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World J Exp Med. May 20, 2015; 5(2): 130-139
Published online May 20, 2015. doi: 10.5493/wjem.v5.i2.130
Does physical therapy and rehabilitation improve outcomes for diabetic foot ulcers?
Yasemin Turan, Bulent M Ertugrul, Benjamin A Lipsky, Kevser Bayraktar
Yasemin Turan, Kevser Bayraktar, Department of Physical Therapy and Rehabilitation, Faculty of Medicine, University of Adnan Menderes, 09100 Aydin, Turkey
Bulent M Ertugrul, Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, University of Adnan Menderes, 09100 Aydin, Turkey
Benjamin A Lipsky, Department of Medicine, University of Washington (Emeritus), Seattle, WA 98195, United States
Benjamin A Lipsky, Department of Medicine, University of Oxford, OX1 3PT Oxford, United Kingdom
Author contributions: Turan Y wrote and designed the paper; Ertugrul BM wrote and designed the paper; Lipsky BA wrote and revised the paper; Bayraktar K wrote the paper.
Conflict-of-interest: No conflicts of interest for any of the authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bulent M Ertugrul, MD, Associate Professor, Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, University of Adnan Menderes, 09100 Aydin, Turkey. bertugrul@adu.edu.tr
Telephone: +90-256-4441256 Fax: +90-256-2146495
Received: November 7, 2014
Peer-review started: November 9, 2014
First decision: December 12, 2014
Revised: January 5, 2015
Accepted: January 18, 2015
Article in press: January 20, 2015
Published online: May 20, 2015
Processing time: 195 Days and 6.8 Hours
Abstract

One of the most common and serious complications of diabetes mellitus is ulceration of the foot. Among persons with diabetes, 12%-25% will present to a healthcare institution for a foot disorder during their lifespan. Despite currently available medical and surgical treatments, these are still the most common diabetes-related cause of hospitalization and of lower extremity amputations. Thus, many adjunctive and complementary treatments have been developed in an attempt to improve outcomes. We herein review the available literature on the effectiveness of several treatments, including superficial and deep heaters, electro-therapy procedures, prophylactic methods, exercise and shoe modifications, on diabetic foot wounds. Overall, although physical therapy modalities seem to be useful in the treatment of diabetic foot wounds, further randomized clinical studies are required.

Keywords: Diabetic foot; Ulcer; Treatment; Physical therapy; Rehabilitation

Core tip: People with diabetes are prone to frequent and often have severe foot problems. Treatments for diabetic foot ulcer (DFU) include surgical debridement and drainage, antimicrobial therapy for infected wounds, pressure off-loading methods and advanced wound dressings. Thus, many clinicians and researchers have made efforts to develop adjunctive or complementary treatments to improve the outcome of DFUs. This paper presents a review of the epidemiology, pathogenesis and clinical manifestations of DFUs, and a discussion of the data available on relevant physical therapies and rehabilitation methods.