UTICAJ TERAPIJE LASEROM MALE SNAGE NA PRAG PROSTORNE PERCEPCIJE I ELEKTRONEUROGRAFSKI NALAZ BOLESNIKA SA DIJABETIČKOM POLINEUROPATIJOM

Abstract

Introduction Low-intensity laser therapy (LILT) can be applied in cases when patients with diabetic polyneuropathy (DPN) suffer from chronic severe neuropathic pain.

Objective We wanted to analyse influence of LILT on spatial perception threshold (SPT) and electroneurographic (ENG) parameters in patients with painful DPN.

Method We analysed 45 patients (25 males), average age 54.3 years (54.3±10.9), with clinical and ENG signs of painful DPN. The patients were divided into two groups: A and B. Group A consisted of 30 patients with DPN who had 30 LILT treatments over the period of 12 weeks and group B consisted of 15 patients with DPN who received only vitamin therapy per os within the same period. Prior to and after 12 weeks of treatment, the following ENG parameters were determined using surface electrodes: motor (MCV) and sensory conduction velocities (SCV) values (in m/s) of nervus (n.) peroneus (NP), n. tibialis (NT) and n. medianus (NM) and their motor distal latency (MDL) values (in ms). SPT value (score as number from 1 to 8) was determined with Tactile Circumferential Discriminator on dorsal part of foot’s big toe skin. For statistical analysis, we used Student’s t-test and Pearson correlation (sig. 2 tailed) study.

Results We registered statistically significant difference between SPT (p<0.01) values prior to (5.25±1.11) and after (4.87±0.90) LILT, as well as NMMCV (p<0.05) values prior to (47.18±5.08) and after (49.12±3.72) LILT. Besides, we registered, only after LILT, statistically significant correlation beetwen SPT and NMDML (p<0.01) values and also beetwen SPT and NMSCV (p<0.05) values. The differences and correlations beetwen other analysed parameters before and after treatments were not significant (p>0.05).

Conclusion In this study we registered significant decrease of SPT and increase of NMMCV after LILT and that indicated a favourable effect of this treatment in analysed patients with painful DPN. In our opinion these results need further investigation.

Keywords: laser therapy; low intensity; spatial perception threshold; electroneurography; diabetic polyneuropathy