Effects of monochromatic infrared photo energy on balance performance for patients with Diabetic Peripheral Neuropathy

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Effects of monochromatic infrared photo energy on balance performance for patients with Diabetic Peripheral Neuropathy

 

Author: Ng, Yu-kee Eric
Title: Effects of monochromatic infrared photo energy on balance performance for patients with Diabetic Peripheral Neuropathy
Degree: M.Sc.
Year: 2007
Subject: Hong Kong Polytechnic University -- Dissertations.
Diabetes -- Treatment.
Diabetic neuropathies.
Foot -- Diseases -- Treatment.
Radiography, Medical.
Department: Dept. of Rehabilitation Sciences
Pages: xiii, 91 leaves : ill. (some col.) ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2174193
URI: http://theses.lib.polyu.edu.hk/handle/200/370
Abstract: Balance performance has been shown related to Diabetic Peripheral Neuropathy (DPN). However, the extent of balance dysfunction was not reported. The balance dysfunction due to DPN could cause severe complications and affect patients' mobility level and quality of life. Reliable and specific balance tests were essential to truly reflect the balance disability and allowed clinicians to provide effective rehabilitation. However, no specific balance tests are available for assessing diabetic balance dysfunction and there is no specific physiotherapy electrotherapeutic intervention to manage balance dysfunction due to DPN. This study examined the balance performance of diabetic patients by comparing with healthy control subjects. The sensitivity, specificity and discriminative validity of two balance tests, FICSIT-4 test and Functional Reach test to diabetic balance dysfunction were examined. Finally, the treatment effectiveness of Monochomatic near-InfraRed photo Energy (MIRE) in improving balance dysfunction due to DPN was evaluated by comparing with placebo group. A double-blinded randomized controlled study was used. Forty-six subjects suffered from diabetic peripheral neuropathy and Fifty-four age-matched healthy subjects were recruited. Their age range was 47 to 74. The balance performances between the diabetic subjects and healthy subject were compared using two balance tests, FISCIT-4 test and Functional Reach test. The sensitivity, specificity and discriminative validity of the tests were further examined by Receiver Operating Characteristic (ROC) curve analysis and discriminant function analysis. In the treatment effectiveness study, the diabetic subjects were further randomized into active and placebo groups. Both groups followed the same treatment procedures and received ten sessions of MIRE treatment within three weeks. However, only the active group received MIRE treatment with average power per treatment pad was 480mW while the placebo group received sham treatment without energy output. Their balance performances were assessed in four treatment periods, baseline, sessions five, session ten and four-week follow-up. Repeated measures analysis of variance (ANOVA) was used for data analysis. The balance performance of the diabetic subjects showed significant worse than healthy subjects (p < 0.001). Moreover, both balance tests showed high sensitivity (63% to 65%), specificity (70% to 91%) to balance dysfunction due to DPN. Furthermore, the balance ability of diabetic subjects in active group was significantly improved across treatment period (p < 0.05) compared with baseline but not in the placebo group. However, no significant group effects were found in this study. Patients with DPN were a unite group of patients with significant balance dysfunction. Specific management should be adopted to prevent further complications resulted from poor balance. FICSITS-4 test and Functional Reach test were the good choices for assessing patients' balance dysfunction due to DPN. Specific interventions should be should be used to improve this balance impairment and MIRE may be a choice. Further studies with higher statistical power and larger sample size were recommend for group comparisons.

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