Journal
SENSORS
Volume 20, Issue 18, Pages -Publisher
MDPI
DOI: 10.3390/s20185129
Keywords
plantar pressure; range of motion; diabetic neuropathies; exercise; diabetic foot; clinical trial; physical therapy
Funding
- Sao Paulo Research Foundation [FAPESP 2017/17848-3]
- National Council for Scientific and Technological Development, Brazil (CNPq) [407252/2018-5]
- FAPESP [2019/02522-0, 2019/06405-9]
- Agency Coordination of Improvement of Higher Education Personnel (CAPES) [001]
- CNPq, Brazil [304124/2018-4]
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Foot-ankle strengthening and mobility exercises are part of international guideline recommendations for people at risk of diabetic foot disease. We examined the feasibility and preliminary efficacy of a 12-week foot-ankle exercise program on clinical, functional and biomechanical outcomes in people with diabetic neuropathy (DPN). We randomly allocated 30 people with DPN to usual care (control) or usual care plus a supervised exercise program (intervention). For feasibility, we assessed recruitment rate and participant adherence and satisfaction. For program efficacy, we assessed baseline to 12-week changes in daily physical activity level, gait speed, tactile sensitivity, ankle range of motion, DPN symptoms, quality of life, foot health and functionality, foot strength and plantar pressure during gait, using paired t-tests (p< 0.05). In 52 weeks, we recruited 45 eligible participants (0.90/week). Program adherence was 80% and participants' satisfaction had a mean (SD) of 4.57 (0.70) out of 5. The intervention group significantly improved on toes strength, contact time during gait and DPN symptoms, and peak forefoot pressures increased over time; controls showed significantly increased heel peak pressures and force. The exercise program was feasible, based on a moderate recruitment rate and an adherent and satisfied population, and the intervention showed several positive preliminary effects over time compared to usual care.
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