Walking Programs Benefit Diabetics with Foot Ulcers

January 20, 2009
Shivani Parmar, MPH

Patients with diabetic peripheral neuropathy "might be able to engage in a graduated walking program under close supervision of a medical professional and thus prevent other life threatening illnesses."

Researchers at the University of Missouri have published a new study in the journal Physical Therapy concluding that patients with diabetic peripheral neuropathy (DM+PN) “might be able to engage in a graduated walking program under close supervision of a medical professional and thus prevent other life threatening illnesses.”

Foot ulcers often occur in patients with DM+PN “due to the loss of muscle, which would expose the bones to greater pressure under the foot, or to loss of feeling in the foot.” While the recommendation in the past for such cases has been to advise patients to stay off their feet, this study revealed evidence to the contrary.

Lead researcher Joseph LeMaster, associate professor of family and community medicine, University of Missouri, reviewed the effects of “lower-extremity exercise and walking intervention programs on foot ulcer occurrence in people with diabetic peripheral neuropathy” in a 12-month randomized controlled trial.

Seventy-nine study participants were separated into a control and intervention group, with the intervention group participating in leg-strengthening exercises, a graduated walking program, and frequent monitoring from healthcare professionals, and phone calls for motivation every other week. Both groups were given eight sessions of physical therapy along with regular foot care.

LeMaster found an increase in the number of foot lesions and ulcers in the intervention group during the first six months of the study, but by the end of the year, these numbers decreased in comparison to the control group.

“Because weight-bearing activity did not lead to a significant increase in foot ulcers, our study suggests that weight-bearing exercise might be appropriate for people with DM+PN if the patient currently has no foot ulcers, wears proper footwear, and is in a walking program that is well-supervised and safely monitored by a medical profession,” said LeMaster.

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