Direct Current Neuromuscular Electrical Stimulation for Treatment of Peripheral Neuropathy

NCT ID: NCT05442021

Last Updated: 2023-05-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

148 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-01

Study Completion Date

2023-05-20

Brief Summary

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This study will compare two methods of electrical stimulation (alternating current and direct current) as an adjunctive therapy to treating peripheral neuropathy. Both types of electrical stimulation have been used in clinical practice for physical therapy, however direct current stimulation is much less common and there is less known about their impact on physical therapy outcomes. The aim of this project is to show the efficacy of a novel device, the Neubie direct current device, compared to traditional TENS unit, in clinical physical therapy treatment of neuropathy. Outcomes measured will include three methods of two-point discrimination, vibration sense, pain, and score on the modified Toronto Clinical Neuropathy scale.

Detailed Description

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To determine the efficacy of direct current electrical stimulation (the Neubie device) on long-term symptoms and severity of neuropathy, participants will enroll in a 6-week treatment regimen at one of 9 Hands On Physical Therapy associated clinic sites listed included in application. The first session will consist of an EMG/NCS evaluation to determine severity of neuropathy and to rule out polyneuropathy, which will serve as baseline (and a within subject control) for the intervention.

Participants will then undergo a specialized neuropathy protocol that includes traditional PT therapy for neuropathy, as well as treatment with the Neubie (or traditional e-stim) both during PT exercises and as additional treatment after sessions. Subjects receive an evaluation session that includes an Electrodiagnostic Study, pain assessment, evaluation of two-point discrimination, and vibration sense.

The experimental group subjects follow with 12 sessions of physical therapy over a 6-week period which include: a 30-min foot bath session with the Neubie and 15-min of various physical therapy exercises.

The control group subjects follow with 12 sessions of physical therapy over a 6-week period which include: a 30-min footbath with TENS and 15-min of various physical therapy exercises.

At the end of the 12 sessions of treatment, subjects receive a final evaluation session that includes an Electrodiagnostic Study, pain assessment, evaluation of two-point discrimination, and vibration sense.

Participants will receive 12 treatments over 6 weeks. EMG/NCS and a neuropathy pain questionnaire will be measured at both the initial evaluation and at the completion of the final session, and will provide both quantitative and qualitative data on the severity of neuropathy symptoms.

Conditions

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Neuropathy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Study will be divided into two randomly assigned groups - control and experimental. Control group will receive traditional e-stim treatment with TENS plus physical therapy. Experimental group will receive direct current e-stim treatment with the Neubie device plus physical therapy.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Outcomes will be assessed by clinicians at Hands on Diagnostics locations. Assessors will be blinded to which intervention participant has received.

Study Groups

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Neubie Direct Current Electrical Stimulation

The experimental group subjects follow with 12 sessions of physical therapy over a 6-week period which include: a 30-min foot bath session using the Neubie and 15-min of various physical therapy exercises.

Group Type EXPERIMENTAL

Neubie Direct Current Electrical Stimulation Device

Intervention Type DEVICE

Direct Current Electrical Stimulation Device that uses electrodes non-invasively on the skin to stimulate muscle fibers.

Transcutaneous Electrical Nerve Stimulation

The control group subjects follow with 12 sessions of physical therapy over a 6-week period which include: a 30-min footbath with TENS and 15-min of various physical therapy exercises.

Group Type OTHER

TENS

Intervention Type DEVICE

Transcutaneous Electrical Nerve Stimulation device - uses alternating current delivered through electrodes on the skin.

Interventions

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Neubie Direct Current Electrical Stimulation Device

Direct Current Electrical Stimulation Device that uses electrodes non-invasively on the skin to stimulate muscle fibers.

Intervention Type DEVICE

TENS

Transcutaneous Electrical Nerve Stimulation device - uses alternating current delivered through electrodes on the skin.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Must have a minimum score of 1 on the modified Toronto Clinical Neuropathy Score
* Must be able to attend weekly sessions for the 6 week period of the study (no extended travel)
* Must be at least 18 years old.

