Francia Piergiorgio, Anichini Roberto, De Bellis Alessandra, Seghieri Giuseppe, Lazzeri Renzo, Paternostro Ferdinando, Gulisano Massimo
Ital J Anat Embryol. 2015;120(1):21-32.
It is well known that limited joint mobility of the ankle and foot level, impaired muscular performance and reduced gait speed are risk factors for ulceration in diabetic foot. The aim of this study was to evaluate the effect of an experimental protocol of exercise therapy on joint mobility, muscular strength and gait speed in a group of long-term diabetic subjects.
The protocol consisted of a 12-week supervised training program; both joint mobility and muscular strength at the ankle were measured before and after exercise therapy respectively by an inclinometer and isometric dynamometers in 26 diabetic subjects and compared to 17 healthy controls.
Ankle joint mobility of plantar flexion was reduced about 36% and dorsal flexion by about 23% in diabetic subjects compared to controls (p < 0.001), but significantly increased after exercise therapy (p < 0.001 for both). Ankle muscular strength in plantar flexion was reduced by about 51% and in dorsal flexion by 30% in diabetic patients compared to controls, but these also significantly increased after exercise therapy (p < 0.001). Consequently, patients' walking speed increased after exercise therapy by 0.28 m/s (p < 0.001).
A 12-week supervised program of exercise therapy significantly improves joint mobility, muscular performance and walking speed in diabetic patients--thus limiting one of the pathogenic factors of diabetic foot and potentially preventing disability.
众所周知，踝关节和足部关节活动受限、肌肉功能受损以及步态速度降低是糖尿病足溃疡的危险因素。本研究旨在评估一项运动疗法实验方案对一组长期糖尿病患者关节活动度、肌肉力量和步态速度的影响。
该方案包括一个为期12周的有监督的训练计划；分别在运动疗法前后，使用倾角仪和等长测力计对26名糖尿病患者的踝关节活动度和肌肉力量进行测量，并与17名健康对照者进行比较。
与对照组相比，糖尿病患者的踝关节跖屈活动度降低约36%，背屈活动度降低约23%（p < 0.001），但运动疗法后显著增加（两者均p < 0.001）。与对照组相比，糖尿病患者踝关节跖屈肌肉力量降低约51%，背屈肌肉力量降低30%，但运动疗法后这些指标也显著增加（p < 0.001）。因此，运动疗法后患者的步行速度提高了0.28 m/s（p < 0.001）。
一项为期12周的有监督的运动疗法计划可显著改善糖尿病患者的关节活动度、肌肉功能和步行速度，从而限制糖尿病足的致病因素之一，并有可能预防残疾。
