Iranian Journal of

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Background: Chronic diabetes is substantially associated with circulatory disorders in lower limbs. Vacuum-Compression Therapy (VCT) has been commonly used in treatment of peripheral circulatory disorders. VCT is based on intermittent alteration of Positive- Negative pressure phases. The purpose of this study was to determine effects of VCT on diabetic subjects' peripheral blood flow.

Methods: In this Before-After and case-series study, 18 type 2 diabetic subjects with diabetic neuropathy and/or peripheral vascular disease (PVD) completed the study. Subjects received 45 min of VCT for 10 sessions three times weekly. Blood flow (calf+foot) was measured via venous occlusion plethysmography.          

Results: Among Variables of "Arterial Inflow", "Venous Outflow", "Venous Capacity", "Post-ischemic Reactive Hyperemia" and "Peak Flow of Reactive Hyperemia", only "Venous Outflow"  significantly improved after 10 sessions treatment via VCT (P<0.05).

Conclusions: Arterial blood inflow, which was the most important determinant evaluated in this study, was not increased via VCT. Additional studies are required to investigate the effective VCT parameters and duration of each session and number of sessions, considering progressive and deteriorative natural history of diabetes.

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Background: Balance dysfunction is one of the problems in diabetic patients so that peripheral neuropathy and decreased somatosensory sensitivity are the most important causes for it. One of the supposed theories for diabetic peripheral neuropathy is reduction in blood flow secondary to pathologies of peripheral neural arterioles. Intermittent Pneumatic Compression, regarding to its effect on vessels hemodynamics and perfusion improvements, has been considered in recent years. The aim of this study is to evaluate the effects of this method on improvement of neuropathy signs and symptoms improvement in patients with type 2 Diabetes and neuropathy. Also, regarding to the role of neuropathy on balance impairment, other aim of this study is to investigate the effect of this method on improvement of dynamic balance in diabetic patients. Methods: This study is a clinical trial study. 39 patients with diabetes type 2 and neuropathy divided into intervention (20 patients) and control (19 patients) groups. The intervention group underwent 10 sessions of IPC treatment, with 45 minutes for each session and one day interval between them. Neuropathy severity changes (by Valk and Michigan Questionnaires), Proprioceptive sensation (assessed by Diapason), and balance (by Biodex system), were evaluated in both groups in first and final sessions. Results: Anterior-Posterior Stability Index and Overall Stability Index obtained from Biodex system in level 6 showed significant changes. Vibration sensation, and Valk and Michigan neuropathy questionnaires also showed significant improvements (P<0.05). Conclusion: This study showed that IPC treatment method has positive effects on improvement of neuropathy severity, Vibration sensation and dynamic stability (Biodex).

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Background: One of the most common complications of Diabetic Polyneuropathy (DPN) is decreased balance and Postural Control disorder. Balance has an important role in static and dynamic activities as a base of activities of daily living. The objective of this study was the evaluation and comparison of dynamic and functional balance in patients with DPN and healthy subjects.

Methods: In this study, dynamic and functional balance of 11diabetic patients with DPN (detected by Michigan questionnaire) and 11 healthy subjects were evaluated by Biodex Balance System (BBS) and Tandem Stance (TS) test in open and closed eyes conditions. The participants were matched by age and BMI. An independent t-test was used to compare balance parameters between patient and normal group. Furthermore, the correlation between dynamic balance parameters of BBS and TS tests were calculated using the Pearson’s Correlation Coefficient.

Results: The results of BBS in patients with diabetic peripheral neuropathy were significantly higher than normal subjects (P<0.05). The mean of time of TS test in diabetic group was significantly lower than healthy subjects (P<0.05). Also there was a significant (P=0.004) negative (r = 0.794) correlation between Medio-Lateral stability index (recorded from BBS) and TS with open eye, in diabetes group.

Conclusion: Older adults with DPN have an impaired functional balance in comparison with matched control subjects and this may expose the patients to danger of falling during daily activities.