Musculoskeletal Changes After Physiotherapeutic Intervention in Podiatric Subjects (BIONEDIAN)
Musculoskeletal Changes Induced by Physiotherapeutic Intervention, and Their Impact on the Induction of Diabetic Foot Syndrome and Psychosocial Status in Type 2 Diabetes Mellitus
The recurrence of diabetic foot ulcers (DFU) is a key problem in podiatric care. It is very often given by biomechanical abnormalities frequently present in those patients. The aim of our randomized controlled study is to find possible changes as of plantar pressures as of biomechanics of the ankle and small joints in patients with type 2 diabetes mellitus with different degrees of neuropathy. During this project, investigators will examine the possible impact of 12-week lasting intervention program on the distribution of plantar pressures, joint mobility and muscle strength of lower limbs. The incidence of ulcerations / reulcerations and changes of psychosocial characteristics will be evaluated during the study period.
Approximately 60 patients with Type 2 diabetes mellitus will be included into the study. These patients will be randomized into 3 study groups - patients with type 2 DM with mild form of peripheral sensory neuropathy (20 subjects), patient with severe peripheral neuropathy (20 subjects) and those with diabetic foot syndrome, without active lesion (20 subjects). All patients will undergo 12 week lasting active intervention program consisting of recommendations by a physiotherapist focusing on the improvement of physical fitness, muscle strength and foot joint improvement. Control group will be consisted of 20 patients with healed diabetic foot.
The outcomes of this project will try to objectively verify in the randomized controlled trial the impact of exercise on lower limb biomechanics, mobility, self-sufficiency, quality of life in patients with type 2 diabetes mellitus at risk or already developed diabetic foot syndrome.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Anticipé)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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Prague, Tchéquie, 14200
- Recrutement
- Institute for Clinical and Experimental Medicine
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Contact:
- Eliška Vrátná, Mgr.
- Numéro de téléphone: +420774549214
- E-mail: vratnae@gmail.com
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Contact:
- Vladimíra Fejfarová, MD, PhD
- Numéro de téléphone: +420603877381
- E-mail: vlfe@medicon.cz
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Sous-enquêteur:
- Jitka Hazdrová, MD
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Type 2 diabetes mellitus
- sensoric neuropathy (mild - based on VPV 15-30 V or EMG results, severe - based on VPT above 50 V or EMG results)
- diabetic foot with healed diabetic foot ulcers, inactive Charcot foot
Exclusion Criteria:
- impossibility to exercise
- amaurosis
- non-compliance
- critical limb ischemia
- active ulcer, surgical wound
- active Charcot foot
- active carcinoma
- recent stroke (last 8 weeks)
- recent myocardial infarction (last 8 weeks)
- recent PTA, PCI, bypass (last 8 weeks)
- myopathy
- rheumatoid arthritis
- cox-, gonartrosis of 3rd -4th grade.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: DF patient active
Patients with Type 2 diabetes mellitus and diabetic foot, whose have healed diabetic foot ulcers
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12 week lasting exercise intervention
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Comparateur actif: DF patient control
Patients with Type 2 diabetes mellitus and diabetic foot, whose have healed diabetic foot ulcers
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12 week lasting exercise intervention
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Expérimental: Diabetic patient with mild neuropathy
Patients with Type 2 diabetes mellitus with mild form of peripheral sensory neuropathy
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12 week lasting exercise intervention
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Expérimental: Diabetic patient with severe neuropathy
Patients with Type 2 diabetes mellitus with severe form of peripheral sensory neuropathy
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12 week lasting exercise intervention
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Biomechanics- plantar pressures
Délai: changes after 12 weeks, 24 weeks
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plantar pressures will be evaluated by pedobarograph (in Newtons)
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changes after 12 weeks, 24 weeks
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Biomechanics- biomechanics of the ankle
Délai: changes after 12 weeks, 24 weeks
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biomechanics of the ankle will be assessed by goniometry in angles
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changes after 12 weeks, 24 weeks
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Biomechanics- changes of foot joint angles
Délai: changes after 12 weeks, 24 weeks
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changes of foot joint agles will be evaluated by measurement of X-Rays bones angles - calcaneal pitch, talar-1st metatarsal angle and lateral Talocalcaneal angle
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changes after 12 weeks, 24 weeks
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Fitness - physical activity
Délai: changes after 12 weeks, 24 weeks
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The amount of physical activity will be assessed by IPAQ questioners
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changes after 12 weeks, 24 weeks
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Fitness - muscle strength
Délai: changes after 12 weeks, 24 weeks
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Muscle strength will be measured by dynamometry in Newtons
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changes after 12 weeks, 24 weeks
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Fitness - senior fitness
Délai: changes after 12 weeks, 24 weeks
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fitness will be assessed by seniorfittest containing 2 minutes step test (steps/2 min) and test of sitting (sits/30 seconds)
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changes after 12 weeks, 24 weeks
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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ulceration/reulceration
Délai: changes after 12 weeks, 24 weeks
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detection of the incidence of ulceration/reulceration
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changes after 12 weeks, 24 weeks
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Psychosocial changes - quality of life
Délai: changes after 12 weeks, 24 weeks
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Quality of life will be evaluated by WHO-QoL Bref test (4 domains - high values mean bettr findings
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changes after 12 weeks, 24 weeks
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Psychosocial changes - depression
Délai: changes after 12 weeks, 24 weeks
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Depression status will be asessed by Geriatric Depression Scale (GDS) scale - minimum 0, maximum 30 points (higher then 9 points- mild form of depression, higher then 20 - severe depression
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changes after 12 weeks, 24 weeks
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Psychosocial changes - stress readaptation
Délai: changes after 12 weeks, 24 weeks
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Adaptation to stress will be detected by Stress Readaption Scale (0-400 points) - points higher then 150 - higher risk of worse stress readaptation and therefore higher risk of somatisation
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changes after 12 weeks, 24 weeks
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Metabolism - glucose control
Délai: changes after 12 weeks, 24 weeks
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Investigators will be loked for metabolic changes in diabetes control (HbA1c in mmol/mol, glycemia in mmol/l)
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changes after 12 weeks, 24 weeks
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Metabolism - lipid profile
Délai: changes after 12 weeks, 24 weeks
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The authors will control lipid profiles (Total-, HDL-, LDL-cholesterol in umol/l)
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changes after 12 weeks, 24 weeks
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Metabolism - myokines
Délai: changes after 12 weeks, 24 weeks
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Patients will be checked for changes in selected cytokines nad myokines (IL-4,6,7,8,15 in pg/ml, myostatin in pg/ml, irisin in ng/ml, FGF-21 in pg/ml)
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changes after 12 weeks, 24 weeks
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Collaborateurs et enquêteurs
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Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Anticipé)
Achèvement de l'étude (Anticipé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 546417
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