Reliability of Nerve Function Assessment in People With Peripheral Neuropathy

Li Li, Georgia Southern University
Matthew Lane Holmes, Georgia Southern University
Shuqi Zhang, Louisiana State University
Duckchan Jang, Keimyung University

Abstract

Peripheral Neuropathy (PN) is a neurodegenerative disease that damages the peripheral nervous system [1]. People with PN often report tingling / burning sensations starting at their foot sole. PN is usually symmetrical sensory nerve damage starting at the distal part but progresses proximally. People with PN suffer balance problems and are at the high risk of falling [2, 3]. Studies have tried to find effective treatments for balance impairment in this population. However, there is no effective treatment or technique to measure treatment progress. Traditional strength and endurance exercises have not shown direct evidence to improve balance in people with PN [4]. Alternatively, Tai chi training has been reported to improve balance in people with PN and people with reduced sensory conditions [5, 6]. Tai chi has also been shown to revert the degeneration of foot tactile sensation and, in turn, improve balance in people with PN [7]. This observation combined with other studies, indicates that the key to balance impairment for this population is reduced sensory not motor function [8]. Tactile sensitivity and proprioception, along with nerve function properties should be considered for assessments within this population in relation to balance. Central nerve adaptation could be induced by PN [9], which can be assessed using H- reflex and H-Index [10]. Therefore, the purpose of this study was to examine the reliability of measurements from nerve function test such as H-Reflex, H-Index, H- & M-wave ratio, and related latencies. Also, we tested the reliability of foot tactile sensitivity and ankle proprioception. Any reliable measures could be useful in gauging the progress of the disease and effectiveness of intervention studies involving PN.