Synergistic Effects of Vitamin D and Mindfulness Training in Pain Severity, Pain-Related Disability and Neuropathy-Specific Quality of Life Dimensions in Painful Diabetic Neuropathy: A Randomized Clinical Trial with Placebo-controlled

2020 ◽  
Author(s):  
Roya taghadosi nia ◽  
mohammadreza davoudi ◽  
Seyyed Mojtaba Ahmadi ◽  
Amir Abbas Taheri
Keyword(s):  
Quality Of Life ◽  
Vitamin D ◽  
Neuropathic Pain ◽  
Diabetic Neuropathy ◽  
Mindfulness Training ◽  
Pain Severity ◽  
Oral Dosage ◽  
Life Questionnaire ◽  
Painful Diabetic Neuropathy

Abstract Background: This study aimed to examining Synergistic effect of Vitamin D (VD) Supplement and mindfulness on neuropathic pain severity, Pain-Related Disability and Neuropathy-Specific Quality of Life dimensions in painful diabetic neuropathy.Methods: In this randomized controlled trial, totally 225 patients with painful diabetic neuropathy were randomly allocated to five groups: (1) mindfulness and placebo, (2) placebo, (3) mindfulness, (4) VD, and (5) mindfulness and VD. Mindfulness training includes twelves sessions and VD patients received a daily four thousand IU oral dosage (four capsules) with 28,000 IU vitamin D weekly for 12 weeks. Laboratory analyses, Sun exposure time, Vitamin D intake, BMI and Physical activity measured in pre-test and posttest. Pain-Related Disability measured with The Pain Disability Index (PDI). For other outcome variables Neuropathy Specific Quality of Life questionnaire and Neuropathic pain severity scale was utilized.Results: In baseline, measures were not different among the groups. At the end-of-treatment, for outcome variables results showed improvement in all groups except the “placebo” group. About other groups, there was not any difference between VD and mindfulness groups (in and not combined with placebo). However, “VD + mindfulness” has a greater improvement rather than VD and mindfulness groups (P<0.05). Moreover, both protocols have no significant effects on, FBS, BMI and energy intakes (P>0.05).Conclusion: Combining VD and mindfulness can reduce pain severity and pain-related disability, so with these changes patients improve their quality of life.

scholarly journals Improvement in Neuropathy Specific Quality of Life in Patients with Diabetes after Vitamin D Supplementation

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Uazman Alam ◽  
Asher Fawwad ◽  
Fariha Shaheen ◽  
Bilal Tahir ◽  
Abdul Basit ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vitamin D ◽  
Diabetic Neuropathy ◽  
Subscale Score ◽  
Vitamin D Supplementation ◽  
Painful Diabetic Neuropathy ◽  
Open Label ◽  
Patients With Diabetes ◽  
Baseline Response

Objective. To assess the effect of vitamin D supplementation on neuropathy specific quality of life (NeuroQoL) in patients with painful diabetic neuropathy. Methods. This prospective, open label study was conducted between June 2012 and April 2013. Patients with symptomatic diabetic neuropathy were given a single dose of 600,000 IU intramuscular vitamin D, and NeuroQol was assessed at baseline and at five follow-up visits every 4 weeks. Results. Of 143 participants, 41.3% were vitamin D deficient (vitamin D < 20 ng/ml). Treatment with vitamin D resulted in a significant increase in 25(OH)D (P<0.0001) and a significant improvement in the NeuroQoL subscale score for emotional distress (P=0.04), with no significant change in the other NeuroQoL domains of painful symptoms and paresthesia, loss of temperature and touch sensation, unsteadiness, limitation in daily activities, and interpersonal problems. There was a significant reduction in patient perception about foot problems on QoL of “quite a lot” (P<0.05) and “very much” (P<0.0001) with a significant reduction in the baseline response of having a “poor” QoL from 5.2% to 0.7% (P<0.0001) and an increase in the response of an “excellent QoL” from 1.5% to 7.4% (P<0.0001). Conclusion. Vitamin D is effective in improving quality of life in patients with painful diabetic neuropathy.

scholarly journals The effect of exercise therapy combined with psychological therapy on physical activity and quality of life in patients with painful diabetic neuropathy: a systematic review

2019 ◽  
Vol 19 (3) ◽  
pp. 433-439 ◽  
Author(s):  
Charlotte C.M. van Laake-Geelen ◽  
Rob J.E.M. Smeets ◽  
Suzan P.A.B. Quadflieg ◽  
Jos Kleijnen ◽  
Jeanine A. Verbunt
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Systematic Review ◽  
Diabetic Neuropathy ◽  
Exercise Therapy ◽  
Treatment Modalities ◽  
Current Evidence ◽  
Psychological Interventions ◽  
Painful Diabetic Neuropathy

