Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Effect of Nerve Mobilization on Vibration Perception Threshold in Diabetic Peripheral Neuropathy


Affiliations
1 Punjabi University, Patiala, India
2 Amar Hospital, Patiala, India
3 Gian Sagar College of Physiotherapy, Banur, Patiala, India
     

   Subscribe/Renew Journal


Purpose of the study: To determine the effects of Nerve Mobilisation on Vibration Perception Threshold (VPT) in Diabetic Peripheral Neuropathy.

Materials and Methods: 30 male subjects with VPT > 25, mean height of 175.93 and mean weight of 82.53 kg on the basis of thorough assessment and after signing informed consent were randomly divided into experimental and control group. The vibration perception Threshold was measured on all the four points on the plantar aspect of the foot i.e. pulp of the toe and 1st, 3rd and 5th metatarsal heads bilaterally for both the groups on Day 1 prior to treatment.

The subjects in the experimental group were given Tibial nerve mobilization bilaterally. This procedure was continued for a total of 21 days. The subjects in the control group were not given any intervention.

Dependent Variables: VPT readings at great toe and 1st, 3rd and 5th metatarsal head.

The subjects in both the groups were reassessed for Vibration Perception Threshold on the 21st Day. The post- test measurements of VPT were then compared with the pre - test ones and the appropriate data analysis was done.

Results: It was found that the subjects who were given tibial nerve mobilization showed reduction in VPT scores .

Conclusion: Nerve mobilisation may be an effective technique for delaying the diabetes related peripheral neuropathy, if detected at its earlier stages. This will ultimately help in preservation of the vibration sense of the foot and consequently reduce or delay the incidence of the devastating effects such as foot ulceration which may lead to foot amputation.


Keywords

Diabetic Peripheral Neuropathy, Vibration Perception Threshold, Nerve Mobilization
Subscription Login to verify subscription
User
Notifications
Font Size


  • Boulton AJ (1997) Foot Problems in Patient With Diabetes Mellitus. In: Pickup J, Williams G ed. Textbook of Diabetes. London. United Kingdom: Blackwell Science: 1-58.

  • Boulton AJM., Kubrusly DB, Bowker JH, Skyler JS and Sosenko JM (1986) Impaired vibratory perception and diabetic foot ulceration. Diabet Med. 3: 335-337.

  • Vinik AL, Master RE, Mitchell BD and Freeman R (2003) Diabetic Autonomic Neuropathy. Diabet Care. 26: 1553-1579.

  • Vinik AL, Park TS, Stansberry KB and Pitteneger GL (2000) Diabetic neuropathies. Diabetolgia: 43: 957-973.

  • Apelqvist J, Larsson J and Agardh CD (1993) Long-term prognosis for diabetic patients with foot ulcers. J inter med. 233, 485-491.

  • Singh N, David G and Benjamin A (2005) Preventing Foot Ulcers in Patient with Diabetes. JAMA. 293: 217-228.

  • Baker PF, Ladds M and Rubinson KA (1977) Measurement of the flow properties of isolated axoplasm in a defined chemical environment Journal Physiology. 269(1): 10-11.

  • Robert J and David Butler (2006) Management of peripheral neuropathic pain: Integrating neurobiology, neurodynamic and clinical evidence. Physical Therapy in Sports.7: 36-49.

  • Gary D, Hall GD, Van Way CW and Kung FT (1993) Peripheral nerve elongation with tissue expansion techniques, J Trauma, 34(3): 401-405.

  • Michal D, Dariusz B, Izabela K and Zbigniew W (2007) Principles of neuromobilization for treating musculoskeletal disease. Medsportpress, 2(6); 9: 111-121.

  • Lundborg G and Dahlin LB (1992) The pathophysiology of nerve compression. Hand Clinic, 8(2): 215-27.

  • Lundborg G and Ryedvik B (1973) Effects of stretching the tibial nerve of the rabbit: a prelimnary study of the intraneural circulation and the barrier circulation of the perineurium. J Bone Joint Surg. 55: 390-401.

  • Lundborg G (1988) Intraneural microcirculation. Journal Orthop Clin North Am,19(1): 1-12.

  • Sarkari E and Multani NK (2007) Efficacy of Neural mobilisation in India. J Execise Science Physiother. 3(2): 136-141.

  • Colette R, Jane G and Nicola J (2004) Effect of straight leg raise examination and treatment on vibration thresholds in the lower limb: a pilot study in asymptomatic subjects, Manual Therapy, 10: 2: 136-143.

  • Antonella C, Hau P, Johan M, David G and Aristidis V (2002) The Forefoot to Rearfoot Plantar pressure Ratio is increased in severe Diabetic Neuropathy and Can predict Foot Ulceration. Diabet Care 25: 1066-1071.

  • Abe Y, Doi K and Kawai (2005) An experimental model of Nerve adhesion in rabbits. British Journal of Plastic Surgery, 58(4): 533-540.

  • Andrew JM, Boulto, RA, Malik, JC and Jay M S (2004) Diabetic Somatic Neuropathies. Diabet Care. 27: 1458-1486.

  • Butler D (2005) The neurodynamic techniques. Adelaide, Australia: Noigroup Publication.

  • Butler D (1991) Mobilisation of the nervous system Melbourne, Australia: Churchill Livingstone.

  • Cade WT (2008) Diabetes related Microvascular and Macrovascular disease in the Physical Therapy setting. Physical therapy, 88: 1322-1335.

  • Young MJ, Breddy JL, Veves A and Boulton AJ (1994) The Diabetic Neuropathic Foot Ulceration using Vibration Perception Thresholds. A prospective study. Diabet Care. 17(6): 557-560.


Abstract Views: 680

PDF Views: 0




  • Effect of Nerve Mobilization on Vibration Perception Threshold in Diabetic Peripheral Neuropathy

Abstract Views: 680  |  PDF Views: 0

Authors

Pankaj Preet Singh
Punjabi University, Patiala, India
Sandeep Singh
Punjabi University, Patiala, India
Rohit Aggarwal
Amar Hospital, Patiala, India
Jagmohan Singh
Gian Sagar College of Physiotherapy, Banur, Patiala, India

Abstract


Purpose of the study: To determine the effects of Nerve Mobilisation on Vibration Perception Threshold (VPT) in Diabetic Peripheral Neuropathy.

Materials and Methods: 30 male subjects with VPT > 25, mean height of 175.93 and mean weight of 82.53 kg on the basis of thorough assessment and after signing informed consent were randomly divided into experimental and control group. The vibration perception Threshold was measured on all the four points on the plantar aspect of the foot i.e. pulp of the toe and 1st, 3rd and 5th metatarsal heads bilaterally for both the groups on Day 1 prior to treatment.

The subjects in the experimental group were given Tibial nerve mobilization bilaterally. This procedure was continued for a total of 21 days. The subjects in the control group were not given any intervention.

Dependent Variables: VPT readings at great toe and 1st, 3rd and 5th metatarsal head.

The subjects in both the groups were reassessed for Vibration Perception Threshold on the 21st Day. The post- test measurements of VPT were then compared with the pre - test ones and the appropriate data analysis was done.

Results: It was found that the subjects who were given tibial nerve mobilization showed reduction in VPT scores .

Conclusion: Nerve mobilisation may be an effective technique for delaying the diabetes related peripheral neuropathy, if detected at its earlier stages. This will ultimately help in preservation of the vibration sense of the foot and consequently reduce or delay the incidence of the devastating effects such as foot ulceration which may lead to foot amputation.


Keywords


Diabetic Peripheral Neuropathy, Vibration Perception Threshold, Nerve Mobilization

References