Efficacy of Biophysical Energies on Healing of Diabetic Skin Wounds in Cell Studies and Animal Experimental Models: A Systematic Review

doi:10.3390/ijms20020368

. 2019 Jan 16;20(2):368.

doi: 10.3390/ijms20020368.

Efficacy of Biophysical Energies on Healing of Diabetic Skin Wounds in Cell Studies and Animal Experimental Models: A Systematic Review

Rachel Lai-Chu Kwan¹, Song Lu², Harry Ming-Chun Choi³, Luther C Kloth⁴, Gladys Lai-Ying Cheing⁵

Affiliations

¹ Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China. rachel.lc.kwan@connect.polyu.hk.
² Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China. songlu.u.washington@gmail.com.
³ Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China. harry.choi@connect.polyu.hk.
⁴ Department of Physical Therapy, College of Health Sciences, Marquette University, Milwaukee, WI 53201-1881, USA. luther.kloth@marquette.edu.
⁵ Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China. Gladys.Cheing@polyu.edu.hk.

PMID: 30654555
PMCID: PMC6359711
DOI: 10.3390/ijms20020368

Efficacy of Biophysical Energies on Healing of Diabetic Skin Wounds in Cell Studies and Animal Experimental Models: A Systematic Review

Rachel Lai-Chu Kwan et al. Int J Mol Sci. 2019.

. 2019 Jan 16;20(2):368.

doi: 10.3390/ijms20020368.

Authors

Rachel Lai-Chu Kwan¹, Song Lu², Harry Ming-Chun Choi³, Luther C Kloth⁴, Gladys Lai-Ying Cheing⁵

Affiliations

¹ Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China. rachel.lc.kwan@connect.polyu.hk.
² Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China. songlu.u.washington@gmail.com.
³ Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China. harry.choi@connect.polyu.hk.
⁴ Department of Physical Therapy, College of Health Sciences, Marquette University, Milwaukee, WI 53201-1881, USA. luther.kloth@marquette.edu.
⁵ Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China. Gladys.Cheing@polyu.edu.hk.

PMID: 30654555
PMCID: PMC6359711
DOI: 10.3390/ijms20020368

Abstract

We have systematically assessed published cell studies and animal experimental reports on the efficacy of selected biophysical energies (BPEs) in the treatment of diabetic foot ulcers. These BPEs include electrical stimulation (ES), pulsed electromagnetic field (PEMF), extracorporeal shockwave (ECSW), photo energies and ultrasound (US). Databases searched included CINAHL, MEDLINE and PubMed from 1966 to 2018. Studies reviewed include animal and cell studies on treatment with BPEs compared with sham, control or other BPEs. Information regarding the objective measures of tissue healing and data was extracted. Eighty-two studies were eventually selected for the critical appraisal: five on PEMF, four each on ES and ECSW, sixty-six for photo energies, and three about US. Based on the percentage of original wound size affected by the BPEs, both PEMF and low-level laser therapy (LLL) demonstrated a significant clinical benefit compared to the control or sham treatment, whereas the effect of US did not reveal a significance. Our results indicate potential benefits of selected BPEs in diabetic wound management. However, due to the heterogeneity of the current clinical trials, comprehensive studies using well-designed trials are warranted to confirm the results.

Keywords: biophysical energies; cell; diabetes mellitus; experimental models; skin wounds; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Systematic reviews flow diagram of the selected BPEs literature search.

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References

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1. Dubský M., Jirkovská A., Bem R., Fejfarová V., Skibová J., Schaper N.C., Lipsky B.A. Risk factors for recurrence of diabetic foot ulcers: Prospective follow-up analysis in the Eurodiale subgroup. Int. Wound J. 2013;10:555–561. doi: 10.1111/j.1742-481X.2012.01022.x. - DOI - PMC - PubMed
1. Dinh T., Tecilazich F., Kafanas A., Doupis J., Gnardellis C., Leal E., Tellechea A., Pradhan L., Lyons T.E., Giurini J.M., et al. Mechanisms Involved in the Development and Healing of Diabetic Foot Ulceration. Diabetes. 2012;61:2937–2947. doi: 10.2337/db12-0227. - DOI - PMC - PubMed

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[1] American Diabetes Association FAST FACTS—Data and Statistics about Diabetes. [(accessed on 18 December 2017)]; Available online: http://professional.diabetes.org/admin/UserFiles/0%20-%20Sean/Documents/....

