Systematic review and meta-analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance
To evaluate the effects of foot and ankle physical therapy on ankle and first metatarsophalangeal joint range of motion (ROM), peak plantar pressures (PPPs) and balance in people with diabetes. MEDLINE, EBSCO, Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database of Systematic Re...
| Main Authors: | , , , , |
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| Format: | Journal Article |
| Language: | English |
| Published: |
2023
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| Online Access: | http://hdl.handle.net/20.500.11937/94008 |
| _version_ | 1848765827339255808 |
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| author | Lepesis, V. Marsden, J. Rickard, A. Latour, Jos Paton, J. |
| author_facet | Lepesis, V. Marsden, J. Rickard, A. Latour, Jos Paton, J. |
| author_sort | Lepesis, V. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | To evaluate the effects of foot and ankle physical therapy on ankle and first metatarsophalangeal joint range of motion (ROM), peak plantar pressures (PPPs) and balance in people with diabetes. MEDLINE, EBSCO, Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database of Systematic Reviews, PROSPERO, EThOS, Web of Science and Google Scholar were searched in April 2022. Randomised Controlled Trials (RCT), quasi-experimental, pre-post experimental design and prospective cohort studies were included. Participants were people with diabetes, neuropathy and joint stiffness. Interventions included physical therapy such as mobilisations, ROM exercises and stretches. Outcome measures focused on ROM, PPPs and balance. Methodological quality was assessed with Critical Appraisal Skills Programme RCT and Risk-of-Bias 2 tool. Meta-analyses used random-effects models and data was analysed using the inverse variance method. In total, 9 studies were included. Across all studies, participant characteristics were similar; however, type and exercise dosage varied greatly. Meta-analysis was performed with four studies. Meta-analysis showed significant effects of combined exercise interventions in increasing total ankle ROM (3 studies: MD, 1.76; 95% CI, 0.78–2.74; p = 0; I2 = 0%); and reducing PPPs in the forefoot area (3 studies; MD, −23.34; 95% CI, −59.80 to 13.13; p = 0.21, I2 = 51%). Combined exercise interventions can increase ROM in the ankle and reduce PPPs in the forefoot. Standardisation of exercise programmes with or without the addition of mobilisations in the foot and ankle joints needs further research. |
| first_indexed | 2025-11-14T11:41:26Z |
| format | Journal Article |
| id | curtin-20.500.11937-94008 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | eng |
| last_indexed | 2025-11-14T11:41:26Z |
| publishDate | 2023 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-940082024-01-23T02:52:40Z Systematic review and meta-analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance Lepesis, V. Marsden, J. Rickard, A. Latour, Jos Paton, J. diabetes exercises mobilisations peak plantar pressures range of motion balance Humans Ankle Joint Diabetic Neuropathies Ankle Exercise Therapy Range of Motion, Articular Diabetes Mellitus Ankle Ankle Joint Humans Diabetic Neuropathies Diabetes Mellitus Range of Motion, Articular Exercise Therapy To evaluate the effects of foot and ankle physical therapy on ankle and first metatarsophalangeal joint range of motion (ROM), peak plantar pressures (PPPs) and balance in people with diabetes. MEDLINE, EBSCO, Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database of Systematic Reviews, PROSPERO, EThOS, Web of Science and Google Scholar were searched in April 2022. Randomised Controlled Trials (RCT), quasi-experimental, pre-post experimental design and prospective cohort studies were included. Participants were people with diabetes, neuropathy and joint stiffness. Interventions included physical therapy such as mobilisations, ROM exercises and stretches. Outcome measures focused on ROM, PPPs and balance. Methodological quality was assessed with Critical Appraisal Skills Programme RCT and Risk-of-Bias 2 tool. Meta-analyses used random-effects models and data was analysed using the inverse variance method. In total, 9 studies were included. Across all studies, participant characteristics were similar; however, type and exercise dosage varied greatly. Meta-analysis was performed with four studies. Meta-analysis showed significant effects of combined exercise interventions in increasing total ankle ROM (3 studies: MD, 1.76; 95% CI, 0.78–2.74; p = 0; I2 = 0%); and reducing PPPs in the forefoot area (3 studies; MD, −23.34; 95% CI, −59.80 to 13.13; p = 0.21, I2 = 51%). Combined exercise interventions can increase ROM in the ankle and reduce PPPs in the forefoot. Standardisation of exercise programmes with or without the addition of mobilisations in the foot and ankle joints needs further research. 2023 Journal Article http://hdl.handle.net/20.500.11937/94008 10.1002/dmrr.3692 eng http://creativecommons.org/licenses/by/4.0/ fulltext |
| spellingShingle | diabetes exercises mobilisations peak plantar pressures range of motion balance Humans Ankle Joint Diabetic Neuropathies Ankle Exercise Therapy Range of Motion, Articular Diabetes Mellitus Ankle Ankle Joint Humans Diabetic Neuropathies Diabetes Mellitus Range of Motion, Articular Exercise Therapy Lepesis, V. Marsden, J. Rickard, A. Latour, Jos Paton, J. Systematic review and meta-analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance |
| title | Systematic review and meta-analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance |
| title_full | Systematic review and meta-analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance |
| title_fullStr | Systematic review and meta-analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance |
| title_full_unstemmed | Systematic review and meta-analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance |
| title_short | Systematic review and meta-analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance |
| title_sort | systematic review and meta-analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance |
| topic | diabetes exercises mobilisations peak plantar pressures range of motion balance Humans Ankle Joint Diabetic Neuropathies Ankle Exercise Therapy Range of Motion, Articular Diabetes Mellitus Ankle Ankle Joint Humans Diabetic Neuropathies Diabetes Mellitus Range of Motion, Articular Exercise Therapy |
| url | http://hdl.handle.net/20.500.11937/94008 |