Influence Of Hyperbaric Oxygen Therapy On Sensorimotor Functions In Diabetic Peripheral Neuropathy: A controlled randomized trial.

ELSHINNAWY, AHMED M.; WADEE, AMIR N.; FAHMY, SIHAM M.; TAWFICK, AHMED M.

Background: Diabetic peripheral neuropathy progresses with decreased nerve functionality both sensory and motor, leads to high morbidity, mortality, and worsening of the quality of life of patients and their caregivers. Subjects and methods: 42 patients, suffered from diabetic peripheral neuropathy (DPN), assigned randomly into group A (the study group) received 10 sessions of hyperbaric oxygen therapy, breathing 100% of pure oxygen for 60 minutes under 2.5 ATA, in addition to the traditional medical treatment, and group B (the control group) received the traditional medical treatment only. Sensory and motor distal latencies, amplitudes, and nerve conduction velocities were evaluated at the beginning and after two weeks of the study for the sural and peroneal nerves using electromyography (EMG), and patients answered the Arabic Michigan Neuropathy Questionnaire (MNQ) for DPN. Results: The within-group comparisons of the distal latencies showed insignificant decrease in all motor latencies and sensory latencies in group B, while significant decrease of all sensory latencies in group A and only the sensory latencies of left side in group B (P-value= 0.16, 0.32, 0.1, 0.17, 0.004, 0.006, 0.008, and 0.006 in group A, while 0.83, 0.88, 0.12, 0.84, 0.28, 0.71, 0.003 and 0.01 in group B). The within-group comparisons of amplitudes showed insignificant increases in all motor amplitudes and all sensory amplitudes in group B except the stimulating site sole of the left foot. All the sensory amplitudes in group A were significantly increased except the stimulating site head of the left fibula in group A (P-value= 0.56, 0.74, 0.38, 0.66, 0.02, 0.048, 0.04, and 0.15 in group A, while 0.9, 0.44, 0.6, 0.95, and 0.15 in group B). The within-group comparisons of NCV showed an insignificant increase in all motor NCV except the NCV at the stimulating site sole of both right and left feet in group A. There was a significant increase in all sensory NCV in group A. The sensory NCV of group B were insignificantly increased except the stimulating site sole of left foot (P-value= 0.02, 0.13, 0.03, 0.14, 0.0001, 0.01, 0.0001, and 0.0001 in group A, while 0.48, 0.36, 0.72, 0.76, 0.21, 0.17, 0.0001 and 0.08 in group B). The within-group comparisons of MNQ showed a significant decrease in group A, while an insignificant decrease in group B (P-value= 0.0001 and 0.8 respectively). Discussion and Conclusion: Adding HBOT induced oxidative stress and endogenous opioid peptides producing an analgesic effect. Adding HBOT produced therapeutic improved the PDN other than depending only on traditional medical treatment.

HYPERBARIC oxygenation; DIABETIC neuropathies; RANDOMIZED controlled trials; FOOT; OPIOID peptides; PERONEAL nerve; NEURAL conduction

International Journal of Pharmaceutical Research (09752366), 2021, Vol 13, Issue 1, p5286

0975-2366

Academic Journal

10.31838/ijpr/2021.13.01.705