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· DOS Abstracts
An exercise programme for people with severe
polyneuropathy and diabetic foot ulcers - 5 case
reports on feasibility, safety and preliminary
effectiveness
Kajsa Lindberg, Britt Sundekilde Møller, Klaus Kirketerp-Møller, Morten Tange
Kristensen
Rehabilitation Centre Vanløse, Copenhagen Municipality, Denmark; Nurse Clinic Vanløse,
Copenhagen Municipality, Denmark; Copenhagen Wound Healing Center , Bispebjerg
University Hospital, Copenhagen, Denmark ; Physical Medicine and Rehabilitation
Research - Copenhagen (PMR-C), Departments of Physiotherapy and Orthopaedic
Surgery, Copenhagen University Hospital Hvidovre, Denmark
Background:
The common recommendation is that off-loading is necessary for heal-
ing of diabetic foot ulcers, and thereby avoiding a potential amputation. However, this
is commonly associated with an inactive lifestyle. Thus, the management challenge is to
combine off-loading with an active lifestyle that includes regular exercise.
Purpose / Aim of Study:
To investigate if an exercise program for people with diabetes,
severe polyneuropathy and foot ulcer is safe, feasible and preliminary effective.
Materials and Methods:
Five men at a mean (SD) age of 68.2 (7.1) years with diabetic
foot ulcers and severe polyneuropathy, participated in a 10 week municipality- based
aerobic, resistance and ankle mobility exercise program, designed with a minimum of
weight bearing. Safety and feasibility was evaluated by change of the foot ulcer area,
adverse events, adherence to the program, and patient satisfaction.
Findings / Results:
Only minor adverse events occurred, and foot ulcers were reduced
for all participants, from a median of 1.9 (IQR, 1.1-7.3) to 0.0 (0.0-3.0) cm2. All par-
ticipants completed the program with a session attendance from 85- 95%, and with a
satisfaction rate ¡Ý 9 on a 10 point Numeric Rating Scale. The distance on stationary bike
was improved from a mean of 3.30 (1.1) to 5.36 (0.5) kilometers, while training loads
for muscle groups were progressed, and especially for the lower limbs. Knee-extension
strength improved with 23%, while perceived limitations in activities of daily living were
reduced from a median of 4 (IQR, 2-5) to 7 (5-8) points.
Conclusions:
An exercise program for people with diabetes, severe polyneuropathy and
foot ulcers did not compromise the healing of ulcers. Program adherence and patient
satisfaction was extremely high, performances improved, and perceived limitations were
reduced. We suggest the program be further evaluated.
No conflicts of interest reported
55.