Vibrotherapy successfully completed the treatment of a patient with peripheral neuropathy in type 2 diabetes

The presented report describes a 52-year-old woman suffering from type 2 diabetes mellitus and peripheral neuropathy. The patient complained of sleep disturbances, pain and tingling in the feet, and constant stress related to the fear of falling during everyday walking. Since the treatment used did not help significantly, scientists from the University of Medical Sciences in Tehran (Iran) decided to perform on patient a 6-week program of whole-body vibration (WBV).

• After 6 weeks of WBV treatments, the pain in both feet decreased from 6/10 to 1/10 points. As a result, sleep improved – the patient reported that she slept well at night without waking up due to foot pain or paresthesia.
• The severity of neuropathy decreased from 13 (pre-WBV) to just 2 points after WBV!
• Numerous parameters for strength, balance and flexibility were also improved – see Fig. 1.

Prepared on the basis of:

Effects of whole-body vibration on a diabetic type 2 patient with peripheral neuropathy. Amin Kordi Yoosefinejad, Azadeh Shadmehr, Ghloamreza Olyaei et al. Health Science Journal 2012;6(3):576-583.

Study population

A 52-year-old female patient with a 10-year history of type 2 diabetes and a feeling of tingling and numbness in the feet for a year was studied. Pain ailments awakened her painful night sleep and forced her to constantly change position, causing severe sleep disturbances.

Test procedure

The patient underwent a series of measurements. Data were collected three times: before WBV and at the end of 3rd or 6th week of WBV exposure. Among others, the following were examined:

• BMI and waist-to-hip ratio,
• grade of neuropathy (according to the Michigan Diabetic Neuropathy Score, MDNS),
• pain (using the Visual Analog Scale, VAS),
• muscle strength [locally – using the MIE dynamometer (Medical Research Ltd., England), but also generally – using the back-leg-chest dynamometer (BASELINE, USA)],
• balance and mobility were assessed using the Unilateral Stance Test (UST) and the Timed Up and Go Test (TUGT). (UST is a widely used measure of balance and is also a predictor of falls and peripheral neuropathy. TUGT is an important test for mobility and dynamic balance.)

Use of vibration in the study

In the first week, the vibrotherapy treatments consisted of 5 administrations of WBV, each lasting 30 seconds, with a 1-minute break between them (vibration frequency = 30 Hz, amplitude = 2 mm). The same protocol of vibrotherapy was performed for the following weeks, except that the treatment duration changed in the 2nd and 3rd week to five 45-second applications, and in the following weeks – to five 60-second applications.

During the vibrotherapy treatment, the patient stood barefoot on a vibrating plate with a 30-degree knee flexion. She was also instructed to tighten the muscles of the lower limbs during exposure to vibrations and put more stress on the forefoot to adequately dampen the vibrations. The patient was forbidden to support herself with her hands during the procedure.

Results

After 6 weeks of WBV training, the pain in both feet decreased from 6/10 to 1/10 (VAS). As a result, sleep improved – the patient reported that she slept well at night without waking up due to foot pain or paresthesia.

The MDNS severity of neuropathy had decreased from 13 points before WBV to just 2 points after WBV.

In addition, BMI decreased from 26.1 before WBV to 25.3 after vibrotherapy, and the waist-to-hip ratio decreased from 0.97 before WBV to 0.89 after vibrotherapy.

Numerous parameters determining strength, balance and flexibility were also improved, some of which are shown in Fig. 1.

Comment

The presented results suggest that WBV vibrotherapy may be an effective adjuvant treatment in patients with type 2 diabetes and peripheral neuropathy.

The authors also note that at the end of the study, the patient expressed a desire to continue vibrotherapy, wanting to purchase her own vibration plate. The patient was very satisfied with the effects of the therapy, which significantly improved her daily functioning.

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