Physiotherapeutic interventions in the treatment of patients with diabetic foot ulcers: a systematic literature review

Medeiros, Sabrina Evangelista; Rodrigues, Alexandre A. P.; Costa, Rui M.

doi:10.1016/j.physio.2022.09.006

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…There is currently no known intervention other than off‐loading and debridement for Stage 0–2 wounds. Physiotherapeutic interventions, including electrotherapy are adjuvant to standard care (Medeiros et al, 2023), which seems to be used with later‐stage wounds (e.g., Stage 4) when the wound is infected or near to requiring amputation. Our current topical therapeutic gel is effective and safe at 1% and 2% in animals.…”

Section: Discussionmentioning

confidence: 99%

Safety study of topical naltrexone therapy for diabetic skin wounds is confirmed in Göttingen mini‐pigs

McLaughlin

Sassani

Zagon

2023

Drug Development Research

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This study was conducted to determine the safety of topical naltrexone treatment in Göttingen swine. Efficacy of topical naltrexone was performed previously in Sprague‐Dawley rats. In this study, 25 male and female mini‐pigs received topical naltrexone once daily for 30 days. The gel at doses of 1%, 2%, and 10% naltrexone was applied at a dose volume of 0.01 ml/cm2 to an area of unbroken skin encompassing 10% of the animal's surface. Body and food consumption, skin and organ morphology, and clinical signs, including blood analyses were taken periodically. Naltrexone levels in serum were measured at the time of death. No adverse observations were made in the cutaneous skin, autopsied organs, or biochemical parameters. The no‐observed adverse effect level (NOAEL) was considered to be 2% topical application daily. The conclusions from the veterinarians and researchers are that topical naltrexone at 1% or 2% can be used safely in clinical efficacy studies.

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Section: Discussionmentioning

confidence: 99%

Safety study of topical naltrexone therapy for diabetic skin wounds is confirmed in Göttingen mini‐pigs

McLaughlin

Sassani

Zagon

2023

Drug Development Research

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“…A study conducted by Medeiros S concluded that despite the high prevalence and risks associated with DFUs, there is an increasing acknowledgment of the pivotal role physiotherapy can assume in their management. Physiotherapeutic interventions, encompassing exercise, electrotherapy, and manual therapy, hold considerable potential in augmenting the healing process and ameliorating the complications linked with DFUs [11]. Physical activity exerts a noteworthy impact on diminishing glycated hemoglobin levels, with the amalgamation of aerobic and resistance exercises demonstrating heightened efficacy in contrast to engaging in either aerobic or resistance exercise in isolation.…”

Section: Introductionmentioning

confidence: 99%

Physiotherapeutic Interventions in Diabetic Foot Ulcer Management: A Case Report

Waghe,

Athawale

2024

Cureus

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Diabetic foot ulcers (DFUs) represent prominent complications arising from diabetes mellitus, characterized by the development of severe and persistent wounds involving the loss of epidermal and/or dermal layers, with the potential to extend into subcutaneous and underlying tissue structures. In the presented case, a 62year-old male patient presented with complaints of pain and the emergence of blisters on the right foot, marked by an insidious onset and gradual progression in size, ultimately leading to ulcer formation subsequent to blister rupture. The patient had a medical history spanning 25 years of diabetes mellitus, accompanied by diminished range of motion and muscle strength in the affected foot. The primary goals in the management of DFU encompass addressing muscular weakness, skin manifestations, and any associated underlying health comorbidities. Central to this management approach lies the incorporation of physical therapy and rehabilitation modalities. The rehabilitation regimen designed for the patient was tailored to include targeted resistance exercises, infrared radiation therapy, and sensory integration therapy. Outcome measures, including the Numeric Pain Rating Scale (NPRS), World Health Organization Quality of Life questionnaire (WHO-QOL), and Diabetic Foot Self-Care Questionnaire (DFSQ-UMA), demonstrated substantial improvements, reflecting enhanced activities of daily living. This case underscores the pivotal role of incorporating physiotherapy into a comprehensive multidisciplinary approach for optimizing the management of DFUs. Such integration aims to improve patient outcomes and overall quality of life.

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“…Diabetes Mellitus (DM) was one of the first illnesses to be identified, in which the recognition of symptoms by humankind has been generally understood. Because of its high prevalence, and high morbidity and mortality rates (among the top ten causes of death worldwide), DM has been deemed a global epidemic [ 1 ]. Among USA adults prevalence has been increasing overtime, above global rates, from 5.3% in 1976–1980 to 11.5% in 2011–2014, with economic costs reaching 24.0% of the total health care annual budget [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Emerging Antimicrobial and Immunomodulatory Fiber-Based Scaffolding Systems for Treating Diabetic Foot Ulcers

Felgueiras

2023

Pharmaceutics

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Diabetic foot ulcers (DFUs) are one of the main complications of diabetes and are characterized by their complexity and severity, which are frequently aggravated by overexpressed inflammatory factors and polymicrobial infections. Most dressing systems offer a passive action in the treatment of DFUs, being frequently combined with antibiotic or immunomodulatory therapies. However, in many instances due to these combined therapies' inability to properly fight microbial presence, and provide a suitable, breathable and moist environment that is also capable of protecting the site from secondary microbial invasions or further harm, aggravation of the wound state is unavoidable and lower limb amputations are necessary. Considering these limitations and knowing of the urgent demand for new and more effective therapeutic systems for DFU care that will guarantee the quality of life for patients, research in this field has boomed in the last few years. In this review, the emerging innovations in DFU dressing systems via fiber-based scaffolds modified with bioactive compounds have been compiled; data focused on the innovations introduced in the last five years (2017–2022). A generalized overview of the classifications and constraints associated with DFUs healing and the bioactive agents, both antimicrobial and immunomodulatory, that can contribute actively to surpass such issues, has also been provided.

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Physiotherapeutic interventions in the treatment of patients with diabetic foot ulcers: a systematic literature review

Cited by 5 publications

References 30 publications

Safety study of topical naltrexone therapy for diabetic skin wounds is confirmed in Göttingen mini‐pigs

Safety study of topical naltrexone therapy for diabetic skin wounds is confirmed in Göttingen mini‐pigs

Physiotherapeutic Interventions in Diabetic Foot Ulcer Management: A Case Report

Emerging Antimicrobial and Immunomodulatory Fiber-Based Scaffolding Systems for Treating Diabetic Foot Ulcers

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