Effects of weight-bearing exercise on a mini-trampoline on foot mobility, plantar pressure and sensation of diabetic neuropathic feet; a preliminary study

Wararom Kanchanasamut, Praneet Pensri, Wararom Kanchanasamut, Praneet Pensri

Abstract

Objective: Foot and ankle exercise has been advocated as a preventative approach in reducing the risk of foot ulceration. However, knowledge about the appropriate types and intensity of exercise program for diabetic foot ulcer prevention is still limited. The current study aimed to examine the effects of an eight-week mini-trampoline exercise on improving foot mobility, plantar pressure and sensation of diabetic neuropathic feet. Methods: Twenty-one people with diabetic peripheral neuropathy who had impaired sensation perception were divided into two groups. The exercise group received a foot-care education program plus an eight-week home exercise program using the mini-trampoline (n = 11); whereas a control group received a foot-care education only (n = 10). Measurements were undertaken at the beginning, at the completion of the eight-week program and at a 20-week follow-up. Results: Both groups were similar prior to the study. Subjects in the exercise group significantly increased the range of the first metatarsophalangeal joint in flexion (left: p = 0.040, right: p = 0.012) and extension (left: p = 0.013) of both feet more than controlled subjects. There was a trend for peak plantar pressure at the medial forefoot to decrease in the exercise group (p = 0.016), but not in the control group. At week 20, the number of subjects in the exercise group who improved their vibration perception in their feet notably increased when compared to the control group (left: p = 0.043; right: p = 0.004). Conclusions: This is a preliminary study to document the improvements in foot mobility, plantar pressure and sensation following weight-bearing exercise on a flexible surface in people with diabetic neuropathic feet. Mini-trampoline exercise may be used as an adjunct to other interventions to reduce risk of foot ulceration. A larger sample size is needed to verify these findings. This trial is registered with COA No. 097.2/55.

Keywords: Diabetes; foot mobility; foot ulcer; neuropathy; plantar pressure; sensation.

Figures

Figure 1.
Figure 1.
Flowchart of participants.

