Physiotherapy Intervention for Diabetic Foot Ulcers: A Scoping Review.

BACKGROUND/

OBJECTIVES

Understanding the available interventions and circumstances under which physical therapy is administered to patients with diabetic foot ulcers is important to provide more evidence regarding physical therapy and associated outcomes in this population. This study aimed to investigate the scope, nature, and extent of literature on physical therapy interventions for adults with diabetic foot ulcers.

METHODS

Articles on physiotherapy interventions for adults with diabetic foot ulcers published up to 30 June 2024 were included. Relevant articles were identified through searches of PubMed, Scopus, MEDLINE, and the Cochrane Library databases. Opinion articles, study protocols, meeting abstracts, and articles that did not describe physical therapy interventions were excluded.

RESULTS

The systematic search identified 13 articles that met the inclusion criteria. Eleven of the 13 articles were specifically related to outpatient physical therapy. Outpatient physiotherapy included unloading gait instruction, ankle stretching instruction, progressive resistance training, and aerobic exercise. In two other cases, exercise instructions were practiced in the early postoperative period of the wound during the hospitalization period. A multidisciplinary approach aimed at improving postoperative activities of daily living was included. The main efficacy indices were the wound reduction rate, plantar pressure reduction, hemodynamics, ankle joint range of motion, walking ability, and other physical function-related parameters.

CONCLUSIONS

Physiotherapy during outpatient follow-up may contribute to preventing wound deterioration and maintaining physical function in patients with stable DFUs. However, standardized protocols regarding intervention timing, exercise intensity, and wound severity remain unestablished, and interventions should be applied cautiously based on individual clinical conditions.