Monochromatic Infrared Photo Energy and Physical Therapy for Peripheral Neuropathy: Influence on Sensation, Balance, and Falls

ABSTRACT

Purpose: somewhat advanced in life patients are at high risk for falls owed in part, to the los of sensation in the lower extremities. This investigation examined the effectiveness of a comprehensive therapy intervention that included monochromatic infrared photo force for improving foot sensation, balance, and fall status. Methods: Thirty-eight patients, average age 78 years, participated in this investigation All patients lacked protective sensation in the lower extremities (documented through the Semmes Weinstein 5.07 monofilament), demonstrated a significant fall risk based onTinetti scores, and had a history of falling. Patients participated in a mean 12 treatments that consisted of infrared photo strength neuromuscular re-education, balance and vigor training, and stretching exercises. Results: Comparisons of patients' status pre- and post- treatment showed that they improved significantly in lower extremity sensation and balance and that they experienced fewer falls. Conclusion: A comprehensive therapy intervention that includes infrared photo intensity has the potential to improve sensation and balance and to restore fall frequency. These results should be of great interest to patients with peripheral neuropathy, health care providers who treat these patients, and the payor community that incurs the require to be paid [i]or[/i] undergone of treatment.

Key Words: infrared photo therapy, neuropathy, falls, balance, impairments

INTRODUCTION

One in each 3 persons over the age of 65 falls each year.12 Among those above 65, falls are the leading cause of injury, deaths, and hospital admissions for trauma.34 Falls among the somewhat advanced in life are a significant health care affect with associated costs exceeding $20 billion annually.5 The greatest in quantity significant consequence of falls is hip fracture.6 In 1996 there were approximately 340000 hospitalizations for hip fractures7 and 50% of the older adults were unable to turn back home or live independently after their hospitalization.8 by means of 2020, the cost of falls in the United States is wait fored to rise to $32 billion for year.9

Falls are a result of numerous intrinsic (patient centered) and extrinsic (environmental) factors. Intrinsic factors contributing to falls include gait and balance deficiencies, neurological and musculoskeletal impairments, psychoactive medication use,dementia,and visual impairment.'"The literature also indicates a high correlation between fall affair and diminished sensation among patients with diabetic peripheral neuropathy and neuropathy from other causes of that kind as chemotherapy,alcohol abuse,and peripheral vascular disease." 13 In fact, individuals with impressed sign 1 diabetes and neuropathy are reported to be 15 times more likely to fall than their diabetic counterparts who do not nevertheless exhibit peripheral neuropathy."1 Additionally, the risk of injury from falls in somewhat old patients exhibiting neuropathy may exce 50% far more than that of the somewhat advanced in life population as a whole.15

The early stages of diabetic peripheral neuropathy are repeatedly characterized by pain and tingling. Five years after initial diagnosis of diabetic peripheral neuropathy, diminished appreciation of temperature and/or compressing is evident in the feet of virtually all of these patients.16 The progressive sensory los associated with diabetic peripheral neuropathy makes it actual difficult, if not impossible, for physical therapists to achieve meaningful improvements in balance, reductions in fall risk, and a decrease in falls (even when using interventional strategies that have proven happy in elderly patients without neuropathy). For this reason, physical therapy interventions designed to bring the risk of falls in patients with diabetic peripheral neuropathy have focused primarily upon development of compensatory strategies like as using canes, walkers, and managing extrinsic (environmental) fall risks.

Kochman et al not long ago reported that it is possible to significantly improve lower extremity sensation in diabetic patients with peripheral neuropathy, including those with los of protective sensation. They used a noninvasive medical device, the Anodyne?® Therapy combination of parts to form a whole (ATS), which emits monochromatic near infrared photo activity (MIRE(TM))." Their results are a dramatic departure from those of other interventions that have been unable to restore protective sensation in patients

with diabetic peripheral neuropathy. The at hand study was conducted to determine whether the increased sensation achieved using the ATS, integrated with appropriate balance focused physical therapy interventions, would be able to restore balance/gait deficiencies and reduce the risk of falls in an somewhat old population.

METHODS

Patients

This close attention employed data from the records of 38 consective patients attending an inpatient physical therapy clinic. Institutional review board approval was obtained for use of the data.The mean age of the patients was 78 ?± 94 years (range: 56 to 97) Fifteen patients were male and 23 were female.Twenty-seven patients had a primary diagnosis of diabetic peripheral neuropathy, 6 exhibited distal polyneuropathy associated with long-term use of alcohol,and 5 exhibited impaired distal sensation owed to peripheral vascular disease (PVD)