References

    1. King H, Aubert RE, Herman WH. Global burden of diabetes, 199025: prevalence, numerical estimates, and projections. Diabetes Care. 1998;21:1414–10.
    1. Aekplakorn W, Stolk RP, Neal B. The prevalence and management of diabetes in Thai adults: the international collaborative study of cardiovascular disease in Asia. Diabetes Care. 2003;26:2758–2763.
    1. Hämäläinen H, Rönnemaa T, Halonen JP. Factors predicting lower extremity amputations in patients with type 1 or type 2 diabetes mellitus: a population-based 7-year follow-up study. J Intern Med. 1999;246:97–103.
    1. Boulton AJM, Meneses P, Ennis WJ. Diabetic foot ulcers: a framework for prevention and care. Wound Repair Regen. 1999;7:7–16.
    1. Boulton AJM, Malik RA, Arezzo JC. Diabetic somatic neuropathies. Diabetes Care. 2004;27:1458–1486.
    1. Boulton AJM, Vileikyte L, Ragnarson-Tennvall G. The global burden of diabetic foot disease. Lancet. 2005;366:1719–1724.
    1. Adler AI, Boyko EJ, Ahroni JH. Lower-extremity amputation in diabetes. The independent effects of peripheral vascular disease, sensory neuropathy, and foot ulcers. Diabetes Care. 1999;22:1029–1035.
    1. Ramsey SD, Newton K, Blough D. Incidence, outcomes, and cost of foot ulcers in patients with diabetes. Diabetes Care. 1999;22:382–387.
    1. Trautner C, Haastert B, Giani G. Incidence of lower limb amputations and diabetes. Diabetes Care. 1996;19:1006–1009.
    1. American Diabetes Association Foot care in patients with diabetes mellitus. Diabetes Care. 1998;21:s5.
    1. Johannesson A, Larsson GU, Ramstrand N. Incidence of lower-limb amputation in the diabetic and nondiabetic general population: a 10-year population-based cohort study of initial unilateral and contralateral amputations and reamputations. Diabetes Care. 2009;32:275–280.
    1. Tennvall GR, Apelqvist J, Eneroth M. Costs of deep foot infections in patients with diabetes mellitus. PharmacoEconomics. 2000;18:225–238.
    1. Flahr D. The effect of nonweight-bearing exercise and protocol adherence on diabetic foot ulcer healing: a pilot study. Ostomy Wound Manage. 2010;56:40–50.
    1. Haas L. Lower-limb self-management education. In: Bowker JH, Pfeifer MA, editors. Levin and O’Neal’s The diabetic foot. USA: Mosby; 2006. pp. 563–572.
    1. Balducci S, Iacobellis G, Parisi L. Exercise training can modify the natural history of diabetic peripheral neuropathy. J Diabetes Complicat. 2006;20:216–223.
    1. Sovelius R, Oksa J, Rintala H. Trampoline exercise vs. strength training to reduce neck strain in fighter pilots. Aviat Space Environ Med. 2006;77:20–25.
    1. Aragão FA, Karamanidis K, Vaz MA. Mini-trampoline exercise related to mechanisms of dynamic stability improves the ability to regain balance in elderly. J Electromyogr Kinesiol. 2011;21:512–518.
    1. Goldsmith JR, Lidtke RH, Shott S. The effects of range-of-motion therapy on the plantar pressures of patients with diabetes mellitus. J Am Podiatr Med Assoc. 2002;92:483–490.
    1. LeMaster JW, Mueller MJ, Reiber GE. Effect of weight-bearing activity on foot ulcer incidence in people with diabetic peripheral neuropathy: feet first randomized controlled trial. Phys Ther. 2008;88:1385–1398.
    1. Fritz M, Peikenkamp K. Simulation of the influence of sports surface on vertigo ground reaction forces during landing. Med Biol Eng Comput. 2003;41:11–17.
    1. Kidgell DJ, Horvath DM, Jackson BM. Effect of six weeks of dura disc and mini-trampoline balance training on postural sway in athletes with functional ankle instability. J Strength Cond Res. 2007;21:466–469.
    1. Bacarin TA, Sacco IC, Hennig EM. Plantar pressure distribution patterns during gait in diabetic neuropathy patients with a history of foot ulcers. Clinics. 2009;64:113–120.
    1. Boulton AJM, Armstrong DG, Albert SF. Comprehensive foot examination and risk assessment: a report of the task force of the care interest group of the American diabetes association, with endorsement by the American association of clinical endocrinologists. Diabetes Care. 2008;31:1679–1685.
    1. Vileikyte L, Peyrot M, Bundy C. The development and validation of a neuropathy- and foot ulcer-specific quality of life instrument. Diabetes Care. 2003;26:1549–1555.
    1. Miklitsch C, Krewer C, Freivogel S. Effects of a predefined mini-trampoline training programme on balance, mobility and activities of daily living after stroke: a randomized controlled pilot study. Clin Rehabil. 2013;27:939–947.
    1. Giagazoglou P, Kokaridas D, Sidiropoulou M. Effects of a trampoline exercise intervention on motor performance and balance ability of children with intellectual disabilities. Res Dev Disabil. 2013;34:2701–2707.
    1. Hof AL. The equations of motion for a standing human reveal three mechanisms for balance. J Biomech. 2007;40:451–457.
    1. Márquez G, Aguado X, Alegre LM. The trampoline after effect: the motor and sensory modulations associated with jumping on an elastic surface. Exp Brain Res. 2010;204:575–584.
    1. Cavagna GA. Storage and utilization of elastic energy in skeletal muscle. Exerc Sport Sci Rev. 1977;5:89–129.
    1. Duca DD, Moore EPJ. End-use properties: polymerization, characterization, properties, processing, application. In: Moore EPJ, editor. Polypropylene handbook. New York, NY: Hanser/Gardner Publications Inc; 1996. pp. 237–256.
    1. Zimny S, Schatz H, Pfohl M. The role of limited joint mobility in diabetic patients with an at-risk foot. Diabetes Care. 2004;27:942–946.
    1. Fernando DJ, Masson EA, Veves A. Relationship of limited joint mobility to abnormal foot pressures and diabetic foot ulceration. Diabetes Care. 1991;14:8–11.
    1. Rich J, Veves A. Forefoot and rearfoot plantar pressure in diabetic patients: correlation to foot ulceration. Wounds. 2000;12:82–87.
    1. Perry J, Burnfield JM. Gait analysis: normal and pathological function. 2nd. Thorofare, NJ: SLACK Incorporated; 2010.
    1. Delbridge L, Perry P, Marr S. Limited joint mobility in the diabetic foot: relationship to neuropathic ulceration. Diabet Med. 1988;5:333–337.
    1. Maiorana A, O’Driscoil G, Cheetham C. The effect of combined aerobic and resistance exercise training on vascular function in type 2 diabetes. J Am Coll Cardiol. 2001;38:860–866.
    1. Kluding PM, Pasnoor M, Singh R. The effect of exercise on neuropathic symptoms, nerve function, and cutaneous innervation in people with diabetic peripheral neuropathy. J Diabetes Complications. 2012;26:424–429.
    1. Marios T, Dalton S, Smart NA. The effect of tele-monitoring on exercise adherence, functional capacity, quality of life and glycemic control in patients with type II diabetes. J Sports Sci Med. 2012;11:51–56.

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