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Research Papers

An exercise program for people with severe peripheral neuropathy and diabetic foot ulcers – a case series on feasibility and safety

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Pages 183-189 | Received 30 Jan 2018, Accepted 25 Jun 2018, Published online: 07 Oct 2018
 

Abstract

Purpose: To examine a non-weightbearing exercise program for persons with severe peripheral neuropathy (PN) and a diabetic foot ulcer in terms of feasibility and safety.

Materials and methods: Five men (mean (SD) age of 68.2 (7.1) years) with diabetes, severe peripheral neuropathy and an active foot ulcer, participated in a 10-week exercise program. Program adherence, patient satisfaction, healing of foot ulcers, adverse advents, ability to perform activities of daily life, and changes in muscle strength were assessed.

Results: All participants completed the program with a session attendance from 85 to 95%, and with high satisfaction (≥9 points on a 10-point numeric rating scale). Only minor adverse events occurred, and ulcers were reduced for all participants, from a median of 1.9 (IQR, 1.1–7.3) cm2 to 0.0 (0.0–3.0) cm2. The distance on stationary bike was improved from a mean (SD) of 3.30 (1.1) to 5.36 (0.5) kilometers, and strength training loads were progressed. Ability to perform in self-selected activities of daily living improved from a median of 4.3 (2–5) to 6.7 (5–8) on the Patient Specific Functional Scale (0–10 points), while maximal isometric knee-extension muscle strength improved with 23%.

Conclusions: A non-weightbearing exercise program for people with diabetes, severe peripheral neuropathy and foot ulcers seems feasible and safe. Further studies are needed to confirm these findings.

    Implications for rehabilitation

  • An exercise program designed for people with severe peripheral neuropathy and diabetic foot ulcers can be safe by means of not compromising healing of foot ulcers.

  • Feasible in terms of attendance and progression.

  • An alternative to passive waiting for ulcer to heal in a population already deconditioned.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study was partly funded by a grant from the Danish Physiotherapy Association.

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