The effect of nonweight-bearing exercise and protocol adherence on diabetic foot ulcer healing: a pilot study

Innovative approaches to the prevention and treatment of foot wounds in persons with diabetes mellitus are needed and preliminary research suggests that exercise therapy may increase joint mobility and blood flow. A 12-week, prospective, quasi-experimental pilot study was conducted to evaluate the potential influence of nonweight-bearing ankle exercises, and adherence to same, on the size of neuropathic, diabetic foot wounds in community-dwelling older adults. Nineteen patients were recruited. Of those, 10 (88.9% men) were randomized to ankle exercise treatments and nine (50% men) continued their previous care regimen. Patients randomized to the exercise program were younger and had smaller wounds than those in the control group (average age 62.2 ± 8.54 versus 74.25 ± 16.25 years and measurement 0.94 cm2 ± 1.89 versus 2.53 cm2 ± 3.647, respectively). Thirty percent (30%) of the patients in the exercise and 33.3% in the control group healed. The percent wound reduction between groups was not significantly different (Mann Whitney U test, P = .696). Adherence to the recommended exercise program was variable but 70% performed some exercises. The results of this pilot study provide important lessons for future studies, including the need to enroll more patients and provide more exercise guidance. Considering the increasing prevalence of diabetes mellitus and resultant complications, as well as the potential benefits of this non-invasive treatment regimen, larger studies are warranted.