Moderate-to-Vigorous-Intensity Physical Activity Observed in People With Diabetes-Related Foot Ulcers Over a One-Week Period

Abstract

Background: Regular moderate-to-vigorous-intensity physical activity results in health benefits in people with diabetes. No study has observed the moderate-to-vigorous-intensity physical activity typically performed by people with diabetes-related foot ulcers (DFU) in their everyday free-living environments. We observed the bouts, and accumulated time, spent doing moderate-to-vigorous-intensity physical activity in cases with DFU compared with diabetes-related peripheral neuropathy (DPN) and diabetes (DM) controls over a one-week period. Methods: This was a secondary analysis of a cross-sectional case-control study. Participants wore a multisensor device for >5 days (>22 hours per day). Primary outcomes included the number, duration (minutes) and intensity (metabolic equivalent tasks [METs]) of bouts of moderate-to-vigorous-intensity physical activity (defined as at least >3 METs for >10 consecutive minutes). Secondary outcomes included the total accumulated times spent doing moderate-to-vigorous-intensity physical activity (>3 METs) and doing sedentary-intensity activity (<1.5 METs). DFU subgroups with minor amputations and nonremovable offloading devices were also analyzed. Results: Overall, 15 DM, 23 DPN, and 27 DFU participants were included. All groups recorded similar low median daily numbers (0.33, 0.29, 0.25 numbers, respectively), duration (15, 17, 14 minutes), and intensity of daily bouts of moderate-to-vigorous-intensity physical activity (4.1, 4.3, 3.9 METs) (all, P > .1). Median accumulated daily time spent doing moderate-to-vigorous-intensity physical activity was also similar (40, 37, 36 minutes; P > .8). Those with DFU had more mean accumulated daily time spent doing sedentary-intensity activity (796 minutes) compared to DPN (720 minutes; P < .05), but not compared to DM (728 minutes; P < .08). DFU subgroups with minor amputations had more median accumulated daily time spent doing moderate-to-vigorous-intensity physical activity (66, 28 minutes; P < .05) and less mean time doing sedentary-intensity activity (745, 837; P < .05) than those without amputations. Conclusions: People with DFU performed similar low numbers of daily bouts of moderate-to-vigorous-intensity physical activity to controls, but spend more time doing sedentary-intensity activities. Interventions that gradually increase the moderate-to-vigorous-intensity physical activity in people with DFU should be investigated.

Factors associated with adherence to using removable cast walker treatment among patients with diabetes-related foot ulcers

“…Sample size calculations were based on the following assumptions: (i) five factors would likely be included in the final multiple linear regression model based on the only previous similar study identifying five factors associated with adherence in their multiple linear regression model, 6 that a minimum of 10 participants is necessary for each included factor according to statistics texts so as not to overfit such a multiple linear regression model, 14 and 5%–10% of participants may have activity monitor failure or drop out as reported in a previous study of activity in patients with DFU. 15 Thus, assuming five final factors would be included in the final regression model, each factor needing 10 participants, and with a drop-out rate of 10%, we conservatively estimated a sample size of 60 participants was required to address the aims of this study.…”

Efficacy of a Self-managed Cooling Intervention for Pain and Physical Activity in Individuals With Recently Healed Chronic Venous Leg and Diabetic Foot Ulcers

“…Few individuals improved in their overall activity level for METs (minutes per week); however, few participants completed the questionnaire at 6-month end of study. One MET is defined as approximately 1 kcal/kg/h and includes activities such as sleeping, lying quietly, or meditating 37. Activities achieving levels of moderate-intensity physical activity typically include brisk walking, swimming leisurely, or cycling leisurely, whereas activities achieving vigorous-intensity physical activity include jogging, cycling fast, or playing a game of football.…”

“…One MET is defined as approximately 1 kcal/kg/h and includes activities such as sleeping, lying quietly, or meditating. 37 Activities achieving levels of moderate-intensity physical activity typically include brisk walking, swimming leisurely, or cycling leisurely, whereas activities achieving vigorous-intensity physical activity include jogging, cycling fast, or playing a game of football. Sedentary activities typically include lying, sitting, eating, or standing quietly.…”

Evaluating the role of muscular exercise in modulating the progress of peptic ulcer treated by quercetin or dexilant in male albino rats

“…The mechanism by which moderate exercise significantly decrease UI with concomitant significant increase of CI have not been reported but it is possible that physical activity may affect peptic ulcer disease through various biologic mechanisms, including improving the immune system's ability to neutralize the effects of aspirin and improving a person's ability to deal with stressful situations. (Lee et al, 2019).…”