Physical Activity Participation in People With an Active Diabetic Foot Ulceration: A Scoping Review

Abstract

Background: Being physically active on a regular basis has a favourable impact on diabetes-related complications. With the exception of evidence advising individuals with an active diabetic foot ulceration (DFU) to avoid weight-bearing activity, no physical activity (PA) recommendations are currently provided for this population.

Objective: The aim of this scoping review was to examine and map the existing research evidence of PA participation for individuals with an active DFU.

Design: A scoping review using the Arksey and O'Malley framework was conducted in electronic databases and grey literature from inception to June 2020 to identify publications that investigated individuals with type 1 or type 2 diabetes and an active DFU at enrolment in relation to a PA intervention. Reported outcomes had to inform on effects of PA on any health or wound parameters.

Results: Nineteen articles from 17 distinct studies met inclusion criteria. Fourteen of the included studies were published in the last 10 years. Types of exercises and materials used, duration of studies, offloading considerations and provision of wound care varied greatly between studies. Included studies are heterogenous in methodological designs and aims, and reporting was often lacking important components of wound care and PA interventions. A discussion based on descriptive statistics and narrative analysis is provided.

Conclusions: It is not possible from this scoping review to determine what would be the ideal components of a PA program for this specific population. Conclusions are limited by the quality and design of the included studies. No articles evaluated quality of life, mortality or cardiorespiratory capacity, nor were adverse effects routinely reported.

Keywords: activities of daily living; activité physique; activités de la vie quotidienne; diabetic foot ulcer; exercice; exercise; physical activity; plaie plantaire; plantar wound; scoping review; ulcère du pied diabétique; étude de portée.