Consensus-based recommendations on physical activity and exercise in patients with diabetes at risk of foot ulcerations : a Delphi study
Gracia-Sánchez, Alba (Universidad Miguel Hernández de Elche)
López-Pineda, Adriana (Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS))
Lázaro-Martínez, José Luis (Instituto de Investigación Sanitaria del Hospital Clínico San Carlos)
Pérez Pérez, Antonio (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Pomares-Gómez, Francisco J. (Universidad Hospital San juan de Alicante)
Fernández-Seguín, Lourdes María (Universidad de Sevilla)
Gil-Guillén, Vicente F. (Universidad Miguel Hernández de Elche)
Chicharro-Luna, Esther (Universidad Miguel Hernández de Elche)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	Patients with diabetes mellitus are exposed to important complications. Currently little evidence exist on the guidelines that these patients, at some risk of foot ulceration, should follow for physical exercise. To reach a consensus among multidisciplinary and international experts on physical activity/exercise recommendations for patients with diabetes, according to foot ulcer risk. Using a three-round Delphi method, a panel composed of 28 multidisciplinary experts in the management of diabetic foot assessed 109 recommendations on physical activity/exercise for patients with diabetes mellitus, according to their risk of foot ulcer. Consensus was assumed when 80% of responses matched the same category (agreement/disagreement). Twenty-nine experts participated in the first and second rounds of consultation, and twenty-eight did so in the third, reaching final agreement on 86 of the 109 recommendations considered (78. 9%). The study, thus, generated a consensus set of recommendations concerning different aspects of diabetic footcare before, during, and after exercise (e. g. when to examine the foot, how to assess it, what type of sock and insole to use, what types of exercise to perform, and when it is advisable to return to activity after an ulceration). This Delphi study generated recommendations based on the consensus of international experts on physical activity and exercise by patient with diabetes at risk of ulceration. Recommendations considered the state of the foot and the patient's history and status before physical activity and included information on intensity, duration, frequency, and progressions of physical activity/exercise, and the use of custom-made plantar orthoses, shoe prescription, and the convenience of returning to physical activity after an ulceration.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Diabetic foot ; Diabetic neuropathies ; Exercise ; Exercise therapy ; Physical activity
Published in:	Brazilian Journal of Physical Therapy, Vol. 27 (april 2023) , ISSN 1809-9246

DOI: 10.1016/j.bjpt.2023.100500
PMID: 37079949

16 p, 397.8 KB

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