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比较单独和同时应用透热疗法与低强度激光疗法对2型糖尿病伴下肢周围神经病变患者神经症状的影响。

Comparison of the effect of separate and simultaneous application of Tecar therapy and low-level laser therapy on the neurological symptoms of type 2 diabetic patients with peripheral neuropathy of lower limbs.

作者信息

Javan Amoli Mitra, Khademi-Kalantari Khosro, Niajalili Maryam, Daryabor Aliyeh, Sadat Naimi Sedigheh

机构信息

Department of Physical Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Turk J Phys Med Rehabil. 2024 Aug 26;70(3):344-357. doi: 10.5606/tftrd.2024.13419. eCollection 2024 Sep.

Abstract

OBJECTIVES

The study aimed to compare the effects of separate and simultaneous application of Tecar therapy and low-level laser therapy on neurological symptoms of type 2 diabetic patients.

PATIENTS AND METHODS

In this randomized control trial conducted between November 2021 and February 2022, 45 patients (30 females, 15 males; mean age: 65.7±7.6 years; range, 51 to 76 years) with type 2 diabetes and peripheral sensory neuropathy of the lower limbs were randomly divided into three groups: Tecar + sham laser (n=15), Tecar + laser (n=15), and laser + sham Tecar (n=15). Outcome measures for both right and left limbs included tibial motor nerve conduction velocity (MNCV), sural nerve amplitude, sole sensation, and ankle-brachial index (ABI) measured before and after 10 sessions and after a three-month follow-up.

RESULTS

In intergroup comparison, the Tecar + laser group significantly improved compared to the laser + sham Tecar group in terms of tibial MNCV in both limbs after 10 sessions and all measured outcomes after three months (p<0.05). In addition, comparison between the Tecar + laser and Tecar + sham laser groups for tibial MNCV (p=0.021 for the right limb and p=0.002 for the left limb) and ABI (p=0.001 for the right limb and p=0.002 for the left limb) in both limbs after three months was significant. In the intragroup comparison, a significant improvement was found in the laser + sham Tecar group for sole sensation (p<0.001) and ABI (p<0.001) of both limbs after three months compared to before the interventions, whereas in the other two groups, significant improvements were found in all four outcomes.

CONCLUSION

A significant increase was found in neurological outcomes in all three groups after 10 sessions. Moreover, the use of combined Tecar therapy and laser compared to Tecar or laser alone could lead to a more lasting effect in improving the sensory symptoms of type 2 diabetic patients with peripheral neuropathy of the lower limbs.

摘要

目的

本研究旨在比较单独和同时应用特卡疗法与低强度激光疗法对2型糖尿病患者神经症状的影响。

患者与方法

在2021年11月至2022年2月进行的这项随机对照试验中,45例2型糖尿病合并下肢周围感觉神经病变的患者(30例女性,15例男性;平均年龄:65.7±7.6岁;范围51至76岁)被随机分为三组:特卡+假激光组(n = 15)、特卡+激光组(n = 15)和激光+假特卡组(n = 15)。左右下肢的观察指标包括干预10次前后及三个月随访后的胫神经运动神经传导速度(MNCV)、腓肠神经波幅、足底感觉和踝臂指数(ABI)。

结果

组间比较中,特卡+激光组在干预10次后双下肢的胫神经MNCV以及三个月后的所有观察指标方面,与激光+假特卡组相比有显著改善(p<0.05)。此外,三个月后特卡+激光组与特卡+假激光组在双下肢的胫神经MNCV(右下肢p = 0.021,左下肢p = 0.002)和ABI(右下肢p = 0.001,左下肢p = 0.002)方面的比较有显著差异。组内比较中,激光+假特卡组在干预三个月后双下肢的足底感觉(p<0.001)和ABI(p<0.001)与干预前相比有显著改善,而在其他两组中,所有四项观察指标均有显著改善。

结论

三组在干预10次后神经学观察指标均有显著提高。此外,与单独使用特卡疗法或激光相比,联合使用特卡疗法和激光在改善2型糖尿病合并下肢周围神经病变患者的感觉症状方面可能具有更持久的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61a7/11639497/1bfed68f9a4d/TJPMR-2024-70-3-344-357-F1.jpg

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