatosensory neuropathy. Lasers Med Sci. 2017; 32(3):721-28. doi: 10.1007/s10103-016-2137-y.
Shen CC, Yang YC, Liu BS. Effects of large-area irradiated laser phototherapy on peripheral nerve regeneration across
a large gap in a biomaterial conduit. J Biomed Mater Res A. 2013;101:239-52. doi10.1002/jbm.a.34314
Zinman LH, Mylan Ngo F, Eduardo T, NweKT Gogov S, Vera Bril F. Low-intensity laser therapy for painful
symptoms of diabetic sensorimotor poly-neuropathy. A controlled trial. Diabetes Care. 2004;27(4):921-24. doi:
2337/diacare.27.4.921
Yamany AA, Bitesha K. Effect of 850 nm He-Ne laser therapy on nerve conduction and foot planter pressures
distribution of painful diabetic neuropathy: a randomized controlled trial. J Nov Physiother. 2016;6(4):300. doi: 10.4172/2165-7025.1000300
Asad A, Hameed MA, Khan UA, Butt MU, Ahmed N, Nadeem A. Comparison of nerve conduction studies Electromagnetic Therapy Versus Laser Therapy on Peripheral Neuropathy with diabetic neuropathy symptom score and diabetic neuropathy examination score in type-2 diabetics for detection of sensorimotor polyneuropathy. J Pak Med Assoc. 2009;59(9):594-98.
Gyulai F, Rába K, Baranyai I, Berkes E. Bender T. BEMER therapy combined with physiotherapy in patients with
musculoskeletal diseases: A randomized, controlled double blind follow-up pilot study. Evid Based Complement Alternat
Med. 2015;2015:245742. doi: 10.1155/2015/245742.
Bosi E, Conti M, Vermigli C, Cazzetta G, Peretti E. Effectiveness of frequency-modulated electromagnetic neural stimulation in the treatment of painful diabetic neuropathy. Diabetologia. 2005;48(5):817-23. doi: 10.1007/ s00125-005-1734-2
Tasset I, Medina FJ, Jimena I, Aguera E, Gascon F, Feijóo M. Neuroprotective effects of extremely low-frequency
electromagnetic fields on a Huntington’s disease rat model: Effects on neuropathic factors and neuronal
density. Neuroscience. 2012;209:54-63. doi: 10.1016/j. neuroscience.2012.02.034
Weintraub MI, Herrmann DN, Smith AG, Backonja MM, Cole SP. Pulsed electromagnetic fields to reduce diabetic neuropathic pain and stimulate neuronal repair: a randomized controlled trial. Arch Phys Med Rehabil. 2009; 90:1102-9. doi: 10.1016/j.apmr.2009.01.019
Stein C, Eibel B, Sbruzzi G, Lago PD, Plentz RD. 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-
Hsieh YL, Chou LW, Chang PL, Yang CC, Kao MJ. Lowlevel
laser therapy alleviates neuropathic pain and promotes function recovery in rats with chronic constriction injury: possible involvements in hypoxia-inducible factor 1alpha (HIF-1alpha). J Comp Neurol. 2012;520(13):2903-16. doi:
1002/cne.23072.
Barbosa RI1, Marcolino AM, de Jesus Guirro RR, Mazzer N, Barbieri CH, de Cássia Registro Fonseca M . Comparative
effects of wavelengths of low-power laser in regeneration of sciatic nerve in rats following crushing lesion. Lasers Med
Sci. 2010;25(3):423-30. doi: 10.1007/s10103-009-0750-8.
Jang H, Lee H. Meta-analysis of pain relief effects by laser irradiation on joint areas. Photomed Laser Surg. 2012;
(8):405-17. doi: 10.1089/pho.2012.3240
Tumilty S, Munn J, McDonough S, Hurley DA, Basford JR. Low level laser treatment of tendinopathy: A systematic
review with meta-analysis. Photomed Laser Surg. 2010; 28(1): 3-16. doi: 10.1089/pho.2008.2470.
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