The Effect of High Frequency Nerve Stimulation on Interoception and Pain in Dialysis Patients with Peripheral Neuropathy

Background and Purpose: Optimal treatment for Uremic Peripheral Neuropathy in dialysis patients is widely agreed to be pharmacological therapy for the underlying cause. Several authors recommend a rehabilitation program or intensive physiotherapy as a vital part of a patient’s recovery, but there is little definitive evidence that rehabilitation improves outcome. In part, this is due to the lack of research undertaken into the long-term functional outcomes for patients with Peripheral Neuropathy. Objectives: To evaluate High-frequency stimulation on interoception and pain in dialysis subjects with peripheral neuropathy. Methods : Based on the inclusion criteria after obtaining informed consent, thirty subjects were included in the study. The participants were administered 20 minutes of Transcutaneous Electrical Nerve Stimulation (TENS) 3 days per week for 6 weeks. The timed Vibration Sense test at the great toe, medial malleolus, tibial tuberosity, Joint Position sense, and Neuropathy Pain scale were used as outcome measures. Findings : The result obtained after the analysis of paired t-tests within the group shows significant improvement in mean post-test scores of vibration sense test at great toe, medial malleolus, and tibial tuberosity with p value 0.000. The result also shows significant improvement in mean post-test scores of the joint position sense test and neuropathy pain scale with p-value < 0.05. Conclusion : Electrical Nerve stimulation has positively affected interoception and pain for dialysis patients with peripheral neuropathy. TENS may be most beneficial not only for pain reduction but also for subjects with neuropathy symptoms. Novelty : This study evaluated the effectiveness of the electrical modalities over the pain and interoception aspects of peripheral neuropathy, as it was not previously assessed. Keywords: Transcutaneous electrical nerve stimulation, Electrical Stimulation, Peripheral Neuropathy, Uremic Neuropathy, Hemodialysis