Electrical Nerve Stimulation Improves Healing of Diabetic Ulcers

Lundeberg, Thomas; Eriksson, Sven V.; Malm, Mats

doi:10.1097/00000637-199210000-00009

Cited by 96 publications

(124 citation statements)

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“…Interestingly, electrical stimulation has been reported to improve microvascular blood flow in severe limb ischaemia [28], have effects on wound healing (indicating improved tissue circulation) [29,30], and improve insulin resistance [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Effective treatment of symptomatic diabetic polyneuropathy by high-frequency external muscle stimulation

et al. 2005

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Aims/hypothesis: Diabetic distal symmetrical sensory polyneuropathy (DSP) affects 20-30% of diabetic patients. Transcutaneous electrical nerve stimulation (TENS) and electrical spinal cord stimulation have been proposed as physical therapies. We performed a controlled, randomised pilot trial to compare the effects of high-frequency external muscle stimulation (HF) with those of TENS in patients with symptomatic DSP. Methods: Patients with type 2 diabetes and DSP (n=41) were randomised to receive treatment with TENS or HF using strata for non-painful (n=20) and painful sensory symptoms (n=21). Both lower extremities were treated for 30 min daily for three consecutive days. The patients' degree of symptoms and pain were graded daily on a scale of one to ten, before, during and 2 days after treatment termination. Responders were defined by the alleviation of one or more symptoms by at least three points. Results: The two treatment groups were similar in terms of baseline characteristics, such as age, duration of diabetes, neurological symptoms scores and neurological disability scores. The responder rate was significantly higher (p<0.05) in the HF group (80%, 16 out of 20) than in the TENS group (33%, seven out of 21). Subgroup analysis revealed that HF was more effective than TENS in relieving the symptoms of non-painful neuropathy (HF: 100%, seven out of seven; TENS: 44%, four out of nine; p<0.05) and painful neuropathy (HF: 69%, nine out of 13; TENS: 25%, three out of 12; p<0.05). The responders did not differ in terms of the reduction in mean symptom intensity during the trial. Conclusions/interpretation: This pilot study shows, for the first time, that HF can ameliorate the discomfort and pain associated with DSP, and suggests that HF is more effective than TENS. External muscle stimulation offers a new therapeutic option for DSP.

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Section: Discussionmentioning

confidence: 99%

Effective treatment of symptomatic diabetic polyneuropathy by high-frequency external muscle stimulation

et al. 2005

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“…Studies in the literature used different protocols of electrical stimulation for diabetic foot ulcers since. In two, treatment with electrical stimulation was compared to sham treatment [45,46] while in another two studies electrical stimulation was compared to infrared heat lamp [32,41] . Another study compared electrical stimulation to two different control groups, one receiving electrical current at a very low dose (4-mA intensity) and the other not receiving electrical stimulation [47] .…”

Section: Electrotherapy Methodsmentioning

confidence: 99%

“…Another study compared electrical stimulation to two different control groups, one receiving electrical current at a very low dose (4-mA intensity) and the other not receiving electrical stimulation [47] . While all these studies investigated the effect of electrical stimulation the authors did not provide any data on calculation of the sample size and streaming [41,45,46] and the electrical current was administered as symmetrical biphasic, monophasic or square wave current. In all 5 trials the rates of healing, measured by the diameter of the wound, were the main result; in 4 the rates of healing were significantly higher in the study group compared to the control group [32,41,[45][46][47] .…”

Section: Electrotherapy Methodsmentioning

confidence: 99%

Does physical therapy and rehabilitation improve outcomes for diabetic foot ulcers?

Turan

Ertuğrul

Lipsky

et al. 2015

WJEM

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One of the most common and serious complications of diabetes mellitus is ulceration of the foot. Among persons with diabetes, 12%-25% will present to a healthcare institution for a foot disorder during their lifespan. Despite currently available medical and surgical treatments, these are still the most common diabetes-related cause of hospitalization and of lower extremity amputations. Thus, many adjunctive and complementary treatments have been developed in an attempt to improve outcomes. We herein review the available literature on the effectiveness of several treatments, including superficial and deep heaters, electro-therapy procedures, prophylactic methods, exercise and shoe modifications, on diabetic foot wounds. Overall, although physical therapy modalities seem to be useful in the treatment of diabetic foot wounds, further randomized clinical studies are required.

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“…Interrupted unidirectional pulsed current was used daily for 1 hour; this squared pulse had a frequency of 80 Hz and duration of 0.3 ms, with an intensity between 300 and 600 μA. These stimulation parameters were used in a previous study and found to provide a comfortable treatment that is well tolerated by animals [30][31]. Afterward, the animals were immobilized with a restrainer device and then stimulated for 1 hour.…”

Section: Treatment Protocolsmentioning

confidence: 99%

Anodal and cathodal pulsed electrical stimulation on skin wound healing in guinea pigs

Mehmandoust¹,

Torkaman²,

Firoozabadi³

et al. 2007

JRRD

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Abstract-We investigated the effects of anodal and cathodal electrical stimulation on wound healing. In a randomized controlled trial, we divided 42 male albino guinea pigs into two control (C1 and C2) and four experimental (E1-E4) groups. A 3 cm linear incision was made at the dorsal skin of all guinea pigs. A unidirectional pulse current of 300 to 600 microamperes, 80 pps, and 0.3 ms pulse duration was administered for 1 hour a day. In groups E1 and E3 (anodal), a positive polarity was applied for the first 3 days followed by negative polarity the remaining days. In groups E2 and E4 (cathodal), negative polarity was applied for the first 3 days and positive polarity the remaining days. Groups E1, E2, and C1 were killed on day 14 and E3, E4, and C2 on day 21. We measured the percentage of decrease in wound surface area (daily tracing) and tensile strength (on days 14 and 21). The results indicated that both cathodal and anodal stimulations increased the rate of wound closure. Beginning with day 12, we saw a significant difference in the percentage of the decrease in wound surface between all treatment and control groups (p < 0.05). Ultimate tensile strength and stress increased in the anodal compared with the cathodal and control groups; at the end of day 14, ultimate tensile stress in E1 was significantly greater compared with C1 (p < 0.05). We conclude that electrical stimulation, regardless of polarity regimen, benefits wound healing, but anodal stimulation the first 3 days and cathodal stimulation the remaining days can lead to stronger repaired tissue.

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Electrical Nerve Stimulation Improves Healing of Diabetic Ulcers

Cited by 96 publications

References 0 publications

Effective treatment of symptomatic diabetic polyneuropathy by high-frequency external muscle stimulation

Effective treatment of symptomatic diabetic polyneuropathy by high-frequency external muscle stimulation

Does physical therapy and rehabilitation improve outcomes for diabetic foot ulcers?

Anodal and cathodal pulsed electrical stimulation on skin wound healing in guinea pigs

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