Fall Prevention by Short-Foot Exercise in Diabetic Patients

Abstract

A fall during walking is a common problem in diabetic patients due to neuromuscular complications of the foot, especially intrinsic foot muscles (IFMs). Short-foot exercise (SFE) has been reported to strengthen IFMs in healthy individuals. This present study was aimed to investigate effects of SFE on medial longitudinal arch integrity (navicular drop test, NDT) and dynamic postural control (star excursion balance test, SEBT). The SEBT values were measured on single-leg standing in 8 directions (anterior, anteromedial, medial, posteromedial, posterior, posterolateral, lateral, and anterolateral) at baseline, week 4, 8, and 12 (follow up) in 15 diabetic patients: control group (n = 7) and SFE group (n = 8). Results showed that NDT was reduced in SFE group compared to control at week 8 and follow up. The normalized SEBT values in SFE group was significantly higher than baseline only in medial direction and increased from baselines in anteromedial, medial, and posteromedial directions at week 4 and 8, respectively. At the follow-up point, only posteromedial direction showed an improvement of normalized SEBT in SFE group. In conclusion, 8-week SFE reduced foot pronation and improved dynamic postural control in a single-leg standing phase of diabetic foot. The SFE should be continuously applied to diabetic foot since the benefits were not well persistent in the follow-up phase.