Neuromuscular Electrostimulation of the Common Peroneal Nerve Increases Microvascular Flux in the Wound bed of Diabetic Foot Ulcers
Year: 2025
Type: article
Study design: Clinical Trial
Abstract: Objective To measure the effect of neuromuscular stimulation of the common peroneal nerve on the microvascular blood flow within the wound bed of diabetic foot ulcers. Research Design and Methods 13 patients with diabetic foot ulcers (11 neuropathic, 2 neuroischemic) were recruited. Microvascular flux and pulsatility were measured in real time in the wound bed, and at the wound edge, using Laser Speckle Contrast Imaging (Moor FLPI-2; Moor Instruments Ltd, Axminster, United Kingdom). Changes from baseline were measured when the leg muscle pump was activated by 1 Hz neuromuscular stimulation of the common peroneal nerve, using a wearable device (geko, Firstkind Ltd Daresbury, United Kingdom). Results In the 11 neuropathic ulcers, significant increases were seen in all microvascular parameters. Wound bed flux increased by 36% (95%CI 11%-68%, P = .002), and peri-wound flux increased by 92% (95%CI 46%-160%, P = .001). Pulsatility in the wound bed increased by 183% (95%CI 61%-517%, P = .005), while pulsatility in the peri-wound increases by 359% (95%CI 264%-455%, P = .001). Additionally, an increase in flux and pulsatility was observed in the neuroischemic ulcers. Conclusions Neuromuscular stimulation of the common peroneal nerve presents a mode of activating the leg muscle pump without additional pressure insult to the foot and has potential to support the microcirculation during wound-healing, effectively emulating exercise without any of the attendant risks of exercise to the neuropathic or neuroischemic foot.
Authors: David C. Bosanquet, Melissa Blow, Faye Ashton, Keith Harding
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,150
OpenAlex ID: W4409866745