Clinical Parameters Response to Low-Level Laser versus Monochromatic Near-Infrared Photo Energy in Diabetic Patients with Peripheral Neuropathy
Background: Diabetic sensorimotor polyneuropathy
(DSP) is one of the most common microvascular complications of
type 2 diabetes. Loss of sensation is thought to contribute to a lack of
static and dynamic stability and increased risk of falling. Purpose:
The purpose of this study was to compare the effects of low-level
laser (LLL) and monochromatic near-infrared photo energy (MIRE)
on pain, cutaneous sensation, static stability, and index of lower limb
blood flow in diabetic patients with peripheral neuropathy. Methods:
Forty diabetic patients with peripheral neuropathy were recruited for
participation in this study. They were divided into two groups: The
MIRE group, which contained 20 patients, and the LLL group, which
contained 20 patients. All patients who participated in the study had
been subjected to various physical assessment procedures, including
pain, cutaneous sensation, Doppler flow meter, and static stability
assessments. The baseline measurements were followed by treatment
sessions that were conducted twice a week for six successive weeks.
Results: The statistical analysis of the data revealed significant
improvement of pain in both groups, with significant improvement in
cutaneous sensation and static balance in the MIRE group compared
to the LLL group; on the other hand, the results showed no
significant differences in lower limb blood flow between the groups.
Conclusion: LLL and MIRE can improve painful symptoms in
patients with diabetic neuropathy. On the other hand, MIRE is also
useful in improving cutaneous sensation and static stability in
patients with diabetic neuropathy.
[1] M. Harris, R. C. Eastman. “Symptoms of sensory neuropathy in adult
with NIDDM in the US. Population”. Diabetes Care, vol.16, pp.1446-
1452, 1993.
[2] R. A. Boulton AJ, Malik, J. C. Arezzo, “Diabetic somatic neuropathy”.
Diabetes Care, vol. 27, pp. 1458-1486, 2004.
[3] M. Tavakoli, M. Mojaddidi, H. Fadavi, R.A. Malik, “Pathophysioloy
and treatment of painful diabetic neuropathy”. Curr Pain Headache Rep,
vol. 12 (3), pp. 192–197, 2008.
[4] M. Pfeifer, D. R. Ross, J. A. Schrage, D. A. Gelber, M.P. Schumer,
Crain GM, Markwell SJ, Juns S, “A highly successful and novel model
for treatment of chronic painful diabetic peripheral neuropathy”.
Diabetes Care. vol. 16, pp. 1103–1115, 1993.
[5] The Capsaicin Study Group, “Treatment of painful diabetic neuropathy
with topical capsaicin: a multicenter”, double-blind, vehicle-controlled
study. Arch Intern Med. vol. 151, pp.2225–2229, 1991
[6] L. B. Harkless, S. De Lellis.”Improved foot sensitivity and pain
reduction in patients with peripheral neuropathy after treatment with
monochromatic infrared photo energy–MIRE”. J Diabetes
Complications. vol. 20, pp.87-81, 2006. [7] D. A. Arnall, A. G. Nelson, L. Lopez, N. Sanz, L. Iversen, I. Sanz, L.
Stambaugh, S.B. Arnall. “The restorative effects of pulsed infrared light
therapy on significant loss of peripheral protective sensation in patients
with long-term type 1 and type 2 diabetes mellitus”. Acta Diabetol .vol.
43, pp.26 –33, 2006.
[8] Lorneh. Z, Mylanngo. NG, Khint. N. “Low-Intensity Laser Therapy for
Painful Symptoms of Diabetic Sensorimotor Polyneuropathy”. Diabetes
Care. vol.27, pp.921–924, 2004
[9] Andrew J. M. Boulton, David G. Armstrong, Stephen F. Albert.
“Comprehensive Foot Examination and Risk Assessment; Report of the
Task Force of the Foot Care Interest Group of the American Diabetes
Association, with endorsement by the American Association of Clinical
Endocrinologists. Diabetes Care. Vol. 31(8), pp. 1679–1685, 2008.
[10] Monti Bragadin M1, Francini L, Bellone E, Grandis M, Reni L, Canneva
S, Gemelli C, Ursino G, Maggi G, Mori L, Schenone A. “Tinetti and
Berg balance scales correlate with disability in hereditary peripheral
neuropathies: a preliminary study” Eur J PhysRehabil Med. 2014 Dec
10. (Epub ahead of print)
[11] F. Flandry, J. P. Hunt, G. C. Terry, J. C. “Hughston Analysis of
subjective knee complaints using visual analog scale”. American Journal
of Sports Medicine. Vol. 19, pp. 112–118, 1991.
[12] E. J. Gallagher, P. E. Bijur, C. Latimer, W. Silver, “Reliability and
validity of the visual analog scale for acute abdominal pain in the ED”
American Journal of Emergency Medicine. Vol. 20, pp. 287–290, 2002.
