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Range-Of-Motion Exercise Program May Help Prevent Diabetic Neuropathic Ulceration

By reducing peak plantar pressures in the feet of diabetic patients, an unsupervised range-of-motion exercise program may help prevent diabetic neuropathic ulceration.

Jon R. Goldsmith and colleagues at the Dr. William M. Scholl College of Podiatric Medicine at Finch University, in Chicago, Illinois, United States, conducted a randomized controlled study of 19 patients with diabetes (10 men, 9 women) to determine possible benefits of home exercise therapy on joint mobility and plantar pressures.

Nine of the 19 subjects were instructed to perform unsupervised active and passive range-of-motion exercises of the joints in their feet. All subjects were evaluated for joint stiffness and peak plantar pressures at the beginning and conclusion of the study.

After only one month of therapy, the investigators found a statistically significant average decrease of 4.2 percent in peak plantar pressures among patients performing the range-of-motion exercises. However, they noted a 4.4 percent increase in peak plantar pressure among patients in the control group.

Although the joint mobility data revealed no statistically significant differences between the groups, there was a trend for a decrease in joint stiffness in the treatment group, they reported.

"The results of this study demonstrate that an unsupervised range-of-motion exercise program can reduce peak plantar pressures in the diabetic foot," the researchers concluded. "Given that high plantar pressures have been linked to diabetic neuropathic ulceration, it may be possible to reduce the risk of such ulceration with this therapy."
J Am Podiatr Med Assoc 2002; 92: 483-490. "The Effects of Range-of-Motion Therapy on the Plantar Pressures of Patients with Diabetes Mellitus."

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