[2] American Diabetes Association FAST FACTS—Data and Statistics about Diabetes. [(accessed on 18 December 2017)]; Available online: http://professional.diabetes.org/admin/UserFiles/0%20-%20Sean/Documents/....

[3] Margolis D.J., Malay D.S., Hoffstad O.J., Leonard C.E., MaCurdy T., de Nava K.L., Tan Y., Molina T., Siegel K.L. Incidence of Diabetic Foot Ulcer and Lower Extremity Amputation among Medicare Beneficiaries, 2006 to 2008: Data Points #2. [(accessed on 18 December 2017)]; Available online: http://www.ncbi.nlm.nih.gov/books/NBK65149/ - PubMed

[4] Margolis D.J., Malay D.S., Hoffstad O.J., Leonard C.E., MaCurdy T., de Nava K.L., Tan Y., Molina T., Siegel K.L. Incidence of Diabetic Foot Ulcer and Lower Extremity Amputation among Medicare Beneficiaries, 2006 to 2008: Data Points #2. [(accessed on 18 December 2017)]; Available online: http://www.ncbi.nlm.nih.gov/books/NBK65149/ - PubMed

[5] Johannesson A., Larsson G.U., Ramstrand N., Turkiewicz A., Wirehn A.B., Atroshi I. Incidence of lower-limb amputation in the diabetic and nondiabetic general population: A 10-year population-based cohort study of initial unilateral and contralateral amputations and reamputations. Diabetes Care. 2009;32:275–280. doi: 10.2337/dc08-1639. - DOI - PMC - PubMed

[6] Johannesson A., Larsson G.U., Ramstrand N., Turkiewicz A., Wirehn A.B., Atroshi I. Incidence of lower-limb amputation in the diabetic and nondiabetic general population: A 10-year population-based cohort study of initial unilateral and contralateral amputations and reamputations. Diabetes Care. 2009;32:275–280. doi: 10.2337/dc08-1639. - DOI - PMC - PubMed

[7] Dubský M., Jirkovská A., Bem R., Fejfarová V., Skibová J., Schaper N.C., Lipsky B.A. Risk factors for recurrence of diabetic foot ulcers: Prospective follow-up analysis in the Eurodiale subgroup. Int. Wound J. 2013;10:555–561. doi: 10.1111/j.1742-481X.2012.01022.x. - DOI - PMC - PubMed

[8] Dubský M., Jirkovská A., Bem R., Fejfarová V., Skibová J., Schaper N.C., Lipsky B.A. Risk factors for recurrence of diabetic foot ulcers: Prospective follow-up analysis in the Eurodiale subgroup. Int. Wound J. 2013;10:555–561. doi: 10.1111/j.1742-481X.2012.01022.x. - DOI - PMC - PubMed

[9] Dinh T., Tecilazich F., Kafanas A., Doupis J., Gnardellis C., Leal E., Tellechea A., Pradhan L., Lyons T.E., Giurini J.M., et al. Mechanisms Involved in the Development and Healing of Diabetic Foot Ulceration. Diabetes. 2012;61:2937–2947. doi: 10.2337/db12-0227. - DOI - PMC - PubMed

[10] Dinh T., Tecilazich F., Kafanas A., Doupis J., Gnardellis C., Leal E., Tellechea A., Pradhan L., Lyons T.E., Giurini J.M., et al. Mechanisms Involved in the Development and Healing of Diabetic Foot Ulceration. Diabetes. 2012;61:2937–2947. doi: 10.2337/db12-0227. - DOI - PMC - PubMed

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Efficacy of Biophysical Energies on Healing of Diabetic Skin Wounds in Cell Studies and Animal Experimental Models: A Systematic Review

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Efficacy of Biophysical Energies on Healing of Diabetic Skin Wounds in Cell Studies and Animal Experimental Models: A Systematic Review

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