The purpose of this study was to investigate the immediate effects of self-Thai foot massages (STFMs) on the foot skin blood flow, the foot skin temperature, and range of motion (ROM) of the foot and ankle in type 2 diabetic patients with peripheral neuropathy.
Design:
A randomized crossover study.
Subjects:
Twenty five diabetic patients with peripheral neuropathy were recruited.
Interventions:
Participants were randomly assigned to either STFM or Thai foot massage (TFM) performed by a massage therapist; then, they were switched to the other group after a 1-week washout period. In both groups, the foot massage was performed in a seated position on the dominant lower leg and foot for 25 min.
Outcome measures:
Before and immediately after treatment, foot skin blood flow, foot skin temperature, and ROM of the foot and ankle were evaluated. Heart rate was measured throughout the treatment.
Results:
After a single treatment of the massage, foot skin blood flow and ROM of the foot and ankle significantly improved in both groups (p < 0.05). Foot skin temperature did not change in STFM, whereas it significantly increased in TFM. Heart rate significantly increased in STFM, whereas it tended to decrease in TFM.
Conclusions:
Both STFM and TFM by a massage therapist could improve foot skin blood flow and ROM of the foot and ankle in diabetic patients with peripheral neuropathy. An STFM could be a promising alternative treatment that patients can perform at home.
Get full access to this article
View all access options for this article.
References
1.
ChaoCY, CheingGL. Microvascular dysfunction in diabetic foot disease and ulceration. Diabetes Metab Res Rev, 2009; 25:604–614.
2.
van DeursenRW, SimoneauGG. Foot and ankle sensory neuropathy, proprioception, and postural stability. J Orthop Sports Phys Ther, 1999; 29:718–726.
3.
van DeursenRW, SanchezMM, UlbrechtJS, et al.The role of muscle spindles in ankle movement perception in human subjects with diabetic neuropathy. Exp Brain Res, 1998; 120:1–8.
4.
AdamKM, MahmoudSM, MahadiSI, et al.Extended leg infection of diabetic foot ulcers: Risk factors and outcome. J Wound Care, 2011; 20:440–444.
5.
PerrySD, McIlroyWE, MakiBE. The role of plantar cutaneous mechanoreceptors in the control of compensatory stepping reactions evoked by unpredictable, multi-directional perturbation. Brain Res, 2000; 877:401–406.
WangTY, LinSI. Sensitivity of plantar cutaneous sensation and postural stability. Clin Biomech, 2008; 23:493–499.
8.
ZhangS, LiL. The differential effects of foot sole sensory on plantar pressure distribution between balance and gait. Gait Posture, 2013; 37:532–535.
9.
YamauchiJ, KoyamaK. Toe flexor strength is not related to postural stability during static upright standing in healthy young individuals. Gait Posture, 2019; 73:323–327.
10.
SchulteL, RobertsMS, ZimmermanC, et al.A quantitative assessment of limited joint mobility in patients with diabetes. Goniometric analysis of upper extremity passive range of motion. Arthritis Rheum, 1993; 36:1429–1443.
11.
MecagniC, SmithJP, RobertsKE, et al.Balance and ankle range of motion in community-dwelling women aged 64 to 87 years: A correlational study. Phys Ther, 2000; 80:1004–1011.
12.
ChatchawanU, EungpinichpongW, PlandeeP, et al.Effects of Thai foot massage on balance performance in diabetic patients with peripheral neuropathy: A randomized parallel-controlled trial. Med Sci Monit Basic Res, 2015; 21:68–75.
13.
Castro-SanchezAM, Moreno-LorenzoC, Mataran-PenarrochaGA, et al.Connective tissue reflex massage for type 2 diabetic patients with peripheral arterial disease: Randomized controlled trial. Evid Based Complement Alternat Med, 2011; 2011:804321.
14.
Castro-SanchezAM, Moreno-LorenzoC, Mataran-PenarrochaGA, et al.Efficacy of a massage and exercise programme on the ankle-brachial index and blood pressure in patients with diabetes mellitus type 2 and peripheral arterial disease: A randomized clinical trial. Med Clin (Barc), 2010; 134:107–110.
15.
CunninghamJE, KelechiT, SterbaK, et al.Case report of a patient with chemotherapy-induced peripheral neuropathy treated with manual therapy (massage). Support Care Cancer, 2011; 19:1473–1476.
