Clinical Rehabilitation
1–8
© The Author(s) 2014
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DOI: 10.1177/0269215514556298
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CLINICAL
REHABILITATION
Effect of surgical decompression
of nerves in the lower extremity
in patients with painful diabetic
polyneuropathy on stability: A
randomized controlled trial
Joanne FM Macaré van Maurik
1
, Britt ter Horst
1
,
Mireille van Hal
1
, Moshe Kon
1
and Edgar JG Peters
2
Abstract
Objective: To investigate the effect of decompression of nerves in the lower extremity in patients with
painful diabetic polyneuropathy on static balance using a sensitive pressure mat system.
Design: Non-blinded randomized controlled trial.
Setting: Single center study performed at the University Medical Center Utrecht between 2010-2013.
Subjects: Patients with painful diabetic polyneuropathy assessed with the Diabetic Neuropathy Symptom
score and Diabetic Neuropathy Examination between 18-90 years. Exclusion criteria were: physical
problems leading to instability, BMI>35 kg/m2, ankle fractures in history, amputations proximal to the
tarsometatarsal joints, active foot ulcer(s), severe occlusive peripheral vascular diseases.
Intervention: Unilateral surgical nerve decompression at four sites in the lower extremity, the
contralateral limb was used as control (within-patient comparison), with one year follow-up.
Main measures: Preoperatively and 6 and 12 months postoperatively, weight bearing and five variables
of sway of the center of pressure were measured with a pressure mat with eyes open and eyes closed.
T-test was used for evaluation of postoperative results.
Results: Thirty-nine Patients met inclusion criteria and were enrolled for stability testing. Postoperatively
no significant differences for sway variables and weight bearing were seen compared to preoperatively
measurements.
Conclusions: There is no evidence that surgical decompression of nerves of the lower extremity
influences stability within one year after surgery in patients with painful diabetic polyneuropathy.
Keywords
Diabetic polyneuropathy, diabetes mellitus, postural balance, nerve decompression, stability, surgery
Received: 24 March 2014; accepted: 29 September 2014
1
Department of Plastic Surgery, University Medical Center
Utrecht, Utrecht, The Netherlands
2
Department of Medicine, VU university Medical Center,
Amsterdam, The Netherlands
556298CRE 0 0 10.1177/0269215514556298Clinical RehabilitationMacaré van Maurik et al.
research-article 2014
Article
Corresponding author:
Joanne FM Macaré van Maurik, Department of Plastic Surgery,
University Medical Center Utrecht, G.04.122, Heidelberglaan
100, 3584 CX Utrecht, The Netherlands.
Email: j.f.m.macare@umcutrecht.nl
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