title: The benefit of electrical stimulation to enhance perfusion in persons with diabetes mellitus.
abstract: The purpose of this study was to evaluate the effect of galvanic electrical stimulation on vascular perfusion in diabetic patients. Nineteen subjects with diabetes were enrolled. Eleven subjects (57.9%) were diagnosed with impaired peripheral perfusion based upon their initial transcutaneous oximetry values (< 40 mm Hg). The subjects were studied over a 2-day period. On the 1st day, one foot was electrically stimulated for four 60-minute periods by an external electrical stimulation device. Vascular perfusion of both feet was assessed before and after the sessions of electrical stimulation. On the 2nd day, no electrical stimulation was applied and noninvasive vascular measurements were repeated. For the 1st hour, transcutaneous oxygen pressure was measured continuously during stimulation at the lateral aspect of the leg. Subsequently, perfusion between the periods of stimulation was measured on the dorsum of the foot with both transcutaneous oximetry and laser Doppler flowmetry after each stimulation period. In the group with impaired peripheral perfusion, a significant rise in tissue oxygenation as compared to the control measurements was measured during the first 5 minutes of stimulation (p < .040). For those without vascular disease (TcpO2 > 40 mm Hg) however, there was not a significant increase compared to baseline (p = .280). After the periods of stimulation, the stimulated feet did not show any higher perfusion levels than the control feet. Patterns in perfusion during the day, as measured by laser Doppler flowmetry, were similar in the tested feet and in the controls. These data suggest that external subsensory electrical stimulation induces a transient rise in skin perfusion in persons with diabetes and impaired peripheral perfusion.
authors.affiliation: Department of Orthopaedics, University of Texas Health Science Center, San Antonio, TX 78250, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Peters
authors.forename: D G
authors.initials: DG
authors.lastname: Armstrong
authors.forename: R P
authors.initials: RP
authors.lastname: Wunderlich
authors.forename: J
authors.initials: J
authors.lastname: Bosma
authors.forename: S
authors.initials: S
authors.lastname: Stacpoole-Shea
authors.forename: L A
authors.initials: LA
authors.lastname: Lavery
mesh_terms: D000328:Adult; D000368:Aged; D001775:Blood Circulation; D001785:Blood Gas Monitoring, Transcutaneous; D017719:Diabetic Foot / Q000097:blood / Q000503:physiopathology* / Q000628:therapy*; D004599:Electric Stimulation Therapy; D005260:Female; D005528:Foot / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged