Good Vibrations? Can pre-conditioning someone before activity with vibratory therapy reduce risk for ulceration and reulceration? #DiabeticFoot #ActAgainstAmputation #Diabetes

Interesting work from Zhu and coworkers at UIC, Xian and Beijing. It certainly remains to be seen whether this can modulate reactive hyperemia in people with diabetes, but the idea remains compelling.

Effects of Preconditioning Local Vibrations on Subsequent Plantar Skin Blood Flow Response to Walking

Abstract

Weight-bearing exercise such as walking may increase risk of foot ulcers in people with diabetes mellitus (DM) because of plantar ischemia due to repetitive, high plantar pressure. Applications of local vibrations on plantar tissues as a preconditioning intervention before walking may reduce plantar tissue ischemia during walking. The objective of this study was to explore whether preconditioning local vibrations reduce reactive hyperemia after walking. A double-blind, repeated- measures, and crossover design was tested in 10 healthy participants without DM. The protocol included 10-minute baseline, 10-minute local vibrations (100 Hz or sham), 10-minute walking, and 10-minute recovery periods. The order of local vibrations was randomly assigned. Skin blood flow (SBF) was measured over the first metatarsal head during baseline and recovery periods. SBF responses were characterized as peak SBF, total SBF, and recovery time of reactive hyperemia. SBF was expressed as a ratio of recovery to baseline SBF to quantify the changes. Peak SBF in the vibration protocol (6.98 ± 0.87) was significantly lower than the sham control (9.26 ± 1.34, P < .01). Total SBF in the vibration protocol ([33.32 ± 7.98] × 103) was significantly lower than the sham control ([48.09 ± 8.9] × 103, P < .05). The recovery time in the vibration protocol (166.08 ± 32.71 seconds) was not significantly different from the sham control (223.53 ± 38.85 seconds, P = .1). Local vibrations at 100 Hz could reduce walking-induced hyperemic response on the first metatarsal head. Our finding indicates that preconditioning local vibrations could be a potential preventive intervention for people at risk for foot ulcers.

Keywords

diabetic foot ulcers, local vibration, preconditioning, skin blood flow, reactive hyperemia

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