Effect of surgical decompression of nerves in the lower extremity in patients with painful diabetic polyneuropathy on stability: a randomized controlled trial

• Published in: Clinical rehabilitation Vol. 29; no. 10; pp. 994 - 1001
• Main Authors: Macaré van Maurik, Joanne FM, ter Horst, Britt, van Hal, Mireille, Kon, Moshe, Peters, Edgar JG
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.10.2015; Sage Publications Ltd
• Subjects: Ankle; Clinical trials; Decompression, Surgical; Diabetes; Diabetic Neuropathies - surgery; Diabetic neuropathy; Female; Humans; Lower Extremity - innervation; Lower Extremity - surgery; Male; Medical research; Middle Aged; Nerve Compression Syndromes - etiology; Nerve Compression Syndromes - surgery; Netherlands; Outcome Assessment (Health Care); Pain; Patients; Plastic surgery; Postural Balance - physiology; Ulcers; Netherlands; Diabetic polyneuropathy; nerve decompression; postural balance; diabetes mellitus; stability; surgery
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1177/0269215514556298

Objective: To investigate the effect of decompression of nerves in the lower extremity in patients with painful diabetic polyneuropathy on static balance using a sensitive pressure mat system. Design: Non-blinded randomized controlled trial. Setting: Single center study performed at the University Medical Center Utrecht between 2010-2013. Subjects: Patients with painful diabetic polyneuropathy assessed with the Diabetic Neuropathy Symptom score and Diabetic Neuropathy Examination between 18-90 years. Exclusion criteria were: physical problems leading to instability, BMI>35 kg/m2, ankle fractures in history, amputations proximal to the tarsometatarsal joints, active foot ulcer(s), severe occlusive peripheral vascular diseases. Intervention: Unilateral surgical nerve decompression at four sites in the lower extremity, the contralateral limb was used as control (within-patient comparison), with one year follow-up. Main measures: Preoperatively and 6 and 12 months postoperatively, weight bearing and five variables of sway of the center of pressure were measured with a pressure mat with eyes open and eyes closed. T-test was used for evaluation of postoperative results. Results: Thirty-nine Patients met inclusion criteria and were enrolled for stability testing. Postoperatively no significant differences for sway variables and weight bearing were seen compared to preoperatively measurements. Conclusions: There is no evidence that surgical decompression of nerves of the lower extremity influences stability within one year after surgery in patients with painful diabetic polyneuropathy.