Effects of foot-ankle exercises on foot-ankle kinematics, plantar pressure, and gait kinetics in people with diabetic neuropathy: Secondary outcomes from a randomized controlled trial.

Autor: Monteiro RL; Physical Therapy, Speech and Occupational Therapy Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Department of Health and Biological Science, Universidade Federal do Amapá, Macapá, AP, Brazil., Ferreira JSSP; Physical Therapy, Speech and Occupational Therapy Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Silva ÉQ; Physical Therapy, Speech and Occupational Therapy Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Cruvinel-Júnior RH; Physical Therapy, Speech and Occupational Therapy Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Veríssimo JL; Physical Therapy, Speech and Occupational Therapy Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Bus SA; Amsterdam UMC, University of Amsterdam, Department of Rehabilitation medicine, Amsterdam Movement Sciences, Amsterdam, the Netherlands., Sacco ICN; Physical Therapy, Speech and Occupational Therapy Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. Electronic address: icnsacco@usp.br.
Jazyk: angličtina
Zdroj: Brazilian journal of physical therapy [Braz J Phys Ther] 2023 May-Jun; Vol. 27 (3), pp. 100517. Date of Electronic Publication: 2023 Jun 12.
DOI: 10.1016/j.bjpt.2023.100517
Abstrakt: Background: Follow-up report of secondary outcomes of a randomized, single-blinded, parallel controlled trial that investigated the benefits of a foot-ankle therapeutic exercise program on foot-ankle kinematics, plantar pressure, and lower limb kinetics during gait in individuals with diabetic neuropathy (DPN).
Methods: Sixty-six participants with DPN were randomly allocated into a control group (CG; n = 31), which received usual care, and an intervention group (IG; n = 35), which received usual care plus a 12-week group-based foot-ankle exercise program. Outcomes were assessed at baseline and 12 weeks by an assessor blinded to group allocation.
Results: The generalized linear mixed model and intention-to-treat analysis revealed a greater hip extensor moment at push-off and greater hallux contact area in the IG than CG after 12 weeks. A within-group analysis revealed a larger arch height during stance and higher peak pressure and pressure-time integral at the central forefoot region in the IG after 12 weeks compared to baseline. There were no other significant group difference or changes over time in foot-ankle kinematics or in any other joint moment related to overall lower limb biomechanics.
Conclusion: The increases in hip moment at push-off and hallux surface contact area suggest an improvement in the propulsion phase with greater participation of the toes in foot rollover after 12 weeks of a group-based foot-ankle exercises program for people with DPN. Individual face-to-face, longer-term, and more intensive interventions may be needed to positively influence foot-ankle biomechanics and pressure parameters in other plantar areas.
Competing Interests: Conflicts of interest The authors declare no conflicts of interest.
(Copyright © 2023 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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