Abstract Background and aims Approximately 25% of patients with diabetes mellitus type 2 (DMII) develop painful diabetic neuropathy (PDN). PDN is known to affect both mental and physical wellbeing, resulting in anxiety, depression, low quality of life and physical disability. Pharmacological treatment of PDN aims at pain relief and is often ineffective and/or has many side effects. Rehabilitation treatment modalities that are designed to help the patient deal with PDN related complaints, are mostly focussed on either physical (e.g. exercise therapy) or psychological aspects (e.g. cognitive behavioural therapy, CBT). There is emerging evidence that PDN can be approached from a biopsychosocial perspective, in which physical and psychosocial aspects are integrated. From this biopsychosocial approach it is plausible that integrated treatment modalities such as acceptance commitment therapy (ACT) or exposure in vivo (EXP) could be effective in patients with PDN. The objective of this review was to provide an overview of the current evidence on the effects of rehabilitation treatments that combine exercise therapies with psychological therapies in order to improve physical activity (PA) and quality of life (QoL) in patients with PDN. Methods Systematic review of the current literature. EMBASE, MEDLINE, Medline In-Process citations and e-Pubs ahead-of-print, Pedro, Web of Science, PsycINFO, CENTRAL, PubMed and Google Scholar were searched. All studies on interventions combining exercise therapy with psychological interventions in patients with PDN, aged >18 years, were included. Outcome measures were PA, QoL. Results The search resulted in 1603 records after removing duplicates. After screening on titles and abstracts, 100 records remained. From these, not one study reported on interventions that combined exercise therapy with psychological interventions. Through a secondary hand search, a total of three reviews were identified that described a total of five studies regarding either physical or psychological interventions in patients with PDN. These studies reported moderate effects of (1) mindfulness meditation on QoL, (2) CBT on pain severity, (3) mindfulness-based stress reduction intervention on function, health-related QoL, pain catastrophizing and depression, (4) aerobic exercise on QoL and (5) Tai Chi on glucose control, balance, neuropathic symptoms, and some dimensions of QoL in patients with PDN. All studies were of a moderate quality, and results should be interpreted with caution. Conclusions Based on increasing knowledge in the domain of chronic pain, it could be assumed that integrated rehabilitation treatments for patients with PDN are beneficial. There is no literature to support this and more research should be done on integrated biopsychosocial interventions in patients with PDN. Implications This empty review highlights the importance that more research should be done on integrated biopsychosocial interventions in patients with PDN. Currently, our research group is performing a study on the effects of EXP treatment in patients with PDN.

scholarly journals The effects of the physical procedures in patients with diabetic neuropathy

2019 ◽  
Vol 76 (8) ◽  
pp. 787-794
Author(s):  
Vesna Grbovic ◽  
Srdjan Stefanovic ◽  
Svetlana Djukic ◽  
Jasmin Nurkovic ◽  
Natasa Zdravkovic-Petrovic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Therapy ◽  
Diabetic Neuropathy ◽  
Lipoic Acid ◽  
Pain Reduction ◽  
Life Questionnaire ◽  
Alpha Lipoic Acid ◽  
Group A ◽  
Group B

Background/Aim. Neuropathy represents the most frequent complication in the patients with diabetes mellitus (DM). Symmetric distal sensorimotor polyneuropathy (DSP), which represents the most frequent type of diabetic neuropathy, is present in 30% of hospitalized diabetic patients. The aim of our study was to compare the effects of physical therapy (PT) and alpha-lipoic acid (ALA) supplementation on pain reduction and quality of life improvement in the DSP patients. Methods. The study was performed on 60 adult patients with DM type 2 and DSP. The patients were randomly divided into 2 groups: group A (n = 30) was treated by PT and group B (n = 30) was treated by ALA. The study lasted 6 months during which 3 diagnostictherapeutic cycles were performed. To asses their pain before and after every of 3 cycles, we used visual analog scale (VAS). We also evaluated quality of life before the 1st and after the 3rd cycle with the European Quality of Life Questionnaire (EQ-5D-3L). To analyze results between groups we used mixed between-within subjects ANOVA and statistical significance was set on p < 0.05. Results. Pain intensity showed statistically significant influence of both PT and ALA (? = 0.028; p < 0.001). A statistically significant difference between the effects of those two therapy modalities was observed (F = 4.78; p < 0.05): PT reduced pain to the greater extent than ALA. A statistically significant improvement was found in the domain of pain/discomfort both in the group A (? = 0.54, p < 0.001) and group B (? = 0.57, p < 0.001), as well as anxiety/depression (group A: ? = 0.32, p = 0.008; group B: ? = 0.22, p < 0.019) and EQ-VAS (both groups, p < 0.05). Conclusion. Our research showed that physical therapy had a greater influence in pain reduction than alpha-lipoic acid in the patients with DSP.

scholarly journals Neuropathic pain is an independent predictor of worse quality of life in patients with diabetic neuropathy

2020 ◽  
pp. 17-17
Author(s):  
Zoran Vukojevic ◽  
Stojan Peric ◽  
Aleksandra Dominovic-Kovacevic ◽  
Ivo Bozovic ◽  
Sanja Grgic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Diabetic Neuropathy ◽  
Independent Predictor

scholarly journals Anxiety affects disability and quality of life in patients with painful diabetic neuropathy

