Features of the use of ischemic preconditioning for the correction of vibration polyneuropathy of the upper extremities

Introduction. The study of the methods for non-pharmacological correction of vibration polyneuropathy is relevant in view of the high prevalence of vibration disease in various industries, and high occurrence of disability of workers. Ischemic preconditioning has shown its effectiveness in correcting the manifestations of vibration polyneuropathies. The high frequency of nerve compression in tunnels against the background of polyneuropathic lesions in vibration disease dictates the need to study the effectiveness of the method in various forms of vibration polyneuropathy.

The aim of the study was to investigate the effectiveness of ischemic preconditioning in various forms of vibration polyneuropathy.

Materials and methods. Twenty nine patients with a proven diagnosis of vibration disease were examined and treated uisng the ischemic preconditioning. They were divided into 2 groups: group 1 – 18 individuals with upper extremities polyneuropathy without nerve compression, group 2 – 11 subjects with compression complications of polyneuropathy. The examinations included neurological survey, electroneuromyographic investigation before and after the course of ischemic preconditioning conducted according to a patented technique.

Results. A decrease in sensory disturbances and improvement in the impulse conduction along the sensory fibers of the nerves of the upper extremities after a course of ischemic preconditioning in the group of the patients without compression neuropathies were noted. In the group of the patients with polyneuropathies complicated by the nerve compression in tunnels, the positive effect was less significant.

Limitations. The study was limited by the assessment of clinical and electroneuromyographic parameters in 29 patients with vibration disease due to the exposure to local vibration before and after the course of ischemic preconditioning.

Conclusion. The method of ischemic preconditioning is effective as a method for non-pharmacological correction of vibration polyneuropathy. Compression neuropathies are predictors of lower efficiency of the method, and therefore it is important to select patients for the treatment by this method with the preferred inclusion of the patients with uncomplicated vibration polyneuropathies.

Compliance with ethical standards. The study was performed by non-invasive methods and complies with the ethical standards of the Bioethical Committee of the Research Institute for Complex Problems of Hygiene and Occupational Diseases (protocol No.5 of 26.12.2018), elaborated in accordance with the Declaration of Helsinki by the World Medical Association “Ethical Principles for Conducting Scientific Research Involving Humans” as amended in 2013 and “Rules of Good Clinical Practice”, approved by the Order of the Ministry of Health of Russian Federation No. 200n dated April 1, 2016. All examined patients signed a voluntary informed consent to participate in the study.

Contribution:
Yamshchikova A.V. — the concept and design of the study, collection and processing of material, collection of literature data, statistical processing, writing a text;
Fleishman A.N. — the concept and design of the study, editing;
Martynov I.D. — editing;
Bychkovskaya T.A. — collection and processing of material;
Kungurova A.A. — collection and processing of material.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: April 6, 2023 / Accepted: June 7, 2023 / Published: August 30, 2023