Home-Based Exercise to Improve Functional Outcomes in Veterans With a Recently Healed Diabetic Foot Ulcer: Protocol...

Area of Science:

• Diabetic foot ulcer management and rehabilitation.
• Geriatric exercise physiology.
• Clinical trial methodology.

Background:

• Diabetic foot ulcers are a common complication, often leading to immobility and poor health outcomes.
• Current treatments like off-loading restrict mobility, hindering recovery and increasing risks.
• Limited research exists on effective exercise interventions during ulcer remission.

Purpose of the Study:

• To assess the feasibility and acceptability of a home-based exercise regimen for veterans with healed diabetic foot ulcers.
• To evaluate the intervention's impact on lower extremity strength, tissue perfusion, and glycemic control.
• To establish a foundation for future clinical trials on exercise for diabetic foot ulcer survivors.

Main Methods:

• A pilot randomized controlled trial involving 25 veterans (≥50 years) with recently healed diabetic plantar foot ulcers.
• Participants randomized (3:1) to a 12-week home-based exercise program (videoconference classes and cycling) or standard care.
• Outcome measures include feasibility, acceptability, gait speed, strength, physical activity, and cutaneous perfusion.

Main Results:

• The study is funded and protocol approved, with recruitment ongoing.
• As of June 12, 2025, 12 participants enrolled, and 6 randomized.
• Data collection is planned from October 2024 to March 2026.

Conclusions:

• The home-based exercise intervention shows potential for clinical rehabilitation translation in diabetic foot ulcer patients.
• If feasible and acceptable, this intervention warrants testing in a larger multisite randomized clinical trial.
• Future trials will assess impacts on mobility, cardiovascular events, and ulcer recurrence.