Letter to the editor - Transcranial direct current stimulation improves quality of life and physical fitness in diabetic
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LETTER TO THE EDITOR
Letter to the editor - Transcranial direct current stimulation improves quality of life and physical fitness in diabetic polyneuropathy: a pilot double blind randomized controlled trial” Satkarjit Kaur Jhandi 1
&
Nidhi Sharma 1
&
Manu Goyal 2
Received: 8 June 2020 / Accepted: 24 August 2020 # Springer Nature Switzerland AG 2020
Dear Editor, The recently published article, “Transcranial direct current stimulation improves quality of life and physical fitness in diabetic polyneuropathy: a pilot double blind randomized controlled trial” by Galeno Ferreira et al. in Journal of Diabetes and Metabolic Disorders (March 2020, 19(6), 327– 335) [1] is very interesting and well documented. Authors concluded that transcranial direct current stimulation (tDCS) in patients with diabetic polyneuropathy has improved their physical health, functional capacity, bodily pain and physical functioning. We gathered knowledge after reading this article but noticed some points that need more clarification from the authors. First, under the methodology section the study design mentioned “a pilot, parallel, sham, randomized double blind” but in the title it is mentioned as “a pilot double blind randomized controlled trial”,it is remain unclear to the readers that what is the actual study design. Instead it should be pretest posttest control group design [2]. Second, under the methodology section authors have mentioned inclusion criteria (1) clinical diagnoses of chronic symmetrical length – dependent sensorimotor polyneuropathy. But it remains unclear that Type 1 diabetes mellitus and Type 2 diabetes mellitus. (2) Aged 18–60 years, but if authors assessed the physical activity level and dynamic balance of the
* Nidhi Sharma [email protected] 1
Department of Neurological Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana 133207, India
2
Department of Musculoskeletal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana 133207, India
participants, there is a large variability in age group, which may influence the results as the balance is affected by aging. [3] However, under results section, mean age is 60.9 ± 15.26 (active group) and 60.7 ± 9.21 (sham group) [1], it remains again unclear then why authors took age group 18–60 years? Under exclusion criteria (4) amputation is mentioned, but there is a need for specification of the site of the amputation. Third, Authors have mentioned under outcomes section in 5th paragraph that the Douleur Neuropathique 4 Questionnaire (DN4) was used and considered as dependent variable. But the results of this outcome within and between groups were not reported in the study. Moreover, it is advisable that tDCS can give beneficial results in the relief of neuropathic pain [4]. Fourth, Authors have used 30 s chair stand test for the evaluation of
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