Could an Internet-Based Foot-Ankle Therapeutic Exercise Program Modify Clinical Outcomes and Gait Biomechanics in People with Diabetic Neuropathy? A Clinical Proof-of-Concept Study

Author(s)

Cruvinel-Junior, Ronaldo H. H. ; Ferreira, Jane S. S. P. ; Verissimo, Jady L. ; Monteiro, Renan L. L. ; Suda, Eneida Y. Y. ; Silva, Erica Q. ; Sacco, Isabel C. N.

• Document type: Journal article
• Source: SENSORS; v. 22, n. 24, p. 17-pg., 2022-12-01.

Abstract

Previous studies have shown the efficacy of foot-ankle exercises in people with diabetic peripheral neuropathy (DPN), but the quality of evidence is still low. This proof-of-concept study pursues preliminary evidence for potential clinical and gait biomechanical benefits from an internet-based foot-ankle therapeutic exercise program for people with DPN. We randomized 30 individuals with DPN (IWGDF risk category 1 or 2) into either the control group (CG) receiving the usual care or the intervention group (IG) receiving the usual care plus an internet-based foot-ankle exercise program, fully guided by the Sistema de Orientacao ao Pe Diabetico (SOPeD; translation: Diabetic Foot Guidance System) three times per week for 12 weeks. We assessed face-to-face clinical and biomechanical outcomes at baseline, 12 weeks, and 24 weeks (follow up). Participants had good adherence to the proposed intervention and it led to only mild adverse events. The IG showed improvements in the ankle and first metatarsophalangeal joint motion after 12 and 24 weeks, changed forefoot load absorption during foot rollover during gait after 24 weeks, reduced foot pain after 12 weeks, and improved foot function after 24 weeks. A 12-week internet-based foot-ankle exercise program using the SOPeD software (version 1.0) has the potential to reduce foot pain, improve foot function, and modify some important foot-ankle kinematic outcomes in people with DPN. (AU)

• FAPESP's process: 19/02522-0 - Rehabilitation technology for prevention of musculoskeletal and foot dysfunctions of people with Diabetes Mellitus: FootCAre (FoCa) prevention randomized controlled trial
• Grantee: Jane Suelen Silva Pires Ferreira
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 21/00807-8 - Rehabilitation technology for prevention of foot musculoskeletal dysfunctions and treatment of people with Diabetes Mellitus: FOotCAre (FOCA) proof of concept and cost-utility analysis
• Grantee: Ronaldo Henrique Cruvinel Júnior
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 17/17848-3 - Effects of foot muscle strengthening in daily activity and functionality of foot and ankle in diabetic polyneuropathy patients: a randomized controlled trial
• Grantee: Renan Lima Monteiro
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 17/15449-4 - Biomechanical and functional aspects of the musculoskeletal system of runners: chronic effects of therapeutic exercise and aging
• Grantee: Eneida Yuri Suda
• Support Opportunities: Scholarships in Brazil - Post-Doctoral