Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51-Butantã, São Paulo 05360-160, SP, Brazil.
. Department of Biological and Health Science, Federal University of Amapá, Rod. Juscelino Kubitschek, km 02-Jardim Marco Zero, Macapá 68903-419, AP, Brazil.
Sensors (Basel). 2022 Dec 7;22(24):9582. doi: 10.3390/s22249582.
Previous studies have shown the efficacy of foot-ankle exercises in people with diabetic peripheral neuropathy (DPN), but the quality of evidence is still low. This proof-of-concept study pursues preliminary evidence for potential clinical and gait biomechanical benefits from an internet-based foot-ankle therapeutic exercise program for people with DPN. We randomized 30 individuals with DPN (IWGDF risk category 1 or 2) into either the control group (CG) receiving the usual care or the intervention group (IG) receiving the usual care plus an internet-based foot-ankle exercise program, fully guided by the Sistema de Orientação ao Pé Diabético (SOPeD; translation: Diabetic Foot Guidance System) three times per week for 12 weeks. We assessed face-to-face clinical and biomechanical outcomes at baseline, 12 weeks, and 24 weeks (follow up). Participants had good adherence to the proposed intervention and it led to only mild adverse events. The IG showed improvements in the ankle and first metatarsophalangeal joint motion after 12 and 24 weeks, changed forefoot load absorption during foot rollover during gait after 24 weeks, reduced foot pain after 12 weeks, and improved foot function after 24 weeks. A 12-week internet-based foot-ankle exercise program using the SOPeD software (version 1.0) has the potential to reduce foot pain, improve foot function, and modify some important foot-ankle kinematic outcomes in people with DPN.
先前的研究表明，足部-踝关节运动对于患有糖尿病周围神经病变（DPN）的人群是有效的，但证据质量仍然较低。本概念验证研究旨在为基于互联网的足部-踝关节治疗性运动方案为 DPN 患者带来的潜在临床和步态生物力学益处提供初步证据。我们将 30 名患有 DPN 的个体（IWGDF 风险类别 1 或 2）随机分为对照组（CG）和干预组（IG），CG 接受常规护理，IG 则在常规护理的基础上，每周接受三次完全由 Sistema de Orientação ao Pé Diabético（SOPeD；翻译：糖尿病足指导系统）指导的基于互联网的足部-踝关节运动方案，共 12 周。我们在基线、12 周和 24 周（随访）时进行了面对面的临床和生物力学评估。参与者对拟议的干预措施有较好的依从性，且只有轻微的不良事件。IG 在 12 周和 24 周后踝关节和第一跖趾关节活动度有所改善，24 周后步行时足滚动过程中前足负荷吸收发生改变，12 周后足部疼痛减轻，24 周后足部功能改善。使用 SOPeD 软件（版本 1.0）进行为期 12 周的基于互联网的足部-踝关节运动方案，有可能减轻足部疼痛、改善足部功能，并改变 DPN 患者一些重要的足部-踝关节运动学结果。
