Waveform Electrostimulation: Can It Be Another Option For Painful Peripheral Neuropathy?

Raymond Abdo, DPM, and Jaret Walker, DPM

What One Retrospective Analysis Reveals About A New Waveform Device
Now the VST Myodynamic Device® has emerged for the treatment of peripheral neuropathy. The new modality uses a pure, alternating, biphasic, sinusoidal waveform (VST waveform). In order to determine the efficacy of this device, we developed an office-based protocol for a retrospective analysis.
For the study, we included the first 40 consecutive office patients who met the following criteria:
• a diagnosis of any form of peripheral neuropathy either by a neurologist, another physician, or the researchers themselves during their initial clinical exam; and
• the presence of painful peripheral neuropathy in the lower extremity.
We diagnosed 22 patients with DPN, 16 with idiopathic peripheral neuropathy, one with chemo-induced peripheral neuropathy and one with alcohol-induced peripheral neuropathy. The patients’ age range was 35 to 87. The number of months each patient experienced PN symptoms ranged from four to 240 with a mean number of 67 months. Using the VAS pain scale, the patients’ subjective pain from peripheral neuropathy ranged from 1 to 10 with a mean of 5.9. Forty-two percent of the patients were actively taking medicine commonly prescribed to treat the symptoms of peripheral neuropathy.
All patients received the treatment at least twice every week and all had to complete the treatment regimen, which varied from 12 to 40 sessions depending on the severity of the peripheral neuropathy and the patient’s individual response to the therapy. During this study, we did not encourage patients to stop taking anti-neuropathic medication previously prescribed by other physicians nor did we provide any new prescriptions (including supplements or vitamins).
In 2006, patients began receiving VST waveform electrostimulation two to three times a week in our offices. We used four electrode pads, which were controlled by two channels on each lower extremity. The two pads connected to the first channel were over the fibular head and the anterior ankle. The second channel’s pads were posterior-superior to the medial malleolus and across the plantar metatarsal heads. Each therapy session lasted one hour.
After completing the entire therapy regimen, each patient received an exit questionnaire. The questionnaire consisted of the following questions:
• What is your current pain level (on the VAS scale) for your lower extremity peripheral neuropathy symptoms?
• What other benefits have you noticed from your therapy?
• What is the percentage of overall symptom improvement in the lower extremity after going through VST waveform therapy?
• Would you recommend this office therapy to another patient?
We compiled the data from these 40 patients and did a retrospective analysis. We noted a final mean peripheral neuropathy pain reduction of 83 percent with an overall symptom improvement mean of 86 percent. There were other benefits as well. A majority of the patients had a significant improvement in the quality of sleep, improved balance during gait and increased lower extremity sensation. Many of the patients on anti-neuropathic medication during the study had either stopped taking the medicine, decreased their dosage or were planning on talking with the prescribing doctor about eliminating the medication.
The VST waveform therapy required a mean of 24 office sessions. All study participants noted they would recommend this type of therapy to another patient. Study authors noted no adverse events during the treatment. There was no significant statistical difference between either researcher’s final outcomes.

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