• Journal of the Korean Academy of Clinical Electrophysiology
• /
• v.4 no.1
• /
• pp.13-25
• /
• 2006

This study aims to suggest clinical basis of physical therapy of neuromuscular system complication in type diabetic patients through a variety II of analysis methods including echogenicity using ultrasound image and measurement of peripheral nerve function to their neuromuscular system and provide basic materials for preparing evaluation of physical therapy and intervention program. Subjects of this study were 75 type II diabetic patients between 40 and 80 years old and it obtained the following results through echogenisity and function of peripheral nerve. Incidence of neuropathy in type II diabetes was 55.8% in men and 53.1% in women, and total incidence of neuropathy was 54.7%. Echogenicity of patients with neuropathy was significantly increased compared to that of patients with neuropahty. It was also found that there were correlations between function of peripheral nerve and echogenicity of tibialis anterior and gastrocnemius muscle. In addition, it will be important for physical therapists to divide type II diabetic patients into neuropathy and myopathy and interpret and approach changes of neuro-muscular system from comprehensive side.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.13 no.2
• /
• pp.225-234
• /
• 2006

Purpose: This study was done to investigate the effect of self-foot reflexology on peripheral blood circulation, peripheral neuropathy and to determine the feasibility of self-foot reflexology as a nursing intervention. Method: This was nonequivalent control pretest-posttest study with 76 patients with type 2 diabetes mellitus (ages between 40-79) recruited from public health centers in Busan city. Intervention was a 6 week self-foot reflexology, and outcome variables were peripheral blood circulation and peripheral neuropathy(tactile response to monofilament, intensity of symptoms of peripheral neuropathy). ANCOVA was used to do the statistical analysis. A.05 significance level was set for evaluating the effects of self-foot reflexology. Results: The self-foot reflexology was relatively effective not only in reducing peripheral neuropathy(especially tingling sensation and pain) but also in improving ability to sense the 10-g force monofilament. Conclusion: Even though self-foot reflexology was not effective in improving peripheral circulation, it had good effect on improving peripheral neuropathy. Therefore self-foot reflexology can be used as a nursing intervention program for promoting foot care for patients with DM patients.

• Journal of Haehwa Medicine
• /
• v.13 no.1
• /
• pp.47-59
• /
• 2004

Objectives & Methods: We investigated 28 books to study etiology and pathology of Son-Bal Jeorim. Result and Conclusion 1. The eiology of Son-Bal Jeorim is same as it of Bee Jeung(痺症). 2. Generally speaking, the cause of Bee Jeung was distributed Wind(風), Coldness(寒), Wetness (濕) of meridian. Bee Jeung can be devided into SilBi(實痺) and HeoBi(虛痺). In SilBi(實痺) there are PungHanSeupBi(風寒濕痺) and YeolBi(熱痺). In HeoBi(虛痺), there are GiHyeolHeoBi(氣血虛痺), EumheoBi(陰虛痺) and YangHeoBi(陽虛痺). 3. Son-Bal Jeorim belong to peripheral neuropathy in western medicine. 4. Syndrome of acute motor paralysis with variable disturbance of sensory and autonomic function, subacute sensorymotor paralysis, syndrome of chronic sensorimotor polyneuropathy, neuropathy with mitochondrial disease, syndrome of mononeuropathy or nerve plexusopathy. 5. Peripheral neuropathy is caused by carpal tunnel syndrome, diabetic neuropathy, uremic neuropathy, hepatic neuropathy, hypothyroid neuropathy, hyperthyroid neuropathy, neuropathy due to malnutrition, neuropathy due to toxic material, neuropathy due to drug, paraneoplastic neuropathy, hereditary neuropathy, etc. 6. Cerebral apoplexy, myelopathy, peripheral circulatory disturbance, anxiety syndrome cause symptoms of peripheral neuropathy

• Journal of Korean Physical Therapy Science
• /
• v.7 no.2
• /
• pp.559-565
• /
• 2000

This studies were to investigate the effects of low power Helium-Neon Infra-Red (He-Ne IR) laser on the healing of the peripheral neuropathy in diabetic rats. The twenty one Spraque-Dewley adult male rats were assigned to the 3 groups: the control group (7), the diabetic group (7) and the laser group (7). The diabetic group was induced with a single intravenous injection of 50mg/kg body weight streptozotocin dissolved to 0.01mol/L citrate buffer, pH 4.5. The experimental laser group was irradiated low power He-Ne IR laser for 5 minutes every day during 21 days to the diabetic group. The results were as follows: For on and two weeks with laser treatment, there were significantly increased the terminal latencies of the laser treatment group than those of diabetic group, but that was significantly decreased to be similar to the control group on the laser treatment group for three weeks. The change of the amplitude on the laser treatment groups for three weeks was significantly increased to be similar to normal group than that of the diabetic group. As the result, we thank that there were activately effected of lower power He-Ne IR laser on the heeling of the peripheral neurophathy in diabetic rats.

• The Journal of Korean Physical Therapy
• /
• v.19 no.5
• /
• pp.51-63
• /
• 2007

Diabetic foot ulcers result from abnormal mechanical loading of the foot, such as repetitive pressure applied to the plantar aspect of the foot while walking. Diabetic peripheral neuropathy causes changes in foot structure, affecting foot function and subsequently leading to increased plantar foot pressure, which is a predictive risk factor for the development of diabetic foot ulceration. To early identify the insensitive foot makes it possible to prevent diabetic foot ulceration and to protect the foot at risk from abnormal biomechanical loading. Abnormal foot pressures can be reduced using several different approaches, including callus debridement, prescription of special footwear, foot orthosis. injection of liquid silicone, Achilles tendon lengthening, and so forth. Off-loading of the diabetic wound is a key factor to successful wound healing as it is associated with reduced inflammatory and accelerated repair processes. Pressure relief can be achieved using various off-loading modalities including accommodative dressing, walking splints, ankle-foot orthosis, total contact cast, and removable and irremovable cast walkers.

