Suryani Maria, Samekto Widiastuti, Susanto Hardhono, Dwiantoro Luky
Nursing Study Program, St. Elisabeth School Health Science (STIKES St.Elisabeth), Semarang, Indonesia; Medicine Faculty, Diponegoro University, Semarang, Indonesia.
Medicine Faculty, Diponegoro University, Semarang, Indonesia; St. Elisabeth Hospital, Semarang, Indonesia.
J Diabetes Complications. 2021 Sep;35(9):107968. doi: 10.1016/j.jdiacomp.2021.107968. Epub 2021 May 28.
The 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 24weeks.
We 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 24weeks whichever came first. Outcome measures included plantar foot diabetic ulcer recurrence, changes of HbA1c levels, DNE scores, ankle brachial index ABI, and walking speed.
There were significant difference between groups in ulcer recurrence at either 12weeks (intervention 8%, control 68%, RR 0.288; 95% CI 0.156-0.534, P=0.000) within 12weeks. or 24weeks (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 24weeks.
Foot-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.
本研究旨在评估足踝灵活性和抗阻运动对足底糖尿病溃疡复发率、糖化血红蛋白（HbA1c）水平、糖尿病神经病变检查（DNE）评分、踝臂指数（ABI）以及12周和24周内步行速度的影响。
我们进行了一项双盲随机临床试验。50例近期愈合的足底糖尿病溃疡患者被随机分为干预组（n = 25）和对照组（n = 25）。干预组患者在家中每周进行3次足踝灵活性和抗阻运动，两组均接受足部护理教育。在足底糖尿病溃疡复发时或12周和24周（以先到者为准）评估结果。结果指标包括足底糖尿病溃疡复发、HbA1c水平变化、DNE评分、踝臂指数ABI和步行速度。
在12周时（干预组8%，对照组68%，RR 0.288；95%CI 0.156 - 0.534，P = 0.000）或24周时（干预组16%，对照组72%，RR 0.222；95%CI 0.088 - 0.564，P = 0.000），两组间溃疡复发率存在显著差异。两组间DNE评分差值（P = 0.000）和步行速度差值（P = 0.000）存在显著差异，但在12周或24周时，两组间HbA1c差值和ABI差值无显著差异。
足踝灵活性和抗阻运动可降低足底糖尿病溃疡的复发率，改善糖尿病神经病变和步行速度。临床试验编号：NCT04624516。
