Exercise in adults admitted to hospital with diabetes-related foot ulcers: A pilot study of feasibility and safety

Miss Emily Aitken1, Mr. Jonathan Hiew2, Dr. Emma Hamilton3,4,5, A/ Prof. Laurens Manning3,5,6, Mr. Jens Ritter3,7, Dr. Edward Raby6, Mr. Paul Gittings1

1Physiotherapy Department, Fiona Stanley and Fremantle Hospital Group, Murdoch, Australia, 2Podiatry Department, Fiona Stanley and Fremantle Hospital Group, Murdoch, Australia, 3Multidisciplinary Diabetes Foot Unit, Fiona Stanley Hospital, Murdoch, Australia, 43 Endocrinology Department, Fiona Stanley and Fremantle Hospital Group, Murdoch, Australia, 5School of Medicine, University of Western Australia, Perth, Australia, 6Infectious Diseases and Microbiology Department, Fiona Stanley and Fremantle Hospital Group, Murdoch, Australia, 7Vascular Surgery Department, Fiona Stanley and Fremantle Hospital Group, Murdoch, Australia

Introduction: Diabetes-related foot ulcers (DFU) carry a significant burden of mortality, morbidity and economic cost. Evidence suggests that foot ulceration is more prevalent in sedentary adults. Exercise is known to have systemic benefits however the role of exercise for adults with DFU remains unclear. In this project we explored the feasibility, acceptability and safety of a tailored exercise program for adults admitted to hospital with DFU.

Methods: Patients with DFU were recruited from an inpatient hospital setting. Baseline demographics and ulcer characteristics were collected, and participants undertook at least one supervised training session comprising aerobic and resistance exercises. Exercises were chosen based on ulcer location, complying with podiatry recommendations for pressure offloading. A home exercise program was provided to participants. Feasibility and safety were assessed via recruitment rate, retention rate, adherence to inpatient and outpatient follow up, adherence to home exercise completion, and recording of adverse events.

Results: Twenty out of 42 eligible adults consented to participate. Sixteen participants have completed the study programme with the remaining scheduled for completion in April. To date, no adverse events have occurred, 14 of 16 (87.5%) adhered to follow up, and nine of 16 (56.3%) adhered to home exercise completion.

Conclusion: Preliminary results suggest exercise is safe and acceptable to this group. Recruitment did not meet criteria for feasibility however was impacted by the project running only once weekly. We anticipate this would be overcome with greater resources. Further work is required to extend these findings while exploring non-participation and long term engagement.


Biography:

Emily Aitken is a Physiotherapist working at Fiona Stanley and Fremantle Hospital Group in Perth, Western Australia. She has experience working in both rural and urban settings helping people to better manage their chronic health conditions. Emily has developed an interest in utilising physical activity and exercise as prescriptive medicine to improve quality of health outcomes and is particularly passionate about helping people to establish long term behaviour change.

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