Effect of extracorporeal shock wave therapy on skin blood perfusion in patients with diabetic foot: Randomized controlled trial.

Introduction: Diabetes mellitus (DM) is associated with serious microvascular complications, which have significant impact on patient\'s quality of life, morbidity, and mortality. Aim: The aim of this study was to investigate the effect of extracorporeal shock wave therapy (ESWT) on blood perfusion of diabetic foot in patients with type 2 diabetes mellitus (T2DM). Methods: Thirty patients with T2DM, aged 40 to 55 years and were randomly assigned into group-A (study group) received ESWT (3000 shock, 1000/session, 3 sessions, 2 weeks a part, 0.32mJ/mm2) in addition to oral hypoglycemic drugs or group-B (control group) received oral hypoglycemic drugs only. Maximum skin blood perfusion (SBP max), minimum skin blood perfusion (SBP min), and basal mean changes of perfusion (BMCP) of the legs were evaluated at the beginning and after four weeks for both groups. Results: SBP min, SBP max and BMCP were evaluated before and after the study. At the end of the study; SBP min and percentage of improvement (%) for the groups-A and B were 9.9±2.7 (44.93%) and 7.25±3.44 (0.93%) respectively. SBP max and (%) for the groups-A and B were 25.19 ± 4.14, (15.62%), 22.17 ± 2.52, (0.12%) respectively. BMCP and (%) for the groups-A and B were 15.37±2.64 (16.09%) and 12.73± 2.49 (0.29%) respectively (P<0.05). Conclusion: ESWT is effective in increasing blood perfusion and microcirculation in diabetic foot of patient with T2DMP.