Exercise in adults admitted to hospital with diabetes‐related foot ulcers: a pilot study of feasibility and safety
Abstract 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...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Journal of Foot and Ankle Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13047-023-00616-0 |
| _version_ | 1827356281213550592 |
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| author | Emily Aitken Jonathan Hiew Emma J Hamilton Laurens Manning Jens Carsten Ritter Edward Raby Paul M Gittings |
| author_facet | Emily Aitken Jonathan Hiew Emma J Hamilton Laurens Manning Jens Carsten Ritter Edward Raby Paul M Gittings |
| author_sort | Emily Aitken |
| collection | DOAJ |
| description | Abstract 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). |
| first_indexed | 2024-03-08T04:57:33Z |
| format | Article |
| id | doaj.art-857033596f3549d58aa688cf7b8b2230 |
| institution | Directory Open Access Journal |
| issn | 1757-1146 |
| language | English |
| last_indexed | 2024-03-08T04:57:33Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Foot and Ankle Research |
| spelling | doaj.art-857033596f3549d58aa688cf7b8b22302024-02-07T15:05:46ZengWileyJournal of Foot and Ankle Research1757-11462023-01-01161n/an/a10.1186/s13047-023-00616-0Exercise in adults admitted to hospital with diabetes‐related foot ulcers: a pilot study of feasibility and safetyEmily Aitken0Jonathan Hiew1Emma J Hamilton2Laurens Manning3Jens Carsten Ritter4Edward Raby5Paul M Gittings6Physiotherapy DepartmentFiona Stanley and Fremantle Hospital GroupMurdochWesternAustraliaPodiatry DepartmentFiona Stanley and Fremantle Hospital GroupMurdochWesternAustraliaMultidisciplinary Diabetes Foot UnitFiona Stanley HospitalMurdochWesternAustraliaMultidisciplinary Diabetes Foot UnitFiona Stanley HospitalMurdochWesternAustraliaMultidisciplinary Diabetes Foot UnitFiona Stanley HospitalMurdochWesternAustraliaInfectious Diseases and Microbiology DepartmentFiona Stanley and Fremantle Hospital GroupMurdochWesternAustraliaPhysiotherapy DepartmentFiona Stanley and Fremantle Hospital GroupMurdochWesternAustraliaAbstract 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).https://doi.org/10.1186/s13047-023-00616-0ExerciseExercise therapyDiabetic footFoot ulcerDiabetes mellitus |
| spellingShingle | Emily Aitken Jonathan Hiew Emma J Hamilton Laurens Manning Jens Carsten Ritter Edward Raby Paul M Gittings Exercise in adults admitted to hospital with diabetes‐related foot ulcers: a pilot study of feasibility and safety Journal of Foot and Ankle Research Exercise Exercise therapy Diabetic foot Foot ulcer Diabetes mellitus |
| title | Exercise in adults admitted to hospital with diabetes‐related foot ulcers: a pilot study of feasibility and safety |
| title_full | Exercise in adults admitted to hospital with diabetes‐related foot ulcers: a pilot study of feasibility and safety |
| title_fullStr | Exercise in adults admitted to hospital with diabetes‐related foot ulcers: a pilot study of feasibility and safety |
| title_full_unstemmed | Exercise in adults admitted to hospital with diabetes‐related foot ulcers: a pilot study of feasibility and safety |
| title_short | Exercise in adults admitted to hospital with diabetes‐related foot ulcers: a pilot study of feasibility and safety |
| title_sort | exercise in adults admitted to hospital with diabetes related foot ulcers a pilot study of feasibility and safety |
| topic | Exercise Exercise therapy Diabetic foot Foot ulcer Diabetes mellitus |
| url | https://doi.org/10.1186/s13047-023-00616-0 |
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