Paper
Saturday, July 14, 2007
The effect of plantar vibration on the progression of peripheral neuropathy
Geraldine R. Avidano Britton, RN, FNP, PhD, Decker School of Nursing, Binghamton University, Binghamton, NY, USA, Daniel Britton, MD, MS, Neurology Department, University of Rochester School of Medicine and Dentistry, Corning, NY, USA, Leann Lesperance, MD, PhD, Bio-engineering, Binghamton University, Binghamton, NY, USA, and Claudia Haile, BS, Decker School of Nursing, Binghamton Universityy, Corning, NY, USA.
| Learning Objective #1: describe innovative technology that stimulates Pacinian Corpuscles and potentially affects the regeneration of small peripheral nerve fibers. |
| Learning Objective #2: identify correlations among health history, demographic and life-style variables, HgbA1c, and bio-physical referents for peripheral neuropathy. |
Peripheral neuropathy, a diagnosis with significant disability sequelae, has a prevalence approaching 10% in the general population. While its pathophysiology is poorly understood, its most common cause relates to glucose intolerance or overt diabetes. Classification of neuropathies is based on nerve fiber size: large fiber, small fiber and mixed types. To date, the only objective referent for small fiber types is skin biopsy. Plantar vibration, which affects large fibers, has been demonstrated to enhance peripheral and systemic blood flow, peripheral lymphatic and venous drainage. Therefore, since fluid retention in axons, nerve sheaths and surrounding connective tissues may contribute to neuropathy, the purposes of this study are to 1) assess the effect of plantar vibration on regeneration of small peripheral nerve fibers, symptoms and quality of life in subjects with diagnosed peripheral neuropathy; and 2) assess the correlation of health history, demographic variables, diet, alcohol and smoking history with small fiber neuropathy analysis by skin biopsy and other neurological assessments. The design of the study is a randomized block, cross-over experimental with subjects acting as their own controls. Twenty-four subjects (12 men, 12 women; 95.8% White; 70.8% diabetes) with a mean age of 55 years (range, 26-70) were enrolled in the study. Those in the experimental phase of the trial were provided a Juvent 1000-CS device in their homes to be used daily for six months. Measures included health history, HgbA1c, pain inventory scale, neurological exam, obtained at baseline, and at 3, 6, 9 and 12 months, as well as EMG/nerve conduction studies and skin biopsies, at baseline and at 6 and 12 months. Preliminary results will be presented. These study results have implications in the use of alternative therapies in the nursing care of patients with chronic illnesses and in the contribution to evidenced-based data on skin biopsy assays.