Physical Therapy, College of Health Professions, Mercer University, Atlanta, GA.
Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC.
Wounds. 2023 Jan;35(1):9-17. doi: 10.25270/wnds/22007.
The aim of this review was to investigate the effect of exercise, physical activity, stepping characteristics, and loading on DFU healing. A systematic review using proprietary software and a PRISMA 2020 checklist was performed by searching MEDLINE, ProQuest, Scopus, CINAHL, Ovid, and the Cochrane Library for eligible articles from 1960 to December 2020. The primary outcome was time to wound closure. Other outcomes included percentage of DFU healed and time to percentage reduction in DFU. Of the 9 articles included, 6 addressed step activity during the off-loading phase of healing and 3 investigated the addition of NWB exercise on wound healing. Reduced loading via lower daily step activity, less standing duration, and shorter walking bouts in combination with wearing an off-loading device facilitated more rapid wound healing. Exercise seemed to facilitate more rapid healing, as well. Reduced limb loading via daily activity and use of offloading devices improved DFU healing rates. Additional research is necessary to determine the optimal thresholds for exercise, activity, step characteristics, and loading to improve healing outcomes in persons with DFU.
本综述的目的是探讨运动、身体活动、步幅特征和负荷对糖尿病足溃疡（DFU）愈合的影响。通过使用专有的软件和 PRISMA 2020 清单，从 1960 年至 2020 年 12 月，在 MEDLINE、ProQuest、Scopus、CINAHL、Ovid 和 Cochrane 图书馆中搜索了符合条件的文章，进行了系统评价。主要结局是伤口闭合时间。其他结局包括 DFU 愈合的百分比和 DFU 百分比减少所需的时间。在纳入的 9 篇文章中，有 6 篇探讨了愈合过程中离载阶段的步幅活动，3 篇研究了添加非负重运动对伤口愈合的影响。通过降低日常步幅活动、减少站立时间和缩短行走时间，同时使用离载装置来减轻负荷，有助于更快地愈合伤口。运动似乎也能促进更快的愈合。通过日常活动和使用离载装置来减轻肢体负荷可以提高 DFU 的愈合率。需要进一步研究确定运动、活动、步幅特征和负荷的最佳阈值，以改善 DFU 患者的愈合效果。
