Effect of physical therapy on limited joint mobility in the diabetic foot. A pilot study

HM DijsDepartment of Physical Medicine and Rehabilitation, University Clinic of Antwerp, Edegem, Belgium.

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JM RoofthooftDepartment of Physical Medicine and Rehabilitation, University Clinic of Antwerp, Edegem, Belgium.

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MF DriessensDepartment of Physical Medicine and Rehabilitation, University Clinic of Antwerp, Edegem, Belgium.

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PG De BockDepartment of Physical Medicine and Rehabilitation, University Clinic of Antwerp, Edegem, Belgium.

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C JacobsDepartment of Physical Medicine and Rehabilitation, University Clinic of Antwerp, Edegem, Belgium.

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KL Van AckerDepartment of Physical Medicine and Rehabilitation, University Clinic of Antwerp, Edegem, Belgium.

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Eleven patients with limited joint mobility and neuropathy were enrolled in a physical therapy program of passive joint mobilization at a rate of two sessions per week. Treatment resulted in a significant improvement in joint mobility after 10 sessions. Further improvement after 20 sessions did not reach the level of statistical significance, although near-normal joint mobility was attained. After completion of therapy, there was a progressive deterioration in joint mobility. No serious adverse effects were noted during treatment. This study provides some evidence that use of physical therapy may result in significant, although temporary, improvement in the mobility of the ankle and foot joints in diabetic patients with limited joint mobility and neuropathy. As limited joint mobility has been associated with the development of abnormally high pressures under the feet, which in turn may contribute to plantar ulceration in the susceptible neuropathic foot, the results indicate that physical therapy may be useful in the prevention of plantar ulceration in diabetic patients with limited joint mobility and neuropathy, although this must be verified by additional research.