Exclusion Criteria

* Currently pregnant
* Cardiac pacemaker
* Active or recent cancer in the lower limbs
* Active or recent blood clots in the lower limbs
* History of epilepsy
* No open wounds
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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NeuFit - Neurological Fitness and Education

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ramona von Leden, PhD

Role: STUDY_DIRECTOR

NeuFit - Neurological Fitness and Education

Locations

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APEX Physical Therapy

Cape Coral, Florida, United States

Site Status

Catalyst Physical Therapy

Clearwater, Florida, United States

Site Status

APEX Physical Therapy

Fort Myers, Florida, United States

Site Status

Diagnostic Solutions

Springfield, Kentucky, United States

Site Status

Hands-On Physical Therapy

Astoria, New York, United States

Site Status

Hands-On Physical Therapy of Queens Village

Queens Village, New York, United States

Site Status

Panetta Physical Therapy & Diagnostics

Ronkonkoma, New York, United States

Site Status

Courcier Physical Therapy

Edmond, Oklahoma, United States

Site Status

Spine & Rehab Specialists

El Paso, Texas, United States

Site Status

Active Fitness Physical Therapy

Oak Hill, West Virginia, United States

Site Status

Active Fitness Physical Therapy

Victor, West Virginia, United States

Site Status

Countries

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United States

References

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Snyder MJ, Gibbs LM, Lindsay TJ. Treating Painful Diabetic Peripheral Neuropathy: An Update. Am Fam Physician. 2016 Aug 1;94(3):227-34.

Reference Type BACKGROUND
PMID: 27479625 (View on PubMed)

Rogers LC, Andros G, Armstrong DG. Update from the Diabetic Foot Global Conference (DFCon) 2007. Int Wound J. 2007 Dec;4(4):295-7. doi: 10.1111/j.1742-481X.2007.00377.x. No abstract available.

Reference Type BACKGROUND
PMID: 18154623 (View on PubMed)

Thakral G, Kim PJ, LaFontaine J, Menzies R, Najafi B, Lavery LA. Electrical stimulation as an adjunctive treatment of painful and sensory diabetic neuropathy. J Diabetes Sci Technol. 2013 Sep 1;7(5):1202-9. doi: 10.1177/193229681300700510.

Reference Type BACKGROUND
PMID: 24124947 (View on PubMed)

Ziegler D. Treatment of diabetic polyneuropathy: Update 2006. Ann N Y Acad Sci. 2006 Nov;1084:250-66. doi: 10.1196/annals.1372.008.

Reference Type BACKGROUND
PMID: 17151306 (View on PubMed)

Sluka KA, Walsh D. Transcutaneous electrical nerve stimulation: basic science mechanisms and clinical effectiveness. J Pain. 2003 Apr;4(3):109-21. doi: 10.1054/jpai.2003.434.

Reference Type BACKGROUND
PMID: 14622708 (View on PubMed)

Peters EJ, Armstrong DG, Wunderlich RP, Bosma J, Stacpoole-Shea S, Lavery LA. The benefit of electrical stimulation to enhance perfusion in persons with diabetes mellitus. J Foot Ankle Surg. 1998 Sep-Oct;37(5):396-400; discussion 447-8. doi: 10.1016/s1067-2516(98)80048-3.

Reference Type BACKGROUND
PMID: 9798171 (View on PubMed)

Gilcreast DM, Stotts NA, Froelicher ES, Baker LL, Moss KM. Effect of electrical stimulation on foot skin perfusion in persons with or at risk for diabetic foot ulcers. Wound Repair Regen. 1998 Sep-Oct;6(5):434-41. doi: 10.1046/j.1524-475x.1998.60505.x.

Reference Type BACKGROUND
PMID: 9844163 (View on PubMed)

da Silva MP, Liebano RE, Rodrigues VA, Abla LE, Ferreira LM. Transcutaneous electrical nerve stimulation for pain relief after liposuction: a randomized controlled trial. Aesthetic Plast Surg. 2015 Apr;39(2):262-9. doi: 10.1007/s00266-015-0451-6. Epub 2015 Feb 10.

Reference Type BACKGROUND
PMID: 25665520 (View on PubMed)

Ordog GJ. Transcutaneous electrical nerve stimulation versus oral analgesic: a randomized double-blind controlled study in acute traumatic pain. Am J Emerg Med. 1987 Jan;5(1):6-10. doi: 10.1016/0735-6757(87)90281-6.

