Polyneuropathy is an umbrella term for certain disorders of the peripheral nervous system that affect more than one nerve. Depending on the respective cause, motor, sensory or vegetative nerves can be mainly or also jointly affected. The disease can primarily affect the insulating layer of the nerves (myelin) or the cellular extension (axon) itself, it may develop further from the torso (distally) on the hands and feet or much more rarely also closer to the torso (proximally). There are symmetrical and asymmetrical forms, but several peripheral nerves are always affected. The symptoms can be highly varied depending on the type of affected nerve fibres and the affected body region.

Common causes:

• Diabetes mellitus
• Toxic: Alcohol abuse, medications, other toxic substances
• Idiopathic (with no discernible cause)
• Autoimmune disorders (e.g. Guillain–Barré syndrome)
• Infectious diseases (mononucleosis, diphtheria, HIV and others)
• In case of cancer, as a side effect of chemotherapy
• Hereditary (rare)

Possible causes:

• Vitamin B1 deficiency
• Vitamin B12 deficiency
• Vitamin E deficiency
• Vasculitis
• Lead poisoning
• Mercury poisoning
• Other

• The distribution of polyneuropathic paraesthesia on the body can vary. Therefore, the illness often begins with unpleasant paraesthesia of the toes on both sides. When the illness progresses, the distribution of paraesthesia is sometimes described as ‘limited to the area covered by a glove or sock’. The affected body regions may tingle spontaneously, with the patient feeling either unpleasant or sometimes very bothersome numbness or burning pain. Paraesthesia such as feeling hot or cold and feelings of swelling, e.g. ‘as in a vice’ may occur.
• Due to the missing or false sensory information about joint positions, pressure when stepping down and the degree of muscle tension, ‘peripheral’ ataxic coordination disturbances may develop. Such patients are then no longer able to walk confidently, especially with the eyes closed.
• Peripheral, atrophic and often symmetrical paralysis
• Trophic skin changes when peripheral vegetative nerve fibres are affected. Ulcers may then develop as well as the reduced production of perspiration, stomach, bowel and bladder voiding disturbances, impotence, resting tachycardia and pupil response disturbances with a limitation of mydriasis (pupil dilatation).

Cause-specific therapy is based on the underlying disease and/or symptoms. Targeted treatment is only possible if the cause of polyneuropathy has been determined. Examples of cause-specific therapeutic measures:

• Bacterial infection: Treatment with antibiotics, for example in case of borreliosis
• Alcoholism: Abstaining from alcohol, additional administration of vitamin B1
• Symptomatic therapy: Pain relief through painkillers.
  Pain therapy without the use of medications is realised by means of what is known as transcutaneous electrical nerve stimulation (TENS).

It is not possible to make general statements since the severity of symptoms among individuals affected by polyneuropathy differs widely.

The kybun shoe has an unstable sole which promotes the coordination and strength of the feet and the entire body. The wearer can also feel the ground through the sole, boosting confidence while walking and stimulating foot sensitivity.

Symptoms such as dizziness, gait disturbances, and coordination and balance disturbances can therefore be addressed effectively with the kybun shoe. Affected individuals can perform daily, adapted training with the kybun shoe independently.

In case of the paralysis of body parts, the affected individual or attending therapist has to assess whether the kybun shoe addresses the weaknesses and boosts confidence while walking or whether the instability in the kybun shoe still overchallenges the affected individual at this time. As long as the affected individual feels comfortable and safe in the kybun shoe, we recommend it. If there is an increased risk of falling, we would currently advise against the kybun shoe and recommend training the stabilising foot musculature while standing on the kybun mat.

• Give yourself sufficient time to test the kybun shoe or kybun mat so your body can get accustomed to the new feeling while walking and standing.
• Listen to your body, how do you feel? Is the kybun shoe/kybun mat good for you?
  If you feel fatigued or experience pain, take a short break.
• Try to integrate the kybun shoe/kybun mat into your everyday life as much as possible. The more often you train with it, the faster you will notice your body making progress. It is better to use it for shorter periods but more often each day.
• We advise you to perform the kybun exercises regularly every now and again. They loosen the muscles and straighten the body. This relieves strain on the joints. Pain should decrease after just a few hours or days.
  Choose the kybun exercises that are good for you! Some customers prefer easier movements while others find the more intensive exercises helpful; this is highly individual.
• Choose a kybun shoe with a lower rebound effect. This gives you more stability in the midfoot. Have a kybun dealer show you various models.
• If you feel unstable wearing the kybun shoe or are looking for an additional training device to use at home, the kybun mat is the ideal alternative. You can strengthen the foot, leg and back musculature at home on the soft, elastic springy mat. If you feel uncertain, you can hold on to a fixed object. The kybun mat is also available in a choice of different thicknesses (the thicker, the more intensive the training). Ask your local kybun dealer for advice.
• Be sure to maintain an upright posture, avoid taking excessively long steps and keep your gaze forward (do not look at the floor). You should walk straight on the kybun shoe sole and correct any lateral/medial rolling of the ankle joint!