2017 ◽  
Vol 21 (10) ◽  
pp. 1632-1641 ◽  
Author(s):  
C.C. Geelen ◽  
R.J.E.M. Smeets ◽  
S. Schmitz ◽  
J.P. van den Bergh ◽  
M.E.J.B. Goossens ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetic Neuropathy ◽  
Painful Diabetic Neuropathy

scholarly journals Comparison of the efficacy and tolerability of an oral dosage form made from Fumaria vaillantii versus cetirizinein management of chronic urticaria: A single-blind, randomized, clinical trial

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Fatemeh Eghbalian ◽  
Nafiseh Esmaili ◽  
Mehrdad Karimi ◽  
Fahimeh Mohajerani ◽  
Roja Rahimi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Adverse Events ◽  
Chronic Urticaria ◽  
Fumaric Acid ◽  
Oral Dosage ◽  
Inflammatory Factor ◽  
Life Questionnaire ◽  
Significant Difference

BACKGROUND: Chronic urticaria (CU) is one of the common allergic diseases whose conventional treatments have failed to desirably manage it. Fumariavaillantii is used in Persian medicine to treat CU. The anti-inflammatory and anti-histaminic effects of chemical components of Fumaria such as fumaric acid and caffeic acid were confirmed. Dimethyl fumarate reduces the pro- inflammatory contribution and monomethyl fumarate can increase IL-4, an antiinflammatory interleukin, or can decrease IFN- , an inflammatory factor. The current study assesses the efficacy and tolerability of Fumaria vaillantii versus cetirizine in the management of CU. METHODS: The formulation and standardization of Fumaria syrup were done in Tehran University of Medical Sciences. Patients were randomized to twice- daily treatment with Fumaria syrup or cetirizine syrup (n=39 in each group) for four weeks. The efficacy assessment included Urticaria Activity Score (UAS) and Chronic Urticaria Quality of Life Questionnaire (CUQ2oL) and the safety evaluations included Common Terminology Criteria for Adverse Events Questionnaire. RESULTS: The fumaric acid content in 5 ml of Fumaria syrup was calculated to be 0.12 mg. The results of clinical trial showed that UAS was significantly higher in the Fumaria group than in the cetirizine group, after the first week of follow-up (p<0.001), but no significant difference was demonstrated between the two groups on week 4 (p=0.57). One month after the research was finished, the UAS score of the cetirizine group was significantly higher than that of the Fumaria group (p<0.001). After finishing the interventions, difference of CU-Q2oL was not significant between the two groups; however, the QOL score was significantly lower in the Fumaria group (p<0.001) at 8th week. About adverse events, the incidence of somnolence in the Fumaria group was significantly lower than in the cetirizine group (p<0.001). CONCLUSIONS: Fumaria vaillantii demonstrated its effects on CU later than cetirizine, but led to more permanent effects, better quality of life, and lower incidence of adverse events as compared to cetirizine. More clinical trials with higher populations are needed to achieve more conclusive results.

scholarly journals Pain, Depression, and Quality of Life in Neuromyelitis Optica Spectrum Disorder

2021 ◽  
Vol 8 (3) ◽  
pp. e985
Author(s):  
Ilya Ayzenberg ◽  
Daniel Richter ◽  
Eugenia Henke ◽  
Susanna Asseyer ◽  
Friedemann Paul ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Neuromyelitis Optica ◽  
Clinical Characteristics ◽  
Short Form ◽  
Spectrum Disorder ◽  
Pain Severity ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Upper Thoracic

ObjectivesTo evaluate prevalence, clinical characteristics, and predictors of pain, depression, and their impact on the quality of life (QoL) in a large neuromyelitis optica spectrum disorder (NMOSD) cohort.MethodsWe included 166 patients with aquaporin-4–seropositive NMOSD from 13 tertiary referral centers. Patients received questionnaires on demographic and clinical characteristics, PainDetect, short form of Brief Pain Inventory, Beck Depression Inventory–II, and Short Form 36 Health Survey.ResultsOne hundred twenty-five (75.3%) patients suffered from chronic NMOSD-associated pain. Of these, 65.9% had neuropathic pain, 68.8% reported spasticity-associated pain and 26.4% painful tonic spasms. Number of previous myelitis attacks (OR = 1.27, p = 0.018) and involved upper thoracic segments (OR = 1.31, p = 0.018) were the only predictive factors for chronic pain. The latter was specifically associated with spasticity-associated pain (OR = 1.36, p = 0.002). More than a third (39.8%) suffered from depression, which was moderate to severe in 51.5%. Pain severity (OR = 1.81, p < 0.001) and especially neuropathic character (OR = 3.44, p < 0.001) were associated with depression. Pain severity and walking impairment explained 53.9% of the physical QoL variability, while depression and walking impairment 39.7% of the mental QoL variability. No specific medication was given to 70.6% of patients with moderate or severe depression and 42.5% of those with neuropathic pain. Two-thirds (64.2%) of patients with symptomatic treatment still reported moderate to severe pain.ConclusionsMyelitis episodes involving upper thoracic segments are main drivers of pain in NMOSD. Although pain intensity was lower than in previous studies, pain and depression remain undertreated and strongly affect QoL. Interventional studies on targeted treatment strategies for pain are urgently needed in NMOSD.

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