全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Treatment of Peripheral Neuropathy: Combination Therapy Using LED Light, Extracorporeal Shockwave Therapy, Platelet Rich Plasma, and an Oral Dietary Supplement

DOI: 10.4236/ijcm.2023.145021, PP. 250-259

Keywords: Peripheral Neuropathy, LED Light Therapy Device, Extracorporeal Shockwave Therapy, PRP Injections, Oral Supplement, Multi-Modality Treatment, Pain

Full-Text   Cite this paper   Add to My Lib

Abstract:

Objectives: Peripheral neuropathy (PN) is a significant contributor to disability in the elderly. It is also one of the most prevalent complications of type 2 diabetes, prediabetes and metabolic syndrome. PN is commonly associated with pain, numbness, tingling, burning, and cramping in the feet and legs. Current treatment options are limited to controlling pain, seizures and use of antidepressant medications. These treatments have undesirable side effects and don’t stop PN progression. Here we utilized a combination of individual-specific modalities to improve local circulation and relieve PN symptoms. Methods: We conducted an open-label, multicenter pilot trial with 34 subjects (19 males and 15 females ranging from 40 - 85 years of age). All of the participants were diagnosed with peripheral neuropathy and had bilateral symptoms in their feet, and many reported the same symptoms (pain, numbness, tingling, burning, and cramping) in their lower legs. The duration of symptoms ranged from four months to over six years. On Day 0, subjects were given a 90-day supply of the oral supplement with dosing instructions and a LED light therapy device. They also received three platelet-rich plasma (PRP) injections in their lower extremities. Subjects also received an extracorporeal shockwave therapy (ESWT) treatment for each foot and subsequently twice per week for the first six weeks, then once weekly for the duration of the study. Subjects filled out the Brief Pain Index (BPI) at weekly intervals. On Day 90, subjects completed the Patient Global Impression of Change (PGIC) survey. Results: There were significant responses to pain, as evidenced by BPI scores at weeks 8, 9, 10 and 11 (p = 0.02, 0.01, 0.02, and 0.003, respectively). Analysis of the final day PGIC survey showed a favorable outcome for 73% of participants (p = 0.003), with the majority reporting Very Much Improved. Conclusions: By utilizing a multi-modality treatment protocol that includes PRP, LED light therapy, ESWT and an oral dietary supplement, we observed significant reductions in BPI scores. Quality of life and their overall impression of change (PGIC) were significantly improved, and there were no significant side effects.

