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Can an electrical pulsed radio frequency device relieve pain and improve function in patients with pedal diabetic neuropathy? A single blind randomized placebo-controlled trial.

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Can an electrical pulsed radio frequency device relieve pain and improve function in patients with pedal diabetic neuropathy? A single blind randomized placebo-controlled trial.

Randomized single blind placebo-controlled study
Human Research Ethics Committee (Medical) University of the Witwatersrand
Date Considered 26/10/2016
Date of Approval 30/11/2016
Trial clearance and registration certificate number: M161037 P Berger
Author
Berger P and Landau S
Author Information

1Phyllis P Berger Faculty: University of the Witwatersrand pberger@icon.co.za; +27 824117777

2Stanley S Landau
Centre for Diabetes and Endocrinology (CDE), Houghton: S. Landau stanl@cdediabetes.co.za +27 825558255

Abstract
Can an electrical pulsed radio frequency device relieve pain and improve function in patients with pedal diabetic neuropathy? A single blind randomized placebo-controlled trial. Aim: A randomised single-blind placebo study was conducted on 80 patients with pedal diabetic peripheral neuropathy in 2 cities and their surrounds in South Africa to determine if a pulsed radio frequency current (PRF) can produce changes in the primary outcome of the DN4 Test and possibly in the BPI-short form. Method: Patients were selected by their physicians at Centres for Diabetes and randomised into 2 groups – 40 patients each in the groups (A=Active, B =Placebo). Inclusion criteria were pedal Diabetic Peripheral Neuropathy and having a score of 4 or 4+/10 in the DN4 Test. Exclusion criteria: previous experience with the pulsed radio frequency current and having: peripheral or spinal cord stimulator, pacemaker, metal implants and pregnancy. The DN4 was the primary objective and BPI-SF (secondary) was also tested at baseline, after 3 treatments and 3 follow ups at 1, 3 and 6 months. Each patient had 3 treatments or placebo once weekly for 10 mins bilaterally at the sciatic nerve in the popliteal fossa. Results: Data were analysed using the SAS version (9.4 statistical program). Results are expressed as mean and standard deviation by groups (A=Active, B=Placebo). There were differences for age and gender in these 2 groups (Age, p=0.030, gender p=0.01) and adjustments were made where applicable. There were also differences evident regardless of age and gender. The DN4 demonstrated that between baseline and 3 treatments there was a reduction in pain and symptoms greater for the A group: p= 0.010 regardless of age and gender. Between baseline and 1month there was a reduction in pain in both groups, but no significant difference between them p=0.10 but gender and age, nearly significant. There were no differences at 3 and 6 months. In the BPI-SF there were differences between the active and placebo groups in the worst, average and present pain with positive p values some with adjustment for age and gender. For relations with other people there was evidence of significant changes some regardless and some adjusted for age and gender and also relations with other people and without analgesics at baseline. There was no differences even after adjustments for age and gender for work an
Conclusion

After 3 treatments of PRF current, the DN4 Test demonstrates significant improvements in neuropathic pain and
symptoms in certain patients with diabetic peripheral neuropathy.

Keywords:
diabetic peripheral neuropathy; pulsed radio frequency current

Trial registry number: M161037
University of the Witwatersrand Human Research Ethics Committee (Medical)