Estrategias de intervención con movilizaciones neurales para mejorar las respuestas sensoriales y funcionales en la neuropatía periférica diabética

Abstract

Type 2 diabetes mellitus is a condition in which glucose levels are not normal and cause damage to peripheral nerve fibers causing diabetic neuropathy, being the most frequent the sensory-motor, whose symptoms include altered tactile perception, temperature, loss of sensation in hands and feet. The evidence of treatments that include neural mobilization is limited, so the aim of this study is to determine whether intervention strategies with neural mobilization improve sensory and functional responses in diabetic peripheral neuropathy. A quantitative-analytical, prospective longitudinal study was carried out. Applying the instruments and whose results were statistically evaluated through the SSPSS program. The instruments applied correspond to a clinical record for the collection of relevant data such as age, sex, BMI, personal pathological history, the Michigan test that carries a questionnaire of 15 questions related to the symptoms in the last week and an exploratory physical examination to know the patient's condition (foot morphology, skin condition, ulcers, amputations), evaluation of tactile and thermal sensitivityxiv (dermatomas: C5, C6, C7, C8, T1, L2, L3, L4, L5, S1, S2) and vibratory (olecranon, radial styloid, external malleolus and hallux), dynamometry where the maximum hand grip strength and foot dorsiflexion strength are evaluated; these instruments applied pre and post treatment. Being a small sample, the entire population of 37 diabetic individuals was included in the intervention with neural mobilizations of sliding type for the median, radial, ulnar, sciatic and peroneal nerves, in daily sessions during 8 weeks. In the relationship of variables, the Student's T revealed data of a significant improvement in this group since the second evaluation obtained positive results after the intervention, where the strategies of sliding neural mobilization for upper and lower limb are optimal to reduce symptoms such as cramps, numbness, loss of sensitivity to touch, temperature and vibration in hands and feet. However, these strategies do not affect foot morphology and skin appearance. These results provide reliability of neural mobilization as a conservative treatment in diabetic peripheral neuropathy