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Rethinking diabetic foot ulcer care: Integrating exercise and physical activity
Jane E Nakamura1, Angela J Fong1, Abbi D Lane1
1School of Kinesiology, University of Michigan, Ann Arbor, MI, USA.
Journal of Diabetes and Its Complications
|December 23, 2025
Summary
Movement interventions show promise for diabetic foot ulcers (DFU), but more research is needed. Studies highlight the need for consistent methods to determine the effectiveness of exercise in healing DFUs.
Area of Science:
- Podiatry
- Diabetology
- Physical Therapy
Background:
- Diabetic foot ulcers (DFU) are often treated with offloading, which can be misinterpreted as complete immobility.
- Reduced mobility increases sedentary time and associated health risks in DFU patients.
Purpose of the Study:
- To review the literature on movement-based interventions for DFU patients.
- To evaluate the impact of reducing sedentary time, increasing physical activity (PA), and exercise on DFU healing.
Main Methods:
- A narrative review of 16 articles examining exercise interventions in individuals with DFU.
- Analysis of existing studies on movement and DFU care.
Main Results:
- While many studies suggest therapeutic benefits of exercise for DFU, methodological inconsistencies limit definitive conclusions.
- Evidence indicates potential for movement to aid ulcer healing, but efficacy is not firmly established.
Conclusions:
- Further research is required to establish the efficacy of movement-based interventions for DFU healing.
- Future studies must address adherence, weight-bearing progression, and program specifics (frequency, intensity) for DFU patients.
- Identifying barriers and facilitators to movement engagement in DFU patients is crucial for advancing care.
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