Herrera Domenica, Rueda Capistrani Diego E, Obando Vera Sebastian, Sanchez Cruz Camila, Linarez Nuñez Karal A, Banegas Douglas, Argueta Ariane, Murillo Md Maria Isabel, Clervil Kenol, Perez Moreno Elda J, Calderon Martinez Ernesto
Medicine, Pontificia Universidad Católica del Ecuador, Quito, ECU.
Physiotherapy, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, MEX.
Cureus. 2024 Jan 10;16(1):e52019. doi: 10.7759/cureus.52019. eCollection 2024 Jan.
Diabetes mellitus (DM) comprises a spectrum of metabolic disorders distinguished by the persistent elevation of glucose levels in the bloodstream. It stands as a primary risk factor for peripheral arterial disease (PAD), denoted by atherosclerosis affecting the lower extremities. One clinical manifestation of symptomatic PAD is intermittent claudication alleviated by rest but also capable of presenting as atypical leg pain. Confirmatory diagnostic measures, including the ankle-brachial index (ABI), toe-brachial index (TBI), or Doppler waveform analysis, are imperative in the verification of PAD. For management, the recommendation is to incorporate physiotherapy alongside concurrent medical interventions, such as anticoagulants, antiplatelet agents, statins, or, in certain cases, surgical procedures. This narrative review seeks to elucidate the advantages of physiotherapy in diabetic patients with PAD, contributing to the deceleration of disease progression and improving symptoms. Although supervised exercise therapy is strongly supported by empirical evidence as more beneficial, the absence of supervised environments is a common issue. Consequently, the preference lies in the combination of supervised exercise with home-based regimens. The objective is that each patient exercises for more than three days per week, progressively extending their duration weekly. This approach has demonstrated a noteworthy enhancement in walking functionality, exercise tolerance, pain alleviation, and an overall improvement in the quality of life for patients.
糖尿病（DM）包括一系列代谢紊乱，其特征是血液中葡萄糖水平持续升高。它是外周动脉疾病（PAD）的主要危险因素，外周动脉疾病表现为影响下肢的动脉粥样硬化。有症状的PAD的一种临床表现是间歇性跛行，休息可缓解，但也可能表现为非典型腿痛。包括踝臂指数（ABI）、趾臂指数（TBI）或多普勒波形分析在内的确诊诊断措施对于PAD的确诊至关重要。在治疗方面，建议在进行抗凝剂、抗血小板药物、他汀类药物等同时进行的药物干预，或在某些情况下进行外科手术的同时结合物理治疗。本叙述性综述旨在阐明物理治疗对糖尿病合并PAD患者的益处，有助于减缓疾病进展并改善症状。尽管有经验证据强烈支持监督运动疗法更有益，但缺乏监督环境是一个常见问题。因此，更倾向于将监督运动与家庭治疗方案相结合。目标是让每位患者每周锻炼三天以上，并逐渐增加每周的锻炼时长。这种方法已证明能显著提高患者的行走功能、运动耐量、缓解疼痛，并全面改善生活质量。
