Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, Rua Cipotânea, 51 - Butantã, São Paulo, SP 05360-000, Brazil.
Department of Physical Therapy, Federal University of Amapá, Rod. Juscelino Kubitschek, km 02 - Jardim Marco Zero, Macapá, AP 68903-419, Brazil.
Sensors (Basel). 2020 Sep 9;20(18):5129. doi: 10.3390/s20185129.
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 ( < 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.
足踝强化和活动度练习是国际指南建议糖尿病足病高危人群采取的措施之一。我们研究了为期 12 周的足踝运动方案对糖尿病周围神经病变（DPN）患者的临床、功能和生物力学结局的可行性和初步疗效。我们将 30 名 DPN 患者随机分配至常规护理（对照组）或常规护理加监督运动方案（干预组）。为了评估可行性，我们评估了招募率和参与者的依从性及满意度。为了评估方案疗效，我们采用配对 t 检验（ < 0.05）评估了从基线到 12 周时日常体力活动水平、步态速度、触觉灵敏度、踝关节活动范围、DPN 症状、生活质量、足部健康和功能、足部力量和足底压力的变化。在 52 周时，我们招募了 45 名符合条件的参与者（每周 0.90 名）。方案依从性为 80%，参与者的满意度平均为 4.57（0.70）（满分 5 分）。干预组的足趾力量、步态接触时间和 DPN 症状明显改善，足前掌峰值压力随时间增加而增加；对照组的足跟峰值压力和力明显增加。基于适度的招募率和依从性及满意度高的人群，该运动方案具有可行性，且与常规护理相比，干预组在随访期间显示出了一些积极的初步效果。
