Powell Mark W, Carnegie Dale H, Burke Thomas J
Northwest Orthopedic Center, Springdale, AR 72764, USA.
Age Ageing. 2006 Jan;35(1):11-6. doi: 10.1093/ageing/afi215. Epub 2005 Nov 22.
to determine whether restoration of sensation, impaired due to diabetic peripheral neuropathy (DPN), would reduce the number of falls and the fear of falling and improve activities of daily living (ADL) in a Medicare-aged population.
retrospective cohort study of patients with documented, monochromatic near-infrared phototherapy (MIRE)-mediated, symptomatic reversal of DPN.
responses to a health status questionnaire following symptomatic reversal of DPN.
252 patients (mean age 76 years) provided health information following symptomatic reversal of diabetic neuropathy (mean duration 8.6 months).
incidence of falls and fear of falling decreased within 1 month after reversal of peripheral neuropathy and remained low after 1 year. Likewise, improved ADL were evident soon after reversal of peripheral neuropathy and showed further improvement after 1 year. Overall, reversal of peripheral neuropathy in a clinician's office and subsequent use of MIRE at home was associated with a 78% reduction in falls, a 79% decrease in balance-related fear of falling and a 72% increase in ADL (P < 0.0002 for all results).
reversal of peripheral neuropathy is associated with an immediate reduction in the absolute number of falls, a reduced fear of falling and improved ADL. These results suggest that symptomatic reversal of diabetic neuropathy will have a substantial favourable, long-term socioeconomic impact on patients with DPN and the Medicare system, and improve the quality of life for elderly patients with diabetes and peripheral neuropathy.
确定因糖尿病周围神经病变(DPN)导致的感觉恢复是否会减少医疗保险覆盖年龄段人群的跌倒次数和跌倒恐惧,并改善日常生活活动(ADL)。
对有记录的、经单色近红外光疗法(MIRE)介导的、有症状的DPN逆转患者进行回顾性队列研究。
DPN有症状逆转后对健康状况问卷的回答。
252名患者(平均年龄76岁)在糖尿病神经病变有症状逆转后(平均病程8.6个月)提供了健康信息。
周围神经病变逆转后1个月内跌倒和跌倒恐惧的发生率下降,1年后仍保持在低水平。同样,周围神经病变逆转后不久ADL就有明显改善,1年后进一步改善。总体而言,在临床医生办公室进行周围神经病变逆转并随后在家中使用MIRE与跌倒减少78%、与平衡相关的跌倒恐惧减少79%以及ADL增加72%相关(所有结果P<0.0002)。
周围神经病变的逆转与跌倒绝对数量的立即减少、跌倒恐惧的降低以及ADL的改善相关。这些结果表明,糖尿病神经病变的有症状逆转将对DPN患者和医疗保险系统产生重大的长期有利社会经济影响,并改善老年糖尿病和周围神经病变患者的生活质量。