References

[1]  Stino, A.M. and Smith, A.G. (2017) Peripheral Neuropathy in Prediabetes and Metabolic Syndrome. Journal of Diabetes Investigation, 8, 646-685.
https://doi.org/10.1111/jdi.12650
[2]  Dewanjee, S., Das, S., Das, A.K., Bhattacharjee, N., Dihingia, A., Dua, T.K., et al. (2018) Molecular Mechanism of Diabetic Neuropathy and Its Pharmacotherapeutic Targets. European Journal of Pharmacology, 833, 472-523.
https://doi.org/10.1016/j.ejphar.2018.06.034
[3]  US Food and Drug Administration.
https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPCD/classification.cfm?ID=ILY
[4]  Sánchez, M., Anitua, E., Delgado, D., Sanchez, P., Prado, R., Orive, G. and Padilla, S. (2017) Platelet-Rich Plasma, a Source of Autologous Growth Factors and Biomimetic Scaffold for Peripheral Nerve Regeneration. Expert Opinion on Biological Therapy, 17, 197-212.
https://doi.org/10.1080/14712598.2017.1259409
[5]  Hassanien, M., Elawamy, A., Kamel, E.Z., Khalifa, W.A., Abolfadl, G.M., Roushdy, A., El Zohne, R.A. and Makarem, Y.S. (2020) Perineural Platelet-Rich Plasma for Diabetic Neuropathic Pain, Could It Make a Difference? Pain Medicine (Malden, Mass.), 21, 757-765.
https://doi.org/10.1093/pm/pnz140
[6]  Yu, W., Wang, J., and Yin, J. (2011) Platelet-Rich Plasma Is a Promising Product for Treating Peripheral Nerve Regeneration after Nerve Injury. The International Journal of Neuroscience, 121, 176-180.
https://doi.org/10.3109/00207454.2010.544432
[7]  Seabaugh, K.A., Thoresen, M. and Giguère, S. (2017) Extracorporeal Shockwave Therapy Increases Growth Factor Release from Equine Platelet-Rich Plasma in Vitro. Frontiers in Veterinary Science, 4, Article 205.
https://doi.org/10.3389/fvets.2017.00205
[8]  Muacevic, A., Adler, J.R., Abushukur, Y. and Knackstedt, R. (2022) The Impact of Supplements after Peripheral Nerve Injury. Cureus, 14, e25135.
[9]  Agathos, E., Tentolouris, A., Eleftheriadou, I., Katsaouni, P., Nemtzas, I., Petrou, A., et al. (2018) Effect of Alpha-Lipoic Acid on Symptoms and Quality of Life in Patients with Painful Diabetic Neuropathy. Journal of International Medical Research, 46, 1779-1790.
https://doi.org/10.1177/0300060518756540
[10]  Didangelos, T., Karlafti, E., Kotzakioulafi, E., Margariti, E., Giannoulaki, P., Batanis, G., et al. (2021) Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year, Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients, 13, Article 395.
https://doi.org/10.3390/nu13020395
[11]  Mottaghi, T., Khorvash, F., Maracy, M., Bellissimo, N. and Askari, G. (2019) Effect of Folic Acid Supplementation on Nerve Conduction Velocity in Diabetic Polyneuropathy Patients. Neurological Research, 41, 364-368.
https://doi.org/10.1080/01616412.2019.1565180
[12]  Zelman, D.C., Gore, M., Dukes, E., Tai, K.-S. and Brandenburg, N. (2005) Validation of a Modified Version of the Brief pain Inventory for Painful Diabetic Peripheral Neuropathy. Journal of Pain Symptom Management, 29, 401-410.
https://doi.org/10.1016/j.jpainsymman.2004.06.018
[13]  Liang, K.Y. and Zeger, S.L. (1986) Longitudinal Data Analysis Using Generalized Linear Models. Biometrika, 73, 13-22.
https://doi.org/10.1093/biomet/73.1.13
[14]  Zeger, S.L. and Liang, K.Y. (1986) Longitudinal Data Analysis for Discrete and Continuous Outcomes. Biometrics, 42, 121-130.
https://doi.org/10.2307/2531248
[15]  Vitoriano, N.A.M., Mont’Alverne, D.G.B., Martins, M.I.S., Silva, P.S., Martins, C.A., Teixeira, H.D., et al. (2019) Comparative Study on Laser and LED Influence on Tissue Repair and Improvement of Neuropathic Symptoms during the Treatment of Diabetic Ulcers. Lasers in Medical Science, 34, 1365-1371.
https://doi.org/10.1007/s10103-019-02724-5
[16]  Wang, C.J., Cheng, J.H., Kuo, Y.R., Schaden, W. and Mittermayr, R. (2015) Extracorporeal Shockwave Therapy in Diabetic Foot Ulcers. International Journal of Surgery, 24, 207-209.
https://doi.org/10.1016/j.ijsu.2015.06.024
[17]  Snyder, R., Galiano, R., Mayer, P., Rogers, L.C., Alvarez, O. and Sanuwave Trial Investigators (2018) Diabetic Foot Ulcer Treatment with Focused Shockwave Therapy: Two Multicentre, Prospective, Controlled, Double-Blinded, Randomized Phase III Clinical Trials. Journal of Wound Care, 27, 822-836.
https://doi.org/10.12968/jowc.2018.27.12.822
[18]  Esposito, C., Garzarella, E.U., Santarcangelo, C., Di Minno, A., Dacrema, M., Sacchi, R., et al. (2021) Safety and Efficacy of Alpha-Lipoic Acid Oral Supplementation in Reducing Pain with Unknown Etiology: A Monocentric, Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Biomedicine and Pharmacotherapy, 144, Article 112308.
https://doi.org/10.1016/j.biopha.2021.112308
[19]  Boghdadi, M.A., Afify, H.E., Sabri, N., Makboul, K., and Elmazar, M. (2017) Comparative Study of Vitamin B Complex Combined with Alpha Lipoic Acid versus Vitamin B Complex in the Treatment of Diabetic Polyneuropathy in Type 2 Diabetic Patients. Clinical and Experimental Pharmacology, 7, Article 1000241.
[20]  Tesfaye, S. and Sloan, G. (2020) Diabetic Polyneuropathy—Advances in Diagnosis and Intervention Strategies. European Endocrinology, 16, 15-20.
[21]  Wang, S., Liu, X. and Wang, Y. (2022) Evaluation of Platelet-Rich Plasma Therapy for Peripheral Nerve Regeneration: A Critical Review of Literature. Frontiers in Bioengineering and Biotechnology, 10, Article 2022.
https://doi.org/10.3389/fbioe.2022.808248
[22]  Shao, S., Pan, R. and Chen, Y. (2020) Autologous Platelet-Rich Plasma for Diabetic Foot Ulcer. Trends in Endocrinology and Metabolism, 31, 885-890.
https://doi.org/10.1016/j.tem.2020.10.003

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133

WeChat 1538708413