Physical rehabilitation modulates microRNAs involved in multiple sclerosis: a case report

Effectiveness of neuromuscular taping on balance, proprioception, pain, and nerve conduction parameters in patients with diabetic peripheral neuropathy: a two-group pretest-posttest randomized sham-controlled trial study protocol

Background

The management of diabetic peripheral neuropathy (DPN) comprises a multidimensional approach. Along with pharmacological treatment, physiotherapy has gained applaudable popularity in improving the symptoms of DPN. Neuromuscular taping (NMT) is effective in improving motor, sensory, and balance impairments in many neuromuscular and musculoskeletal conditions but no research has conducted to evaluate the effect of NMT on balance, proprioception, pain, and nerve conduction parameters in patients with DPN.

Purpose

To evaluate the effectiveness of NMT on balance, proprioception, pain, and nerve conduction parameters in patients with DPN.

Methods

50 DPN patients aged 40-60 years, scored ≥ 2/13 on physical appearance and ≥ 1/10 on physical examination of Michigan Neuropathy Screening Instrument (MNSI), > 12 on Leeds Assessment of Neuropathic Symptom and Sign (LANSS) scale and < 45 on Berg Balance Scale (BBS) will be included. The experimental group (EG) will receive NMT at the tibialis anterior, tibialis posterior, and peroneus longus muscle and transverse arch of the foot and TENS at the tibial and peroneal nerves (80 Hz, 50 Amp, 0.2 ms square pulses, 2 to 3 times sensory threshold) and the control group (CG) will receive sham taping at the ankle joint and TENS with the same parameters as EG. Outcome measures will be taken at baseline, at 4 weeks, and at 8 weeks of intervention, respectively.

Conclusion

The results obtained upon completion of this study may provide a cost-effective non-invasive treatment option to improve the outcomes that will be measured in the present study in patients with DPN.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01275-5.

microRNAs: key modulators of disease-modifying therapies in multiple sclerosis

There is a high level of heterogeneity in symptom manifestations and response to disease-modifying therapies (DMTs) in multiple sclerosis (MS), an immune-based neurodegenerative disease with ever-increasing prevalence in recent decades. Because of unknown aspects of the etiopathology of MS and mechanism of action of DMTs, the reason for this variability is undetermined, and much remains to be understood. Traditionally, physicians consider switching to other DMTs based on the exacerbation of symptoms and/or change in the results of magnetic resonance imaging and biochemical factors. Therefore, identifying biological treatment response markers that help us recognizing non-responders rapidly and subsequently choosing another DMTs is necessary. microRNAs (miRNAs) are micromanagers of gene expression which have been profiled in different samples of MS patients, highlighting their role in pathogenetic of MS. Recent studies have investigated expression profiling of miRNAs after treatment with DMTs to clarify possible DMTs-mediated mechanism and obtaining response to therapy biomarkers. In this review, we will discuss the modulation of miRNAs by DMTs in cells and pathways involved in MS.

Unraveling the Molecular Determinants of Manual Therapy: An Approach to Integrative Therapeutics for the Treatment of Fibromyalgia and Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

Application of protocols without parameter standardization and appropriate controls has led manual therapy (MT) and other physiotherapy-based approaches to controversial outcomes. Thus, there is an urgency to carefully define standard protocols that elevate physiotherapy treatments to rigorous scientific demands. One way in which this can be achieved is by studying gene expression and physiological changes that associate to particular, parameter-controlled, treatments in animal models, and translating this knowledge to properly designed, objective, quantitatively-monitored clinical trials (CTs). Here, we propose a molecular physiotherapy approach (MPTA) requiring multidisciplinary teams, to uncover the scientific reasons behind the numerous reports that historically attribute health benefits to MT-treatments. The review focuses on the identification of MT-induced physiological and molecular responses that could be used for the treatment of fibromyalgia (FM) and chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). The systemic effects associated to mechanical-load responses are considered of particular relevance, as they suggest that defined, low-pain anatomic areas can be selected for MT treatment and yet yield overall benefits, an aspect that might result in it being essential to treat FM. Additionally, MT can provide muscle conditioning to sedentary patients without demanding strenuous physical effort, which is particularly detrimental for CFS/ME patients, placing MT as a real option for integrative medicine programs to improve FM and CFS/ME.

Physical rehabilitation modulates microRNAs involved in multiple sclerosis: a case report

This study shows that neuromuscular taping improves gait, balance, pain and ability to walk and conduct daily activities in a multiple sclerosis patient. It is the first study to identify a panel of miRNAs modulated throughout rehabilitation using neuromuscular taping in a multiple sclerosis patient.