[13] E.J. Gallagher EJ, M. Libman M, P. E. Biju, “Prospective validation of
clinically important changes in pain severity measured on a visual
analog scale”. Ann Emerg Med .vol.38, pp.633-38, 2001.
[14] S. Pace, T.F. Burke. “TF: Intravenous morphine for early pain relief in
patients with acute abdominal pain”. AcadEmerg Med. Vol.3, pp. 1086 -
1092,1996
[15] S. L. DeLellis, D. H. Carnegie, T. J. Burke. “Improved sensitivity in
patients with peripheral neuropathy: effects of monochromatic infrared
photo energy”. J Am Podiatr Med Assoc. vol. 95, pp. 143–147, 2005.
[16] J. K. Clifft JK, R. J. Kasser RJ, T. S. Newton TS, A. J. Bush, “The effect
of monochromatic infrared energy on sensation in patients with diabetic
peripheral neuropathy: a double-blind, placebo-controlled study”,
Diabetes Care. Vol. 28, pp. 2896–900, 2005.
[17] Z. Peric, B. Cvetkovic, “Electrophysiological Evaluation of Low-
Intensity Laser Therapy in Patients with Diabetic Polyneuropathy”, Med
Biol. vol.13(1), pp. 11-1, 2006
[18] Z. Peric, B. “Influence of low-intensity laser therapy on spatial
perception threshold and electroneurographic finding in patients with
diabetic polyneuropathy” SrpArhCelokLek. vol. 135, pp.257-263, 2007.
[19] L. A. Lavery, D. P. Murdoch, J. Williams, and D. C. Lavery, “Does
anodyne light therapy improve peripheral neuropathy in diabetes? A
double-blind, sham-controlled, randomized trial to evaluate
monochromatic infrared photoenergy” .Diabetes Care, vol. 31(2), pp.
316–321, 2008
[20] D. R. Leonard., M. H. Farooqi, S. Myers, “Restoration of Sensation,
Reduced Pain, and Improved Balance in Subjects with Diabetic
Peripheral Neuropathy: A Double- Blind, Randomized, Placebo-
Controlled Study with Monochromatic Near-Infrared Treatment”,
Diabetes Care. Vol. 27(1), pp. 168–172, 2004.
[1] M. Harris, R. C. Eastman. “Symptoms of sensory neuropathy in adult
with NIDDM in the US. Population”. Diabetes Care, vol.16, pp.1446-
1452, 1993.
[2] R. A. Boulton AJ, Malik, J. C. Arezzo, “Diabetic somatic neuropathy”.
Diabetes Care, vol. 27, pp. 1458-1486, 2004.
[3] M. Tavakoli, M. Mojaddidi, H. Fadavi, R.A. Malik, “Pathophysioloy
and treatment of painful diabetic neuropathy”. Curr Pain Headache Rep,
vol. 12 (3), pp. 192–197, 2008.
[4] M. Pfeifer, D. R. Ross, J. A. Schrage, D. A. Gelber, M.P. Schumer,
Crain GM, Markwell SJ, Juns S, “A highly successful and novel model
for treatment of chronic painful diabetic peripheral neuropathy”.
Diabetes Care. vol. 16, pp. 1103–1115, 1993.
[5] The Capsaicin Study Group, “Treatment of painful diabetic neuropathy
with topical capsaicin: a multicenter”, double-blind, vehicle-controlled
study. Arch Intern Med. vol. 151, pp.2225–2229, 1991
[6] L. B. Harkless, S. De Lellis.”Improved foot sensitivity and pain
reduction in patients with peripheral neuropathy after treatment with
monochromatic infrared photo energy–MIRE”. J Diabetes
Complications. vol. 20, pp.87-81, 2006. [7] D. A. Arnall, A. G. Nelson, L. Lopez, N. Sanz, L. Iversen, I. Sanz, L.
Stambaugh, S.B. Arnall. “The restorative effects of pulsed infrared light
therapy on significant loss of peripheral protective sensation in patients
with long-term type 1 and type 2 diabetes mellitus”. Acta Diabetol .vol.
43, pp.26 –33, 2006.
[8] Lorneh. Z, Mylanngo. NG, Khint. N. “Low-Intensity Laser Therapy for
Painful Symptoms of Diabetic Sensorimotor Polyneuropathy”. Diabetes
Care. vol.27, pp.921–924, 2004
[9] Andrew J. M. Boulton, David G. Armstrong, Stephen F. Albert.
“Comprehensive Foot Examination and Risk Assessment; Report of the
Task Force of the Foot Care Interest Group of the American Diabetes
Association, with endorsement by the American Association of Clinical
Endocrinologists. Diabetes Care. Vol. 31(8), pp. 1679–1685, 2008.
