TY - JOUR
T1 - Exercise in adults admitted to hospital with diabetes-related foot ulcers
T2 - a pilot study of feasibility and safety
AU - Aitken, Emily
AU - Hiew, Jonathan
AU - Hamilton, Emma J.
AU - Manning, Laurens
AU - Ritter, Jens Carsten
AU - Raby, Edward
AU - Gittings, Paul M.
PY - 2023/12
Y1 - 2023/12
N2 - BACKGROUND: Diabetes-related foot ulcers result in significant mortality, morbidity and economic costs. Pressure offloading is important for ulcer healing, but patients with diabetes-related foot ulcers are presented with a dilemma, because whilst they are often advised to minimise standing and walking, there are also clear guidelines which encourage regular, sustained exercise for patients with diabetes. To overcome these apparently conflicting recommendations, we explored the feasibility, acceptability and safety of a tailored exercise program for adults admitted to hospital with diabetes-related foot ulcers. METHODS: Patients with diabetes-related foot ulcers were recruited from an inpatient hospital setting. Baseline demographics and ulcer characteristics were collected, and participants undertook a supervised exercise training session comprising aerobic and resistance exercises followed by prescription of a home exercise programme. Exercises were tailored to ulcer location, which complied with podiatric recommendations for pressure offloading. Feasibility and safety were assessed via recruitment rate, retention rate, adherence to inpatient and outpatient follow up, adherence to home exercise completion, and recording of adverse events. RESULTS: Twenty participants were recruited to the study. The retention rate (95%), adherence to inpatient and outpatient follow up (75%) and adherence to home exercise (50.0%) were all acceptable. No adverse events occurred. CONCLUSIONS: Targeted exercise appears safe to be undertaken by patients with diabetes-related foot ulcers during and after an acute hospital admission. Recruitment in this cohort may prove challenging, but adherence, retention and satisfaction with participation in exercise were high. TRIAL REGISTRATION: The trial is registered in the Australian New Zealand Clinical Trials Registry (ACTRN12622001370796).
AB - BACKGROUND: Diabetes-related foot ulcers result in significant mortality, morbidity and economic costs. Pressure offloading is important for ulcer healing, but patients with diabetes-related foot ulcers are presented with a dilemma, because whilst they are often advised to minimise standing and walking, there are also clear guidelines which encourage regular, sustained exercise for patients with diabetes. To overcome these apparently conflicting recommendations, we explored the feasibility, acceptability and safety of a tailored exercise program for adults admitted to hospital with diabetes-related foot ulcers. METHODS: Patients with diabetes-related foot ulcers were recruited from an inpatient hospital setting. Baseline demographics and ulcer characteristics were collected, and participants undertook a supervised exercise training session comprising aerobic and resistance exercises followed by prescription of a home exercise programme. Exercises were tailored to ulcer location, which complied with podiatric recommendations for pressure offloading. Feasibility and safety were assessed via recruitment rate, retention rate, adherence to inpatient and outpatient follow up, adherence to home exercise completion, and recording of adverse events. RESULTS: Twenty participants were recruited to the study. The retention rate (95%), adherence to inpatient and outpatient follow up (75%) and adherence to home exercise (50.0%) were all acceptable. No adverse events occurred. CONCLUSIONS: Targeted exercise appears safe to be undertaken by patients with diabetes-related foot ulcers during and after an acute hospital admission. Recruitment in this cohort may prove challenging, but adherence, retention and satisfaction with participation in exercise were high. TRIAL REGISTRATION: The trial is registered in the Australian New Zealand Clinical Trials Registry (ACTRN12622001370796).
KW - Diabetes mellitus
KW - Diabetic foot
KW - Exercise
KW - Exercise therapy
KW - Foot ulcer
UR - http://www.scopus.com/inward/record.url?scp=85151108708&partnerID=8YFLogxK
U2 - 10.1186/s13047-023-00616-0
DO - 10.1186/s13047-023-00616-0
M3 - Article
C2 - 36978157
AN - SCOPUS:85151108708
SN - 1757-1146
VL - 16
SP - 18
JO - Journal of Foot and Ankle Research
JF - Journal of Foot and Ankle Research
IS - 1
M1 - 18
ER -