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Effects of foot muscle strengthening in daily activity and functionality of foot and ankle in diabetic polyneuropathy patients: a randomized controlled trial

Grant number: 17/17848-3
Support type:Scholarships in Brazil - Doctorate
Effective date (Start): June 01, 2018
Effective date (End): May 31, 2021
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Isabel de Camargo Neves Sacco
Grantee:Renan Lima Monteiro
Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil


Considering the several alterations of the feet and ankles present in patients with diabetic polyneuropathy (DPN) and that such changes directly affect the reduction of daily physical activity, the inclusion of a protocol to strengthen the muscles of the feet can be presented as an efficient method to physical therapy treatment, since such exercises aim specifically to strengthen the muscles compromised by DPN. Thus, the inclusion of an exercise protocol for the strengthening of the intrinsic and extrinsic musculature of the feet may add additional effects to the physiotherapeutic interventions. The aim of the present study was to investigate the effects of foot muscle strengthening on daily physical activity levels and walking speed at the end of 12 weeks of study and after one year of follow-up of patients with DPN. A prospective, parallel controlled, randomized trial and blinding of the evaluators will be conducted with 77 patients with DPN up to 75 years old who will be randomly divided into the control or intervention groups, and the latter will receive physical therapy intervention in person 2 times a week for 12 weeks and via Software de orientação ao pé diabético (SOPED) 2 times a week during one year of study. The subjects will be evaluated in 5 moments regarding daily physical activity level, self-selected and rapid gait speed, incidence of foot ulcers, risk of developing ulcer, symptoms, tactile and vibratory feet sensitivity, range of passive movement and foot muscle strength. The hypothesis of this study is that the intervention group will increase daily activity levels, increase self-selected and rapid walking speed, reduce the incidence of plantar ulcers, improve symptoms, increase tactile and vibration sensitivity, increased passive range of motion and increased isometric strength of the feet compared to the control group after 12 weeks of intervention and follow-up year. (AU)

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
SILVA, E. Q.; SUDA, E. Y.; SANTOS, D. P.; VERISSIMO, J. L.; FERREIRA, J. S. S. P.; CRUVINEL JUNIOR, R. H.; MONTEIRO, R. L.; SARTOR, C. D.; SACCO, I. C. N. Effect of an educational booklet for prevention and treatment of foot musculoskeletal dysfunctions in people with diabetic neuropathy: the FOotCAre (FOCA) trial II, a study protocol of a randomized controlled trial. Trials, v. 21, n. 1 FEB 13 2020. Web of Science Citations: 0.
FERREIRA, J. S. S. P.; CRUVINEL JUNIOR, R. H.; SILVA, E. Q.; VERISSIMO, J. L.; MONTEIRO, R. L.; PEREIRA, D. S.; SUDA, E. Y.; SARTOR, C. D.; SACCO, I. C. N. Study protocol for a randomized controlled trial on the effect of the Diabetic Foot Guidance System (SOPeD) for the prevention and treatment of foot musculoskeletal dysfunctions in people with diabetic neuropathy: the FOotCAre (FOCA) trial I. Trials, v. 21, n. 1 JAN 13 2020. Web of Science Citations: 0.
MONTEIRO, RENAN L.; SARTOR, CRISTINA D.; FERREIRA, JANE S. S. P.; DANTAS, MILLA G. B.; BUS, SICCO A.; SACCO, ISABEL C. N. Protocol for evaluating the effects of a foot-ankle therapeutic exercise program on daily activity, foot-ankle functionality, and biomechanics in people with diabetic polyneuropathy: a randomized controlled trial. BMC MUSCULOSKELETAL DISORDERS, v. 19, NOV 14 2018. Web of Science Citations: 2.

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