16.
SajediF, KashaniniaZ, HoseinzadehS, et al.How effective is Swedish massage on blood glucose level in children with diabetes mellitus?. Acta Med Iran, 2011; 49:592–597.
17.
UcuzalM, KananN. Foot massage: Effectiveness on postoperative pain in breast surgery patients. Pain Manag Nurs, 2014; 15:458–465.
18.
WandellPE, ArnlovJ, Nixon AndreassonA, et al.Effects of tactile massage on metabolic biomarkers in patients with type 2 diabetes. Diabetes Metab, 2013; 39:411–417.
19.
FinchP, BaskwillA, MarincolaF, et al.Changes in pedal plantar pressure variability and contact time following massage therapy: A case study of a client with diabetic neuropathy. J Bodyw Mov Ther, 2007; 11:295–301.
20.
MoriH, OhsawaH, TanakaTH, et al.Effect of massage on blood flow and muscle fatigue following isometric lumbar exercise. Med Sci Monit, 2004; 10:CR173–CR178.
21.
BhumisawasdiJ, VannaO, SurinpangN. The self-reliant system for alternative care of diabetes mellitus patients—Experience macrobiotic management in Trad Province. J Med Assoc Thai, 2006; 89:2104–2115.
22.
EungpinichpongW.Effects of femoral artery temporarily occlusion on skin blood flow of foot. J Med Tech Phy Ther, 2002; 14:151–159.
23.
KarnafelW, JuskowaJ, ManiewskiR, et al.Microcirculation in the diabetic foot as measured by a multichannel laser Doppler instrument. Med Sci Monit, 2002; 8:MT137–MT144.
24.
BagavathiappanS, PhilipJ, JayakumarT, et al.Correlation between plantar foot temperature and diabetic neuropathy: A case study by using an infrared thermal imaging technique. J Diabetes Sci Technol, 2010; 4:1386–1392.
25.
ChatchawanU, NarktoP, DamriT, et al.An exploration of the relationship between foot skin temperature and blood flow in type 2 diabetes mellitus patients: A cross-sectional study. J Phys Ther Sci, 2018; 30:1359–1363.
26.
Guzmán-ValdiviaCH, Blanco-OrtegaA, Oliver-SalazarMA, et al.Therapeutic motion analysis of lower limbs using Kinovea. IJSCE, 2013; 2:2231–2307.
27.
BlandJM, AltmanDG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, 1986; 8:307–310.
28.
KenwardMG, JonesB.The analysis of data from 2 × 2 cross-over trials with baseline measurements. Stat Med, 1987; 6:911–926.
29.
CohenJ.A power primer. Psychol Bull, 1992; 112:155–159.
30.
WiltshireEV, PoitrasV, PakM, et al.Massage impairs postexercise muscle blood flow and “lactic acid” removal. Med Sci Sports Exerc, 2010; 42:1062–1071.
31.
YamauchiJ, KoyamaK. Influence of ankle braces on the maximum strength of plantar and toe flexor muscles. Int J Sports Med, 2015; 36:592–595.
32.
MagnussonSP.Passive properties of human skeletal muscle during stretch maneuvers: A review. Scand J Med Sci Sports, 1998; 8:65–77.
33.
WeerapongP, HumePA, KoltGS. The mechanisms of massage and effects on performance, muscle recovery and injury prevention. Sports Med, 2005; 35:235–256.
34.
ZhongX, TanasugarnC, FisherEB, et al.Awareness and practices of self-management and influence factors among individuals with type 2 diabetes in urban community settings in Anhui Province, China. Southeast Asian J Trop Med Public Health, 2011; 42:184–196.
35.
Yilmaz KaradagF, SaltogluN, AkO, et al.Foot self-care in diabetes mellitus: Evaluation of patient awareness. Prim Care Diabetes, 2019; 13:515–520.
36.
FisherJP.Autonomic control of the heart during exercise in humans: Role of skeletal muscle afferents. Exp Physiol, 2014; 99:300–305.
37.
NortonK, NortonL, SadgroveD. Position statement on physical activity and exercise intensity terminology. J Sci Med Sport, 2010; 13:496–502.
38.
ColbergSR, SigalRJ, YardleyJE, et al.Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 2016; 39:2065–2079.
39.
SennS.Cross-Over Trials in Clinical Research, 2nd ed. Chichester: Wiley, 2002:281–285.