Reference Type BACKGROUND
PMID: 3545246 (View on PubMed)

Zhao M, Bai H, Wang E, Forrester JV, McCaig CD. Electrical stimulation directly induces pre-angiogenic responses in vascular endothelial cells by signaling through VEGF receptors. J Cell Sci. 2004 Jan 26;117(Pt 3):397-405. doi: 10.1242/jcs.00868. Epub 2003 Dec 16.

Reference Type BACKGROUND
PMID: 14679307 (View on PubMed)

Kanno S, Oda N, Abe M, Saito S, Hori K, Handa Y, Tabayashi K, Sato Y. Establishment of a simple and practical procedure applicable to therapeutic angiogenesis. Circulation. 1999 May 25;99(20):2682-7. doi: 10.1161/01.cir.99.20.2682.

Reference Type BACKGROUND
PMID: 10338463 (View on PubMed)

Reichstein L, Labrenz S, Ziegler D, Martin S. Effective treatment of symptomatic diabetic polyneuropathy by high-frequency external muscle stimulation. Diabetologia. 2005 May;48(5):824-8. doi: 10.1007/s00125-005-1728-0. Epub 2005 Apr 14.

Reference Type BACKGROUND
PMID: 15830180 (View on PubMed)

DeSantana JM, Walsh DM, Vance C, Rakel BA, Sluka KA. Effectiveness of transcutaneous electrical nerve stimulation for treatment of hyperalgesia and pain. Curr Rheumatol Rep. 2008 Dec;10(6):492-9. doi: 10.1007/s11926-008-0080-z.

Reference Type BACKGROUND
PMID: 19007541 (View on PubMed)

Doucet BM, Griffin L. High-versus low-frequency stimulation effects on fine motor control in chronic hemiplegia: a pilot study. Top Stroke Rehabil. 2013 Jul-Aug;20(4):299-307. doi: 10.1310/tsr2004-299.

Reference Type BACKGROUND
PMID: 23893829 (View on PubMed)

Najafi B, Talal TK, Grewal GS, Menzies R, Armstrong DG, Lavery LA. Using Plantar Electrical Stimulation to Improve Postural Balance and Plantar Sensation Among Patients With Diabetic Peripheral Neuropathy: A Randomized Double Blinded Study. J Diabetes Sci Technol. 2017 Jul;11(4):693-701. doi: 10.1177/1932296817695338. Epub 2017 Feb 1.

Reference Type BACKGROUND
PMID: 28627217 (View on PubMed)

Chandrasekaran S, Davis J, Bersch I, Goldberg G, Gorgey AS. Electrical stimulation and denervated muscles after spinal cord injury. Neural Regen Res. 2020 Aug;15(8):1397-1407. doi: 10.4103/1673-5374.274326.

Reference Type BACKGROUND
PMID: 31997798 (View on PubMed)

Zehr EP, Collins DF, Chua R. Human interlimb reflexes evoked by electrical stimulation of cutaneous nerves innervating the hand and foot. Exp Brain Res. 2001 Oct;140(4):495-504. doi: 10.1007/s002210100857.

Reference Type BACKGROUND
PMID: 11685403 (View on PubMed)

Yang, Z. et al. Scoring systems to screen for diabetic peripheral neuropathy. (Cochrane Database Syst Rev. 2018 Jul 30;2018(7):CD010974. doi: 10.1002/14651858.CD010974.pub2. eCollection 2018 Jul.).

Reference Type RESULT

Kostopoulos D, Rizopoulos K, McGilvrey J, Hauskey J, Courcier J, Connor-Israel K, Koster H, von Leden R. An Open-Label Comparative Study of the Impact of Two Types of Electrical Stimulation (Direct Current Neuromuscular Electrical Stimulation and Transcutaneous Electrical Stimulation) on Physical Therapy Treatment of Diabetic Peripheral Neuropathy. J Diabetes Res. 2025 Feb 4;2025:9970124. doi: 10.1155/jdr/9970124. eCollection 2025.

Reference Type DERIVED
PMID: 39949402 (View on PubMed)

Other Identifiers

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Pro00063515

Identifier Type: -

Identifier Source: org_study_id

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