Summary: In patients hospitalised with diabetic foot ulcers, adding 12 weeks of lower-limb resistance training with breathing regulation to standard care improved glycaemic control and quality of life, but did not significantly improve wound healing.
PICO Summary
| Element | Detail |
|---|---|
| Population | 59 patients hospitalised for type 2 diabetes-related foot ulcers, single centre (exercise n=28, control n=31). |
| Intervention | Standard treatment plus 12 weeks of lower-limb resistance training with breathing-regulation techniques. |
| Comparison | Standard treatment alone. |
| Outcome | Significant improvement in fasting glucose, HbA1c, and all quality-of-life domains over 12 weeks vs control and baseline (p<0.05). No significant change in wound healing (p>0.05). |
Lower-limb resistance training in diabetic foot ulcers
RCT · type 2 diabetes foot ulcers · 12 weeks
Adding 12 weeks of lower-limb resistance training with breathing regulation improved glycaemic control and quality of life, but did not significantly improve wound healing.
Expert Commentary
The instinct to keep patients with foot ulcers moving, with carefully designed non-weight-bearing exercise that respects offloading, is a good one, and showing it can be done safely while improving glucose and quality of life is a worthwhile result. But intellectual honesty requires correcting the framing here: the wound healing did not improve. The study’s own data show no significant difference in healing between groups, so describing this as enhancing wound healing, as the earlier version did, misreads the result. What the programme delivered was better glycaemic control and better wellbeing, which are real and useful, just not the headline outcome a foot-ulcer patient most wants. The trial is also single-centre and modest, and it cannot separate the resistance training from the breathing component. Can I use this with my patients? Yes, but with accurate expectations. I would offer structured non-weight-bearing exercise to a hospitalised foot-ulcer patient for its glycaemic and quality-of-life benefits and to limit deconditioning, while being clear it is not a wound-healing treatment and must never compromise offloading. A larger, longer trial powered for healing would be needed before claiming any direct wound benefit.
References
Wu JL, Yeh ML, Liao J. Effects of a 12-week lower limb resistance training with breathing regulation in patients with diabetes-related foot ulcers: a randomized controlled trial. Appl Nurs Res. 2025;82:151911. doi:10.1016/j.apnr.2025.151911