Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, The Netherlands.
Amsterdam Movement Sciences, program Rehabilitation, Amsterdam, The Netherlands.
Diabetes Metab Res Rev. 2022 Sep;38(6):e3552. doi: 10.1002/dmrr.3552. Epub 2022 Jun 13.
Weight-bearing physical activity is important for people with diabetes-related foot disease but may also contribute to ulceration or delayed ulcer healing. No overview of weight-bearing activity of people at different stages of foot disease is available. We aimed to summarise quantitatively measured daily activity levels in people with diabetes-related foot disease.
We systematically searched peer-reviewed literature for studies reporting objectively measured weight-bearing activity in people with diabetes-related foot disease. We calculated daily step counts' means (over studies) and weighted means (over participants). International Working Group on the Diabetic Foot (IWGDF) risk strata, different climates, and activity indoors versus outdoors were compared.
From 1247 publications, 27 were included. Mean steps/day in people with IWGDF risk 1/2: 6125 (12 studies; 345 participants; weighted mean: 5384). In IWGDF risk 3: 6167 (8 studies; 291 participants; weighted mean: 6239). In those with a foot ulcer: 4248 (6 studies; 186 participants; weighted mean: 4484). People living in temperate oceanic climates are more active compared to those in hotter or more humid climates (mean steps/day for no ulcer: 7712 vs. 5224 [18 studies]; for ulcer: 6819 vs. 2945 [6 studies]). People are more active indoors than outdoors (mean 4047 vs. 2514 [3 studies]).
Levels of weight-bearing physical activity are similar between people with diabetes at various risk levels for foot ulceration but lower for those with a foot ulcer. Weight-bearing activity differs depending on the climatological environment and is higher indoors than outdoors. These findings provide reference for intervention studies or for clinicians aiming to provide mobility advice in this population.
承重体力活动对糖尿病相关足部疾病患者很重要，但也可能导致溃疡或延迟溃疡愈合。目前尚无针对不同足部疾病阶段患者承重活动的综述。我们旨在总结糖尿病相关足部疾病患者的日常活动水平。
我们系统地检索了同行评议文献中关于糖尿病相关足部疾病患者客观测量承重活动的研究。我们计算了每日步数的平均值（跨研究）和加权平均值（跨参与者）。比较了国际糖尿病足工作组（IWGDF）风险分层、不同气候以及室内和室外活动。
从 1247 篇文献中，有 27 篇被纳入。IWGDF 风险 1/2 组的参与者平均每天行走 6125 步（12 项研究，345 名参与者，加权平均值：5384）。IWGDF 风险 3 组的参与者平均每天行走 6167 步（8 项研究，291 名参与者，加权平均值：6239）。有足部溃疡的参与者平均每天行走 4248 步（6 项研究，186 名参与者，加权平均值：4484）。居住在温带海洋性气候的人比居住在较热或较潮湿气候的人更活跃（无溃疡参与者的平均步数/天：7712 比 5224[18 项研究]；溃疡参与者：6819 比 2945[6 项研究]）。与户外活动相比，人们在室内活动更为活跃（平均 4047 比 2514[3 项研究]）。
不同足部溃疡风险水平的糖尿病患者的承重体力活动水平相似，但有足部溃疡的患者水平较低。承重活动因气候环境而异，室内活动高于室外活动。这些发现为干预研究或临床医生为该人群提供活动建议提供了参考。
