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A narrative review of the use of neuromuscular electrical stimulation in individuals with diabetic foot ulceration

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Title: A narrative review of the use of neuromuscular electrical stimulation in individuals with diabetic foot ulceration
Authors: Goodall, R
Langridge, B
Lane, T
Davies, A
Shalhoub, J
Item Type: Journal Article
Abstract: This review aims to summarise the evidence reported on the use of neuromuscular electrical stimulation (NMES) in individuals with diabetic foot ulceration (DFU). A systematic search of EMBASE and MEDLINE databases was performed in February 2019, using search terms relating to the domains DFU and NMES. All primary evidence assessing outcomes of NMES in DFU were included. Of 344 references obtained from database searching, seven met the inclusion criteria and included a total of 140 participants, 77 of whom had DFU. All included studies used prospective designs. Two studies demonstrated improvements in chronic ulcer healing with NMES use, however in each study, only three of the included participants had DFU and subgroup analyses based on ulcer aetiology was omitted. The remaining five studies were produced by the same research group and positive effects of NMES (in combination with heat therapy) on DFU healing were consistently demonstrated. They reported significantly better healing rates with NMES in DFU than in non-diabetic wounds of a similar grade (Healing rate: 70.0±32.3% in DFU vs. 38.4±22.3% in non diabetic ulcers (p<0.01)). These studies did not provide data assessing the isolated effects of NMES without concomitant heat exposure. Data on device tolerability and compliance were lacking. The existing data supports a potential role for NMES in individuals with DFU, however the identified studies inadequately controlled for confounding and were underpowered. Given the significant morbidity and mortality associated with DFU, higher quality evidence is needed to assess the adjunctive role for NMES in this group.
Issue Date: 1-Sep-2020
Date of Acceptance: 3-Dec-2019
URI: http://hdl.handle.net/10044/1/75479
DOI: 10.1177/1534734619898978
ISSN: 1534-7346
Publisher: SAGE Publications
Start Page: 242
End Page: 250
Journal / Book Title: International Journal of Lower Extremity Wounds
Volume: 19
Issue: 3
Copyright Statement: © The Author(s) 2020. The final, definitive version of this paper has been published in International Journal of Lower Extremity Wounds by Sage Publications Ltd. All rights reserved. It is available at: https://journals.sagepub.com/doi/10.1177/1534734619898978
Keywords: Science & Technology
Life Sciences & Biomedicine
Dermatology
Surgery
diabetic foot ulcers
electrical stimulation
chronic wounds
NERVE-STIMULATION
CHRONIC WOUNDS
LOCAL HEAT
ULCERS
chronic wounds
diabetic foot ulcers
electrical stimulation
Dermatology & Venereal Diseases
1103 Clinical Sciences
Publication Status: Published
Online Publication Date: 2020-01-30
Appears in Collections:Department of Surgery and Cancer
Faculty of Medicine