Nerve conduction study of sensory distal nerves in mild diabetic foot neuropathy

Nerve conduction studies of distal sensory nerves are used in diagnosis of polyneuropathy. However at present, there is little data about electrophysiological assessment of these nerves according to severity of polyneuropathy. In this study, we aimed to evaluate sural, dorsal sural and medial plantar nerve conduction studies in different grades of mild diabetic sensory polyneuropathy. Twenty diabetic patients with mild degree of sensory polyneuropathy according to neuropathy disability score, and 20 healthy subjects served as control group were included in this study. In all subjects, motor nerve conduction of posterior tibial nerve, F wave, and sensory nerve conduction of sural, dorsal sural and medial plantar nerves were performed bilaterally. There was a significant statistical reduction in the sural, dorsal sural and medial plantar nerves amplitude with a reduction in the conduction velocities and delay in peak latencies of these nerves between diabetic patients and controls. The sensitivity of medial plantar nerve amplitude was 90%. However, dorsal sural nerve amplitude showed a significant reduction with different grades of diabetic polyneuropathy [p<0.05]. Medial plantar nerve has the highest diagnostic sensitivity. Dorsal sural nerve may be used in following up progression in mild diabetic sensory polyneuropathy

Quantitative assessment of rehabilitation results in peripheral arterial disease

Peripheral arterial disease [PAD] patients are commonly classified on the basis of subjective evaluations of pain and fatigue. It could he important to have, at least, an objective measurement ofJƒtigue for better evaluation of muscle performance and exercise tolerance in such patients as well as for serial quantitative assessment of different vascular rehabilitation programs designed for claudications. Median frequency [MDF] analysis has been recently used to monitor electromyo graphic [EMG] power spectrum shift toward lower frequencies due to muscle fati gue. Twenty-five PAD patients and ten control subjects matched for age and sex were studied. Surface EMO was recorded over the medial gastrocnemius muscle along 40 seconds at maximal voluntaty contraction. The median frequency of the electromyoraphic power spectrum was calculated in the first 10 seconds [TO] and the last 10 seconds [T1]. Change from TO to T1 was statistically calculated and considered as the fatigue index [FI]. EMG reassessment was done for the patients' group after completing a physical training program. Significantly lower initial Ti values, compared with initial TO, were found in both the PAD and the control groups. A highly significant difference was documented regarding all the initial MDF parameters between the patient and control groups. Moreover, a highly significant difference was recorded between the initial and the post-rehabilitation FI in the patients' group. EMG frequency analysis can be considered an easy, painless, practical and reproducible method which has a high degree of precision and accuracy in providing objective information on the muscle performance and fatigue in PAD patients