Educational Forum with Clinical Studies Current Science and Research

O B J E C T I V E— To evaluate the efficacy of combining electrotherapy with amitriptyline for the management of chronic painful peripheral neuropathy in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS— Patients (n = 26) with peripheral neuro p athy were treated with amitriptyline. After 4 weeks, those patients (n = 23) who failed to re s p o n d to amitriptyline or who only had partial relief were randomized between a sham tre a t m e n t g roup (control) or an electrotherapy group. Transcutaneous electrotherapy was given for 12 weeks by a portable unit (H-wave machine) that generated a biphasic exponentially decaying w a v e f o rm (pulse width 4 ms, 25–35 V, 2 Hz). The degree of pain and discomfort was graded on a scale of 0–5. An analog scale was used to re c o rd the overall change in symptoms.
R E S U LT S— Amitriptyline produced some degree of symptomatic relief in 15 (60%) of the 26 patients by the 4th week; pain scores decreased from 3.8 ± 0.1 to 2.9 ± 0.2 (P 0.1) and the overall reduction in pain was 26 ± 5% on an analog scale. In the amitriptyline plus sham treatment group (n = 9), pain scores declined from 2.8 ± 0.3 to 1.9 ± 0.5 (P 0.03) and the overall reduction in pain was 55 ± 12%, suggesting a pro c e d u re – related placebo effect. In the group receiving combined electrotherapy and amitriptyline (n = 14), symptomatic impro v ement occurred in 12 (85%) patients. Five (36%) of the patients in this group became asymptomatic. Pain scores declined from 3.2 ± 0.2 to 1.4 ± 0.4 (P 0.01) and the overall re d u c t i o n in pain was 66 ± 10%. The degree of reduction in pain scores and the incremental relief (above the amitriptyline effect) were significantly greater (P 0.03) with electrotherapy as compare d with sham treatment. The outcomes indicate a substantial beneficial effect of electro t h e r a p y over and above any placebo influ e n c e . C O N C L U S I O N S— Our clinical observations suggest that transcutaneous electrotherapy is effective in reducing the pain associated with peripheral neuro p a t h y. This form of therapy may be a useful adjunctive modality when it is combined with a pharmacological agent, such as amitriptyline, to augment symptomatic re l i e f .

Xanya Sofra Weiss

Xanya Sofra Weiss

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Xanya Sofra Weiss

Xanya Sofra Weiss

Sang Youl Rhee, Suk Chon, Gwanpyo Koh, Jeong Ryung Paeng, Seungjoon Oh, Jeong-taek Woo, Sung Woon Kim, Jin-Woo Kim, and Young Seol Kim

Currently finger pricking is the common method of blood glucose measurement in patients with diabetes mellitus. However, diabetes patients have proven to be reluctant to check their glucose profiles regularly because of the discomfort associated with this technique. Recently, a non-invasive and continuous Reverse
Iontophoresis based Glucose Monitoring Device (RIGMD) was developed in Korea. The study was conducted during the period November 2003-January 2004 on 19 in-patients. Glucose measurements were performed using RIGMD between 10 a.m. and 4 p.m. Concurrent plasma glucose levels were checked hourly and subsequently compared with RIGMD data. The mean error of RIGMD measurements was -3.45±52.99 mg/dL with a mean absolute relative error of 20±15.16%. Measurements obtained by RIGMD were correlated with plasma glucose levels (correlation coefficient; 0.784 (p<0.05))>

Xanya Sofra Weiss

Xanya Sofra Weiss

Carolyn R. McMakin, M.A.,D.C.; 2004

Chronic low back pain associated with myofascial trigger point activity has been historically refractory to conventional treatment (Pain Research and Manage- ment7 (2002) 81) . In this case series study,an analysis of 22 patients with chronic low back pain, of 8.8 years average duration, is presented. Following treatment with frequency-specific microcurrent, astatistically significant 3.8-fold reduction in pain intensity was observed using a visual analog scale.This outcome was achieved over an average treatment period of 5.6 weeks and a visit frequency of one treatment per week. When pain chronicity exceeded 5 years, there was a trendtoward increasing frequency of treatment required to achieve the same magnitude of pain relief. In 90%of these patients, other treatment modalities including drug therapy, chiropractic manipulation, physical therapy, naturopathic treatment and acupuncture had failed to produce equivalent benefits.The microcurrent treatment was the single factor contributing the most consistent difference in patient-reported pain relief. These results support the observation that rigorously designed clinical investigations are warranted.

Xanya Sofra Weiss

Xanya Sofra Weiss