This study evaluated the effects of foot and ankle physical therapy on ankle and first metatarsophalangeal joint range of motion (ROM), peak plantar pressures (PPPs), and balance in people with diabetes, neuropathy, and joint stiffness. The study involved multiple sources for data collection like MEDLINE, EBSCO, Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database of Systematic Reviews, PROSPERO, EThOS, Web of Science and Google Scholar in April 2022.
The research included various types of study designs including Randomised Controlled Trials (RCT), quasi-experimental, pre-post experimental design, and prospective cohort studies. The interventions under consideration were physical therapy such as mobilisations, ROM exercises, and stretches.
In total, 9 studies were included in the research. Though participant characteristics were similar across all studies, the type and exercise dosage varied greatly. A meta-analysis was performed using four of the included studies.
The meta-analysis showed significant effects of combined exercise interventions in increasing total ankle ROM (3 studies: Mean Difference (MD), 1.76; 95% Confidence Interval (CI), 0.78–2.74; p= 0; I2 = 0%) and reducing PPPs in the forefoot area (3 studies; MD, -23.34; 95% CI,−59.80 to 13.13; p= 0.21, I2 = 51%).
The study concluded that combined exercise interventions can increase ROM in the ankle and reduce PPPs in the forefoot. However, the need for standardisation of exercise programmes with or without the addition of mobilisations in the foot and ankle joints is highlighted for further research.