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Article

Feasibility and Preliminary Efficacy of a Foot-Ankle Exercise Program Aiming to Improve Foot-Ankle Functionality and Gait Biomechanics in People with Diabetic Neuropathy: A Randomized Controlled Trial

1
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, Rua Cipotânea, 51 - Butantã, São Paulo, SP 05360-000, Brazil
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Department of Physical Therapy, Federal University of Amapá, Rod. Juscelino Kubitschek, km 02 - Jardim Marco Zero, Macapá, AP 68903-419, Brazil
3
Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Sensors 2020, 20(18), 5129; https://doi.org/10.3390/s20185129
Received: 24 July 2020 / Revised: 19 August 2020 / Accepted: 4 September 2020 / Published: 9 September 2020
(This article belongs to the Collection Sensors in Biomechanics)
Foot-ankle strengthening and mobility exercises are part of international guideline recommendations for people at risk of diabetic foot disease. We examined the feasibility and preliminary efficacy of a 12-week foot-ankle exercise program on clinical, functional and biomechanical outcomes in people with diabetic neuropathy (DPN). We randomly allocated 30 people with DPN to usual care (control) or usual care plus a supervised exercise program (intervention). For feasibility, we assessed recruitment rate and participant adherence and satisfaction. For program efficacy, we assessed baseline to 12-week changes in daily physical activity level, gait speed, tactile sensitivity, ankle range of motion, DPN symptoms, quality of life, foot health and functionality, foot strength and plantar pressure during gait, using paired t-tests (p < 0.05). In 52 weeks, we recruited 45 eligible participants (0.90/week). Program adherence was 80% and participants’ satisfaction had a mean (SD) of 4.57 (0.70) out of 5. The intervention group significantly improved on toes strength, contact time during gait and DPN symptoms, and peak forefoot pressures increased over time; controls showed significantly increased heel peak pressures and force. The exercise program was feasible, based on a moderate recruitment rate and an adherent and satisfied population, and the intervention showed several positive preliminary effects over time compared to usual care. View Full-Text
Keywords: plantar pressure; range of motion; diabetic neuropathies; exercise; diabetic foot; clinical trial; physical therapy plantar pressure; range of motion; diabetic neuropathies; exercise; diabetic foot; clinical trial; physical therapy
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MDPI and ACS Style

Monteiro, R.L.; Ferreira, J.S.S.P.; Silva, É.Q.; Donini, A.; Cruvinel-Júnior, R.H.; Verissímo, J.L.; Bus, S.A.; Sacco, I.C.N. Feasibility and Preliminary Efficacy of a Foot-Ankle Exercise Program Aiming to Improve Foot-Ankle Functionality and Gait Biomechanics in People with Diabetic Neuropathy: A Randomized Controlled Trial. Sensors 2020, 20, 5129. https://doi.org/10.3390/s20185129

AMA Style

Monteiro RL, Ferreira JSSP, Silva ÉQ, Donini A, Cruvinel-Júnior RH, Verissímo JL, Bus SA, Sacco ICN. Feasibility and Preliminary Efficacy of a Foot-Ankle Exercise Program Aiming to Improve Foot-Ankle Functionality and Gait Biomechanics in People with Diabetic Neuropathy: A Randomized Controlled Trial. Sensors. 2020; 20(18):5129. https://doi.org/10.3390/s20185129

Chicago/Turabian Style

Monteiro, Renan L., Jane S.S.P. Ferreira, Érica Q. Silva, Asha Donini, Ronaldo H. Cruvinel-Júnior, Jady L. Verissímo, Sicco A. Bus, and Isabel C.N. Sacco. 2020. "Feasibility and Preliminary Efficacy of a Foot-Ankle Exercise Program Aiming to Improve Foot-Ankle Functionality and Gait Biomechanics in People with Diabetic Neuropathy: A Randomized Controlled Trial" Sensors 20, no. 18: 5129. https://doi.org/10.3390/s20185129

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