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Exercise and the diabetic foot

Discussion in 'Diabetic Foot & Wound Management' started by scotfoot, Jan 2, 2020.

  1. scotfoot

    scotfoot Well-Known Member


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    More evidence that specific , targeted exercise of the foot , can improve foot health , and that this can lead to improved general health .

    Hand and foot exercises for diabetic peripheral neuropathy: A randomized controlled trial

    Mi Mi Thet Mon Win MNSc
    Kiyoko Fukai PhD

    Htwe Htwe Nyunt MNSc

    Khaing Zaw Linn BNSc
    First published: 26 December 2019
    https://doi.org/10.1111/nhs.12676



    Abstract

    Exercises for diabetic peripheral neuropathy remain controversial, especially with regard to recommended precautions and weightbearing exercises for individuals. We aimed to investigate the effect of 8 weeks of simple hand, finger, and foot exercises in patients with diabetic peripheral neuropathy. After randomization, exercise (n = 51) and control (n = 53) groups received usual care and diabetic foot care education; only the exercise group performed exercises. Primary outcomes, including activities of daily living (assessed using the Patient Neurotoxicity Questionnaire), neuropathy severity (monofilament and vibration test), and pain (behavioral rating scale and Visual Analog Scale), and secondary outcomes, including physical function of the hand and foot (grip, pinch, finger counting time, and Timed Up and Go tests), were assessed at baseline, after the 8‐week intervention, and at the 16‐week follow‐up. The exercise group showed significantly stronger improvements in motor score and specific activities of daily living, such as climbing stairs and performing work or chores. Our exercises can be used to improve limb function in patients with diabetic neuropathy.
     
  2. scotfoot

    scotfoot Well-Known Member

    Weak evidence suggests that encouraging blood flow into the foot ,using foot exercises , can promote healing of diabetic foot ulcers . In my opinion , the evidence is weak because few have gone looking .

    Question . If reduced blood flow can lead to cell death and even gangrene , why on earth are prescribed foot exercises , which increase blood flow into the foot , not a front line treatment option for diabetic foot ulcers , since tissue health and repair are so obviously linked to a good blood supply ?
     
  3. scotfoot

    scotfoot Well-Known Member

    From abstract of paper below ; In conclusion, the research results are diabetic foot exercise has effect on distal sensory and peripheral neuropathy.

    Weak evidence becoming moderate ?

    10.5958/0973-9130.2019.00570.X
    The Effects of Foot Exercise to Distal Sensorimotor on Diabetic Peripheral Neuropathy
    Awaluddin Sri Wahyuni1,*, Ardi Muhammad1, Zabitha Ridzka Ayyanun1
    uni.awal@gmail.com, Address: Campus of Department of Nursing, Health Polytechnic of Makassar, South Sulawesi, Indonesia
    Online published on 27 November, 2019.
    Abstract
    Diabetic peripheral neuropathy is one of the complications arising from diabetes mellitus which decreases the function of distal sensory nerve, especially the lower extremity in progressively, and autonomic nerves which could be acute or chronic. This research aimed to determine the effect of diabetic foot gymnastic on distal sensorimotor on people with diabetes with peripheral neuropathy at Jongaya Public Health Center, Tamalate Sub-District, Makassar City. The research method was quasi experiment research design with pretest-posttest research design with control group design. The sample was selected by using purposive sampling. The research results show that foot exercise has effect on sensory sensations (p-value=0.000). There was no effect of diabetic foot exercise on motor sensations (p-value=0.218). Foot exercise has effect on diabetic peripheral neuropathy (p-value=0.005). In conclusion, the research results are diabetic foot exercise has effect on distal sensory and peripheral neuropathy.
     
  4. scotfoot

    scotfoot Well-Known Member

    Still on the same theme , here (below ) , is the conclusion of a paper published in 2017 .

    Looking at the three papers I have mentioned in this thread , one thing jumps out . All the studies involved researchers drawn from the nursing profession .

    Could researchers drawn from this previously , relatively underutilized "bank of brains" , have a tendency towards "research with its head screwed on" ?


    CONCLUSION:

    The ulcer areas decreased significantly in the study intervention group compared to the control group during the 3 follow-up measurements. An important finding in this study was the DFU area decreased more in those who exercised more. Findings suggests foot exercises should be included in the treatment plan when managing patients with diabetic foot ulcers.

    Paper
    The Effect of Foot Exercises on Wound Healing in Type 2 ...


    https://www.ncbi.nlm.nih.gov › pubmed

    by Ş Eraydin - ‎2017 - ‎Cited by 9 - ‎Related articles19 Dec 2017 - The Effect of Foot Exercises on Wound Healing in Type 2 Diabetic Patients With a Foot Ulcer. Eraydin Ş(1), Avşar G. Author information
     
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