Effect of foot-ankle flexibility and resistance exercise in the secondary prevention of plantar foot diabetic ulcer |
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| Institution: | 1. Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia;2. Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt;3. Department of Rehabilitation Sciences, Faculty of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia;4. Department of Physical Therapy for Cardiovascular/Respiratory Disorders and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt;5. Department of Physiotherapy, Center of Radiation Oncology & Nuclear Medicine, Cairo University, Giza, Egypt;6. Department of Physical Therapy for Women''s Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt;7. Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia;8. Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt |
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| Abstract: | AimsThe study aimed to evaluate the effects of foot-ankle flexibility and resistance exercises on the recurrence rate of plantar foot diabetic ulcers, HbA1c levels, diabetic neuropathy examination (DNE) scores, ankle brachial index (ABI), and walking speed within 12 and 24 weeks.MethodsWe conducted a double-blind randomized clinical trial. Fifty patients with recently healed plantar foot diabetic ulcers were randomized to an intervention group that performed foot-ankle flexibility and resistance exercise three times a week in their home (n = 25) or a control group (n = 25). Both groups were given foot care education. Outcomes were assessed at plantar foot diabetic ulcer recurrence or at 12 and 24 weeks whichever came first. Outcome measures included plantar foot diabetic ulcer recurrence, changes of HbA1c levels, DNE scores, ankle brachial index ABI, and walking speed.ResultsThere were significant difference between groups in ulcer recurrence at either 12 weeks (intervention 8%, control 68%, RR 0.288; 95% CI 0.156–0.534, P = 0.000) within 12 weeks.or 24 weeks (intervention 16%, control 72%, RR 0.222; 95% CI 0.088–0.564, P = 0.000).). There were significant differences in the DNE score delta (P = 0.000) and walking speed delta (P = 0.000), but there were no significant differences in the HbA1c delta and ABI delta between groups at either 12 or 24 weeks.ConclusionsFoot-ankle flexibility and resistance exercises can reduce the recurrence of plantar foot diabetic ulcer incidence and improve diabetic neuropathy and walking speed.Clinical trial number: NCT04624516 |
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