Faculty of Physical Education and Sport, Charles University, Prague, Czechia.
Clinical Rehabilitation Division, Institute for Clinical and Experimental Medicine, Prague, Czechia.
Front Endocrinol (Lausanne). 2022 Jul 5;13:869128. doi: 10.3389/fendo.2022.869128. eCollection 2022.
Diabetic foot syndrome (DFS) is a serious late diabetic complication characterised by limited joint mobility and other biomechanical and muscle abnormalities.
To evaluate the effect of an interventional exercise programme on anthropometric parameters, muscle strength, mobility and fitness in patients with diabetic foot in remission.
Thirty-eight patients with type 2 diabetes and DFS without active lesions (mean age 65 ± 6.9 years, BMI 32 ± 4.7 kg.m, waist-hip ratio (WHR)1.02 ± 0.06) were enrolled in our randomised controlled trial. All subjects were randomised into two groups: an intervention group (I; n=19) and a control group (C; n=19). The 12-week exercise intervention focused on ankle and small-joint mobility in the foot, strengthening and stretching of the lower extremity muscles, and improvements fitness. Changes (Δ=final minus initial results) in physical activity were assessed using the International Physical Activity Questionnaire (IPAQ), with joint mobility detected by goniometry, muscle strength by dynamometry, and fitness using the Senior Test (SFT).
Due to reulceration, 15.8% of patients from group I (3/19) and 15.8% of patients from group C were excluded. Based on the IPAQ, group I was more active when it came to heavy (p=0.03) and moderate physical activity (p=0.06) after intervention compared to group C. Group I improved significantly in larger-joint flexibility (p=0.012) compared to controls. In group I, dynamometric parameters increased significantly in both lower limbs (left leg; p=0.013, right leg; p=0.043) compared to group C. We observed a positive trend in the improvement of fitness in group I compared to group C. We also confirmed positive correlations between heavy physical activity and selected parameters of flexibility (r=0.47; p=0.007), SFT (r=0.453; p=0.011) and dynamometry (r=0.58; p<0.0025). Anthropometric parameters, such as BMI and WHR, were not significantly influenced by the intervention programme.
Our 12-week interventional exercise programme proved relatively safe, resulting in improved body flexibility and increased muscle strength in DF patients in remission.
糖尿病足综合征（DFS）是一种严重的糖尿病晚期并发症，其特征为关节活动度受限以及其他生物力学和肌肉异常。
评估介入性运动方案对缓解期糖尿病足患者的人体测量参数、肌肉力量、活动度和健康状况的影响。
我们的随机对照试验纳入了 38 名患有 2 型糖尿病和无活动性病变的 DFS 患者（平均年龄 65±6.9 岁，BMI 32±4.7kg/m，腰臀比（WHR）1.02±0.06）。所有患者均随机分为两组：干预组（I 组；n=19）和对照组（C 组；n=19）。为期 12 周的运动干预侧重于足踝和小关节活动度、下肢肌肉的强化和伸展，以及改善健康状况。使用国际体力活动问卷（IPAQ）评估体力活动的变化（Δ=最终结果减去初始结果），使用量角器检测关节活动度，使用测力计检测肌肉力量，使用 Senior 测试（SFT）检测健康状况。
由于再溃疡，I 组中有 15.8%（3/19）的患者和 C 组中有 15.8%（3/19）的患者被排除。根据 IPAQ，与 C 组相比，I 组在干预后进行剧烈（p=0.03）和中度体力活动（p=0.06）时更为活跃。与对照组相比，I 组的大关节灵活性显著改善（p=0.012）。I 组的左右下肢的测力计参数均显著增加（左腿；p=0.013，右腿；p=0.043）。与 C 组相比，I 组的健康状况改善呈积极趋势。我们还证实，剧烈体力活动与灵活性的某些参数（r=0.47；p=0.007）、SFT（r=0.453；p=0.011）和测力计（r=0.58；p<0.0025）之间存在正相关关系。人体测量参数，如 BMI 和 WHR，不受干预方案的显著影响。
我们为期 12 周的介入性运动方案相对安全，可改善缓解期糖尿病足患者的身体灵活性和肌肉力量。