[10] Monti Bragadin M1, Francini L, Bellone E, Grandis M, Reni L, Canneva
S, Gemelli C, Ursino G, Maggi G, Mori L, Schenone A. “Tinetti and
Berg balance scales correlate with disability in hereditary peripheral
neuropathies: a preliminary study” Eur J PhysRehabil Med. 2014 Dec
10. (Epub ahead of print)
[11] F. Flandry, J. P. Hunt, G. C. Terry, J. C. “Hughston Analysis of
subjective knee complaints using visual analog scale”. American Journal
of Sports Medicine. Vol. 19, pp. 112–118, 1991.
[12] E. J. Gallagher, P. E. Bijur, C. Latimer, W. Silver, “Reliability and
validity of the visual analog scale for acute abdominal pain in the ED”
American Journal of Emergency Medicine. Vol. 20, pp. 287–290, 2002.
[13] E.J. Gallagher EJ, M. Libman M, P. E. Biju, “Prospective validation of
clinically important changes in pain severity measured on a visual
analog scale”. Ann Emerg Med .vol.38, pp.633-38, 2001.
[14] S. Pace, T.F. Burke. “TF: Intravenous morphine for early pain relief in
patients with acute abdominal pain”. AcadEmerg Med. Vol.3, pp. 1086 -
1092,1996
[15] S. L. DeLellis, D. H. Carnegie, T. J. Burke. “Improved sensitivity in
patients with peripheral neuropathy: effects of monochromatic infrared
photo energy”. J Am Podiatr Med Assoc. vol. 95, pp. 143–147, 2005.
[16] J. K. Clifft JK, R. J. Kasser RJ, T. S. Newton TS, A. J. Bush, “The effect
of monochromatic infrared energy on sensation in patients with diabetic
peripheral neuropathy: a double-blind, placebo-controlled study”,
Diabetes Care. Vol. 28, pp. 2896–900, 2005.
[17] Z. Peric, B. Cvetkovic, “Electrophysiological Evaluation of Low-
Intensity Laser Therapy in Patients with Diabetic Polyneuropathy”, Med
Biol. vol.13(1), pp. 11-1, 2006
[18] Z. Peric, B. “Influence of low-intensity laser therapy on spatial
perception threshold and electroneurographic finding in patients with
diabetic polyneuropathy” SrpArhCelokLek. vol. 135, pp.257-263, 2007.
[19] L. A. Lavery, D. P. Murdoch, J. Williams, and D. C. Lavery, “Does
anodyne light therapy improve peripheral neuropathy in diabetes? A
double-blind, sham-controlled, randomized trial to evaluate
monochromatic infrared photoenergy” .Diabetes Care, vol. 31(2), pp.
316–321, 2008
[20] D. R. Leonard., M. H. Farooqi, S. Myers, “Restoration of Sensation,
Reduced Pain, and Improved Balance in Subjects with Diabetic
Peripheral Neuropathy: A Double- Blind, Randomized, Placebo-
Controlled Study with Monochromatic Near-Infrared Treatment”,
Diabetes Care. Vol. 27(1), pp. 168–172, 2004.
@article{"International Journal of Medical, Medicine and Health Sciences:70834", author = "Abeer A. Abdelhamed", title = "Clinical Parameters Response to Low-Level Laser versus Monochromatic Near-Infrared Photo Energy in Diabetic Patients with Peripheral Neuropathy", abstract = "Background: Diabetic sensorimotor polyneuropathy
(DSP) is one of the most common microvascular complications of
type 2 diabetes. Loss of sensation is thought to contribute to a lack of
static and dynamic stability and increased risk of falling. Purpose:
The purpose of this study was to compare the effects of low-level
laser (LLL) and monochromatic near-infrared photo energy (MIRE)
on pain, cutaneous sensation, static stability, and index of lower limb
blood flow in diabetic patients with peripheral neuropathy. Methods:
Forty diabetic patients with peripheral neuropathy were recruited for
participation in this study. They were divided into two groups: The
MIRE group, which contained 20 patients, and the LLL group, which
contained 20 patients. All patients who participated in the study had
been subjected to various physical assessment procedures, including
pain, cutaneous sensation, Doppler flow meter, and static stability
assessments. The baseline measurements were followed by treatment
sessions that were conducted twice a week for six successive weeks.
Results: The statistical analysis of the data revealed significant
improvement of pain in both groups, with significant improvement in
cutaneous sensation and static balance in the MIRE group compared
to the LLL group; on the other hand, the results showed no
significant differences in lower limb blood flow between the groups.
Conclusion: LLL and MIRE can improve painful symptoms in
patients with diabetic neuropathy. On the other hand, MIRE is also
useful in improving cutaneous sensation and static stability in
patients with diabetic neuropathy.", keywords = "Diabetic neuropathy, Doppler flow meter, –Lowlevel
laser, Monochromatic near-infrared photo energy.", volume = "9", number = "7", pages = "569-4", }
