Transcutaneous nerve stimulation versus aerobic exercise in diabetic neuropathy

Background Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes, which is frequently associated with pain. Studies targeting the painful DPN are necessary to support clinical decision-making. Objective The aim of the present study was to investigate the efficacy of transcutaneous electric nerve stimulation (TENS) versus aerobic exercise, and to compare them with regular pharmacological therapy in patients with DPN, using sensory nerve conduction study and the visual analogue scale (VAS). Patients and methods This study included 60 diabetic patients with a history of DPN for 5 years. Patients were divided into three equal groups, all receiving regular pharmacological therapy. Group A received TENS of both lower limbs, three times per week. Group B received aerobic exercise. Group C received only pharmacological therapy. Patients were assessed before and 8 weeks after treatment. The VAS was used to measure the pain intensity before and after treatment, and the medial plantar nerve conduction velocity (NCV) to assess nerve function. Results Group A and B only showed a significant statistical difference between pretreatment and post-treatment pain intensity on VAS, with 41.67 and 16.67% improvement on the VAS, respectively. There was no statistically significant difference in pretreatment and post-treatment as regards the medial plantar NCV in any of the groups. Conclusion TENS, of moderate intensity, carried out at 14 Hz, with a pulse width of 250 ms, for 30 min and three times a week is more efficient than aerobic exercise training program in relieving pain in patients with DPN, whereas neither TENS nor exercise showed any significant effect on medial plantar conduction velocity (CV) in patients with DPN.