Weight-bearing physical activity in people with diabetes-related foot disease: A systematic review @ALPSLimb #ActAgainstAmputation

Continued data / guidance to better define dosing activity as we might dose a drug. From our colleagues Jaap Van Netten, Vera Fijen and and Sicco Bus.

Introduction: Weight-bearing physical activity is important for people with diabetes-related foot disease, but may also contribute to ulceration or delayed ulcer healing. No overview of weight-bearing activity of people at different stages of foot disease is available. We aimed to summarize quantitatively-measured daily activity levels in people with diabetes-related foot disease.

Methods: We systematically searched peer-reviewed literature for studies reporting objectively-measured weight-bearing activity in people with diabetes-related foot disease. We calculated daily step counts’ means (over studies) and weighted means (over participants). IWGDF risk strata, different climates and activity indoors vs. outdoors were compared.

Results: From 1,247 publications, 27 were included. Mean steps/day in people with IWGDF risk 1/2: 6,125 (12 studies; 345 participants; weighted mean: 5,384). In IWGDF risk 3: 6,275 (8 studies; 291 participants; weighted mean: 6,239). In those with a foot ulcer: 4,248 (6 studies; 186 participants; weighted mean: 4,484). People living in temperate oceanic climates are more active compared to those in hotter or more humid climates (mean steps/day for no ulcer: 7,712 vs 5,224 [18 studies]; for ulcer: 6,819 vs. 2,945 [6 studies]). People are more active indoors vs. outdoors (mean 4,047 vs. 2,514 [3 studies]).

Conclusion: Levels of weight-bearing physical activity are similar between people with diabetes at various risk levels for foot ulceration, but lower for those with a foot ulcer. Weight-bearing activity differs depending on the climatological environment, and is higher indoor then outdoors. These findings provide reference for intervention studies or for clinicians aiming to provide mobility advice in this population. This article is protected by copyright. All rights reserved.

From Malindu E. Fernando PhD, MBBS, BHScience (Podiatry) Hons, Stephanie L. Woelfel PT, DPT, CWS, Diana Perry DPM, Bijan Najafi PhD, MSc, Tanzim Khan DPM, Charles DuBourdieu PhD, Laura Shin DPM, and David G. Armstrong DPM, MD, PhD, https://doi.org/10.7547/20-166

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