Effect of Transcranial Direct Current Stimulation on Sensory Integration
Effect of Transcranial Direct Current Stimulation on Sensory Integration
To determine the effect of Transcranial direct current stimulation on sensory integration and
 risk of falling in diabetic polyneuropathy.
PURPOSE:

 To determine the effect of Transcranial direct current stimulation on sensory integration and
 risk of falling in diabetic polyneuropathy.

 BACKGROUND:

 Diabetic polyneuropathy is the most prevalent chronic complication affecting 30% - 50% of
 diabetic patients. Diabetic polyneuropathy usually affect the peripheral, autonomic, and
 central nervous systems with several clinical symptoms .About 80% of the cases of DN manifest
 as distal symmetrical sensorimotor polyneuropathy which is responsible for cases of chronic
 pain; impaired sleep quality; increase of the falling risk associated with weakness and
 increase of the risk of extremities amputation. Transcranial direct current stimulation is
 neurophysiologic intervention that alters cortical excitability to enhance lower extremity
 somato-sensation and thus improve functional outcomes.

 HYPOTHESES:

 There will be no effect of Transcranial direct current stimulation on sensory integration and
 risk of falling in diabetic polyneuropathy
Inclusion Criteria:

 1 - Patient will be diagnosed as having Diabetic Polyneuropathy (DPN) and all patients have
 type II diabetes.

 2-The age of the patients ranged from 35 to 55 years.

 3-Clinically all patients suffered from glove stock hyposthesia, numbness and burning
 sensation and mild distal moror weakness

 4-Patients have sensorymotor peripheral neuropathy according to neurophysiological study to
 detect sensory and motor conduction velocity to confirm diagnosis.

 Exclusion Criteria:

 1. History of diabetic ulcer and amputation .

 2. Osteoporosis.

 3. Fractures of lower limbs.

 4. Gross musculoskeletal problems eg:burn.

 5. Significant Scar tissue or calluses on the feet.

 6. Peripheral vascular diseases (PVD) or Microcirculation problems.

 7. Balance disturbance rather than diabetic peripheral neuropathy as ear problems,
 labrynthinitis, stroke or cerebellar problems.

 8. Visual disturbance.

 9. Autonomic neuropathy.

 10. Advanced Osteoarthritis of lower limbs.

 11. Nerve root compression (Radicuolopathy) affecting lower limbs.

 12. Patients with implanted devices for pain control such as deep brain