• Journal of Yeungnam Medical Science
• /
• v.40 no.4
• /
• pp.328-334
• /
• 2023

An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

• Annals of Clinical Neurophysiology
• /
• v.10 no.1
• /
• pp.29-32
• /
• 2008

Although various criteria on the diagnosis of diabetic neuropathy are applied from trial to trial, being tailored in concert with its purpose, the utmost evidences of the diagnosis are subjective symptoms and objective signs of neurologic deficit. The application and interpretation of auxiliary electrophysiological test including nerve conduction study (NCS) should be made on the context of clinical pictures. The evaluation of the functions of small, thinly myelinated or unmyelinated nerve fibers has been increasingly stressed recently with the advent of newer techniques, e.g., measurement of intraepidermal fiber density, quantitative sensory testing, and autonomic function test. And the studies with those techniques have shed light to the nature of the evolution of diabetic neuropathy. The practical application of these techniques to the diagnosis of diabetic neuropathy in the individual patients, however, should be made cautiously due to several shortcomings: limited accessibility, wide overlapping zone between norm and abnormality with resultant unsatisfactory sensitivity and specificity, difficulty in performing subsequent tests, unproven quantitative correlation with clinical deficit, and invasiveness of some technique. NCS, as an extension of clinical examination, is still the most reliable electrophysiological test in evaluating neuropathy and gives the invaluable information about the nature of neuropathy, whereas the newer techniques need more refinement of the procedure and interpretation, and the accumulation of large scaled data of application to be considered as established diagnostic tools of peripheral neuropathy.

• Journal of muscle and joint health
• /
• v.17 no.1
• /
• pp.35-46
• /
• 2010

Purpose: The purpose of this study was to test the effect of 12-week Tai Chi exercise on glucose control, peripheral nerve modulation, and perceived health for Type 2 diabetic patients with neuropathy. Methods: A pretest posttest design with a nonequivalent control group, 44 diabetic patients with neuropathy were recruited from an outpatient clinic of a university hospital and assigned into Tai Chi or Control groups. The Tai Chi exercise was based on Tai Chi for Diabetes program developed by Lam (2006) and performed one hour for each session twice a week for 12 weeks. Outcome variables were HbA1c, Michigan Neuropathy Screening Instrument scores and perceived health. A total of 25 patients completed both measures of pretest and posttest. Results: The study participants were 67 years old in average, diagnosed by DM for more than 15 years. Those who participated in 12-week Tai Chi exercise (n=13) significantly improved in HbA1c (t=2.23, p=.035) and perceived health (t=-2.28, p=.032) than the control group (n=12). Conclusion: Tai Chi exercise may improve glucose control and health status in patients with Type II diabetes. Further study with larger sample size would be necessary to confirm the effect of Tai Chi on peripheral nerve modulation.

• The Journal of Internal Korean Medicine
• /
• v.37 no.2
• /
• pp.232-236
• /
• 2016

Objective: Diabetic neuropathy is a common complication of diabetes mellitus. Patients with this disease suffer from various peripheral sensory symptoms that are not easily alleviated. We report on a case of a patient with diabetic neuropathy whose symptoms were alleviated after traditional Korean medical treatment.Methods: A patient with hand and foot numbness and coldness diagnosed with diabetic neuropathy was treated with Palmijihwang-tang (Bai Wei Di Huang Wa, 八味地黃湯) three times a day. The progress was evaluated with the numerical rating scale (NRS), neuropathy disability score (NDS), and neuropathy symptom score (NSS).Results: The improvement of symptoms appeared to be faster and more effective than that of conventional treatment. The improvement was observed from the second day of the treatment.Conclusions: This case study shows that Palmijihwang-tang may be an effective treatment for diabetic neuropathy.

• The Korean Journal of Food And Nutrition
• /
• v.21 no.4
• /
• pp.430-435
• /
• 2008

The main cause of diabetic neuropathy, one of the most debilitating complications, is the chronic hyperglycemia, the increase sorbitol or the decrease of nerve growth factor(NGF). NGF, a protein, plays a major role in the development and maintenance of peripheral nervous system. Systemic administration of NGF prevents manifestations of neuropathy in rodent models of diabetic neuropathy. In the previous investigation, we report the hypoglycemia effect of Dioscorea rhizoma extract(DRE) in diabetic mice. The present study shows protective effect of DRE on diabetic neuropathy by induction of NGF protein. We investigated the NGF level in salivary gland and sciatic nerve of normal mouse and the effect of DRE on sciatic nerve conductivity and thermal hyperalgesia test in Type 2 db/db mouse. DRE increased endogenous NGF level in salivary gland and sciatic nerve of mouse. And sensory nerve conductivity velocity(SNCV), motor nerve conductivity velocity(MNCV) and thermal hyperalgesia increased in DRE treatment mice compared with control group. On the basis of our results, we conclude that DRE increase induction of endogenous NGF level and have protective effect on diabetic neuropathy by induction of NGF. Therefore, we propose that long-term use of DRE might help prevention of diabetes-associated complication; diabetic neuropathy.