Effectiveness of Neuromuscular Taping on Balance, Proprioception, Pain and Nerve Conduction Parameters in Patients with Diabetic Peripheral Neuropathy

The section discussed various diagnostic approaches and physical examination techniques for assessing DPN. A comprehensive neurological assessment is crucial, including tests for cranial nerves, muscle tone, and possible systemic illnesses. Key diagnostic methods highlighted include nerve conduction studies (NCS), skin biopsies for intraepidermal nerve fiber density, and corneal confocal microscopy, which provides non-invasive imaging of corneal nerves. The text also emphasizes the importance of quantitative sensory testing (QST) in evaluating sensory function and identifies clinical scoring systems for assessing DPN severity. Pain assessment tools like the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale (LANSS) and the Visual Analog Scale (VAS) are discussed, noting their utility in tracking pain reduction over time. Physiotherapy plays a crucial role in managing DPN by reducing symptoms and enhancing quality of life. Key interventions include exercise programs that improve strength, flexibility, and balance, which help mitigate fall risks and promote circulation. Neuromuscular re-education addresses sensory deficits, while pain management strategies like transcutaneous electrical nerve stimulation (TENS) alleviate neuropathic pain. Patient education on foot care is essential for preventing complications. Research highlights the effectiveness of various conventional physiotherapy treatments, such as LASER therapy and neural mobilization, in reducing pain and disability, underscoring the importance of a multifaceted approach to optimize outcomes for individuals with DPN. Several studies have examined the effects of neuromuscular taping (NMT) on various conditions and populations, but only a few have demonstrated its effectiveness. Notably, there is limited literature on the impact of NMT specifically for DPN, highlighting a gap that warrants further investigation. Exploring the effects of NMT on DPN is essential to establish solid evidence for this emerging treatment method and its potential benefits for patients. A total of 46 participants were recruited and divided into two groups: the experimental group (Group A, N=23) and the control group (Group B, N-23). An 8-week physiotherapy intervention was administered, incorporating NMT on the bilateral tibialis anterior, tibialis posterior. Normality was checked using Shapiro-wilk test and parametric and non- tests were used to analyze the data based on the normality. Both groups e-value demonstrated significant improvements across all variables at p<0.05 though some nerve conduction parameters specifically latency of right and left tibial and peroneal nerves, conduction velocity in the tibial nerves, amplitude in the peroneal nerves, and H-reflex latency and amplitude did not show significant changes (p>0.05). Group A exhibited more substantial clinical and symptomatic improvements compared to Group B, with effect sizes ranging from moderate to large (0.66-1) across all outcomes.

本章节探讨了用于评估糖尿病周围神经病变（Diabetic Peripheral Neuropathy, DPN）的多种诊断方法与体格检查技术。全面的神经系统评估至关重要，涵盖颅神经检查、肌张力评估以及潜在全身性疾病排查。文中重点提及的核心诊断方法包括：神经传导研究（Nerve conduction studies, NCS）、用于检测表皮内神经纤维密度的皮肤活检，以及可无创成像角膜神经的角膜共聚焦显微镜。此外，文本强调了定量感觉测试（Quantitative sensory testing, QST）在评估感觉功能中的重要性，并介绍了用于评估DPN严重程度的临床评分系统。

还讨论了利兹神经病变症状和体征疼痛评估量表（Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale, LANSS）与视觉模拟量表（Visual Analog Scale, VAS）等疼痛评估工具，指出二者可用于追踪随时间推移的疼痛缓解情况。

物理治疗在DPN管理中发挥关键作用，可缓解症状并提升患者生活质量。核心干预措施包括：旨在改善肌力、柔韧性与平衡的运动方案，该方案有助于降低跌倒风险并促进血液循环；神经肌肉再训练用于改善感觉缺损；以及经皮神经电刺激（Transcutaneous electrical nerve stimulation, TENS）等疼痛管理策略，可缓解神经性疼痛。足部护理患者教育对预防并发症亦至关重要。

研究证实，激光治疗与神经松动术等多种常规物理治疗手段可有效减轻疼痛与残疾，凸显了采用多维度方案优化DPN患者预后的重要性。已有多项研究探讨了肌内效贴（Neuromuscular taping, NMT）在多种病症与人群中的应用效果，但仅少数研究证实其有效性。值得注意的是，专门针对DPN的NMT相关研究文献较为匮乏，这一研究空白亟待进一步探索。明确NMT对DPN的影响，可为这一新兴治疗方法提供坚实的循证依据，并挖掘其对患者的潜在获益。

本研究共招募46名受试者，随机分为两组：实验组（A组，n=23）与对照组（B组，n=23）。干预周期为8周，实验组接受双侧胫前肌、胫后肌肌内效贴联合物理治疗。采用夏皮罗-威尔克检验（Shapiro-Wilk test）进行正态性检验，并根据检验结果分别采用参数检验与非参数检验分析数据。结果显示，两组在所有变量上均展现出具有统计学意义的改善（p<0.05），但部分神经传导参数未出现显著变化（p>0.05），具体包括双侧胫神经、腓神经的潜伏期，胫神经传导速度，腓神经波幅，以及H反射的潜伏期与波幅。相较于对照组，实验组在临床与症状改善方面更为显著，所有结局指标的效应量介于0.66至1之间，属于中到大的效应水平。