Liao F, An R, Pu F, Burns S, Shen S, Jan YK, et al.
American journal of physical medicine & rehabilitation. Date of publication 2018 Jul 16;volume ():.
1. Am J Phys Med Rehabil. 2018 Jul 16. doi: 10.1097/PHM.0000000000001002. [Epub
ahead of print]
Effect of Exercise on Risk Factors of Diabetic Foot Ulcers: A Systematic Review
and Meta-analysis.
Liao F(1), An R(2), Pu F(3), Burns S(4), Shen S(5), Jan YK(2)(3).
Author information:
(1)Department of Biomedical Engineering, Xi'an Technological University, Xi'an,
China.
(2)Department of Kinesiology and Community Health, University of Illinois at
Urbana-Champaign, Champaign, IL, USA.
(3)Beijing Advanced Innovation Center for Biomedical Engineering, School of
Biological Science and Medical Engineering, Beihang University, Beijing, China.
(4)Department of Physical Therapy, Langston University, Langston, OK, USA.
(5)Center for Health, Aging, and Disability, University of Illinois at
Urbana-Champaign, Champaign, IL, USA.
The objectives of this study were to examine the effectiveness of different types
of exercise on risk factors of diabetic foot ulcers, including glycated
hemoglobin (HbA1c), peripheral arterial disease (PAD), and diabetic peripheral
neuropathy, in people with type 2 diabetes mellitus (T2DM). PubMed, Web of
Science, Cochrane Library, Scopus, and CINAHL were searched from inception to
January 2018 for relevant articles. Eligible studies were randomized controlled
trials (RCTs) that examined effects of exercise on the selected risk factors.
Twenty RCTs with 1,357 participants were included in the meta-analyses. The
differences in post-intervention values of HbA1c and ankle brachial index (ABI)
between exercise and control groups were synthesized, yielding mean differences
of -0.45% (P<0.00001) and 0.03 (P=0.002), respectively; the differences in
within-group changes in HbA1c were synthesized, yielding mean differences of
-0.19% (P=0.1), -0.25% (P=0.0006), and -0.64% (P=0.006) for aerobic vs.
resistance, combined vs. aerobic, and combined vs. resistance exercise,
respectively. Exercise has a significant effect on reducing HbA1c, while combined
exercise is more effective compared to aerobic or resistance exercise alone.
Exercise also improves ABI. However, evidence regarding the association between
exercise and peripheral neuropathy and risks of diabetic foot ulcers in people
with T2DM remains insufficient.
DOI: 10.1097/PHM.0000000000001002
PMID: 30020090
