Research progress of rehabilitation nursing of diabetic foot_West China Medical Journal

Authors：

ZHU Chuanmei , HU Xiaokun , LI Wei ,  HE Xiaoli

Outpatient Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

HE Xiaoli, Email: 2374897638@qq.com

Keywords：

Diabetic foot; Rehabilitation; Nursing

DOI：

10.7507/1002-0179.201911053

Video：

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Diabetic foot is one of the most common complications of diabetes. The incidence of diabetic foot is high and its treatment is difficult. The cost of treating this disease is huge, which brings a huge burden to patients, families, and society. According to the development process of diabetic foot, this article reviews the rehabilitation nursing of diabetic foot from the perspective of rehabilitation nursing problems, intervention measures, and intervention modes. The rehabilitation nursing problems are summarized as body functions, body structures, activities, and participation; the intervention measures involve rehabilitation education, skin nursing, exercise therapy, mental nursing, hyperbaric oxygen therapy, platelet-rich plasma therapy, and rehabilitation aids; the intervention modes include preventive rehabilitation nursing, in-hospital rehabilitation nursing, community and family rehabilitation nursing, and palliative nursing.

Citation： ZHU Chuanmei, HU Xiaokun, LI Wei, HE Xiaoli. Research progress of rehabilitation nursing of diabetic foot. West China Medical Journal, 2020, 35(5): 618-623. doi: 10.7507/1002-0179.201911053 Copy

1.	Wang L, Gao P, Zhang M, et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013. JAMA, 2017, 317(24): 2515-2523.
2.	中华医学会糖尿病学分会. 中国糖尿病足防治指南 (2019 版)(Ⅰ). 中华糖尿病杂志, 2019, 11(2): 92-108.
3.	王爱红, 赵湜, 李强. 中国部分省市糖尿病足调查及医学经济学分析. 中华内分泌代谢杂志, 2005, 21(6): 496-499.
4.	班绎娟, 冉兴无, 杨川, 等. 中国部分省市糖尿病足病临床资料和住院费用等比较. 中华糖尿病杂志, 2014, 38(7): 499-503.
5.	Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med, 2017, 376(24): 2367-2375.
6.	Hu FB. Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes Care, 2011, 34(6): 1249-1257.
7.	Armstrong DG, Kanda VA, Lavery LA, et al. Mind the gap: disparity between research funding and costs of care for diabetic foot ulcers. Diabetes Care, 2013, 36(7): 1815-1817.
8.	Armstrong DG, Wrobel J, Robbins JM. Guest editorial: are diabetes-related wounds and amputations worse than cancer?. Int Wound J, 2007, 4(4): 286-287.
9.	World Health Organization. International classification of functioning, disability and health. Geneva, Switzerland: World Health Organization, 2001.
10.	中国医疗保健国际交流促进会糖尿病足病分会. 中国糖尿病足诊治指南. 中华医学杂志, 2017, 97(4): 251-258.
11.	Ibrahim A. IDF Clinical Practice Recommendation on the Diabetic Foot: a guide for healthcare professionals. Diabetes Res Clin Pract, 2017, 127: 285-287.
12.	Johnson R, Osbourne A, Rispoli J, et al. The diabetic foot assessment. Orthop Nurs, 2018, 37(1): 13-21.
13.	O’Brien T, Karem J. An initial evaluation of a proof-of-concept 128-Hz electronic tuning fork in the detection of peripheral neuropathy. J Am Podiatr Med Assoc, 2014, 104(2): 134-140.
14.	Ali S, Stone MA, Peters JL, et al. The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabet Med, 2006, 23(11): 1165-1173.
15.	Hoban C, Sareen J, Henriksen CA, et al. Mental health issues associated with foot complications of diabetes mellitus. Foot Ankle Surg, 2015, 21(1): 49-55.
16.	Sheahan H, Canning K, Refausse N, et al. Differences in the daily activity of patients with diabetic foot ulcers compared to controls in their free-living environments. Int Wound J, 2017, 14(6): 1175-1182.
17.	Goodridge D, Trepman E, Embil JM. Health-related quality of life in diabetic patients with foot ulcers: literature review. J Wound Ostomy Continence Nurs, 2005, 32(6): 368-377.
18.	Dorresteijn JA, Kriegsman DM, Assendelft WJ, et al. Patient education for preventing diabetic foot ulceration. Cochrane Database Syst Rev, 2014(12): CD001488.
19.	Prompers L, Huijberts M, Apelqvist J, et al. High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study. Diabetologia, 2007, 50(1): 18-25.
20.	Hingorani A, LaMuraglia GM, Henke P, et al. The management of diabetic foot: a clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine. J Vasc Surg, 2016, 63(2 Suppl): 3s-21s.
21.	Umpierre D, Ribeiro PA, Kramer CK, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA, 2011, 305(17): 1790-1799.
22.	Klein EE, Crews RT, Wu SC, et al. CLEAR Cleat: a proof-of-concept trial of an aerobic activity facilitator to reduce plantar forefoot pressures and their potential in those with foot ulcers. J Am Podiatr Med Assoc, 2008, 98(4): 261-267.
23.	Colberg SR, Albright AL, Blissmer BJ, et al. Exercise and type 2 diabetes: American College of Sports Medicine and the American Diabetes Association: joint position statement. Exercise and type 2 diabetes. Med Sci Sports Exerc, 2010, 42(12): 2282-2303.
24.	Kluding PM, Pasnoor M, Singh R, et al. Safety of aerobic exercise in people with diabetic peripheral neuropathy: single-group clinical trial. Phys Ther, 2015, 95(2): 223-234.
25.	Morrison S, Colberg SR, Parson HK, et al. Exercise improves gait, reaction time and postural stability in older adults with type 2 diabetes and neuropathy. J Diabetes Complications, 2014, 28(5): 715-722.
26.	Singleton JR, Marcus RL, Lessard MK, et al. Supervised exercise improves cutaneous reinnervation capacity in metabolic syndrome patients. Ann Neurol, 2015, 77(1): 146-153.
27.	Amiri S, Behnezhad S. Diabetes and anxiety symptoms: a systematic review and meta-analysis. Int J Psychiatry Med, 2019: 91217419837407.
28.	Richardson C, Adams N, Poole H. Psychological approaches for the nursing management of chronic pain: part 2. J Clin Nurs, 2006, 15(9): 1196-1202.
29.	Zhao D, Luo S, Xu W, et al. Efficacy and safety of hyperbaric oxygen therapy used in patients with diabetic foot: a meta-analysis of randomized clinical trials. Clin Ther, 2017, 39(10): 2088-2094.
30.	Kranke P, Bennett MH, Martyn-St James M, et al. Hyperbaric oxygen therapy for chronic wounds. Cochrane Database Syst Rev, 2015(6): CD004123.
31.	Picard F, Hersant B, Bosc R, et al. The growing evidence for the use of platelet-rich plasma on diabetic chronic wounds: a review and a proposal for a new standard care. Wound Repair Regen, 2015, 23(5): 638-643.
32.	Ahmed M, Reffat SA, Hassan A, et al. Platelet-rich plasma for the treatment of clean diabetic foot ulcers. Ann Vasc Surg, 2017, 38: 206-211.
33.	Kuffler DP. Platelet-rich plasma promotes axon regeneration, wound healing, and pain reduction: fact or fiction. Mol Neurobiol, 2015, 52(2): 990-1014.
34.	Bus SA, van Deursen RW, Armstrong DG, et al. Footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in patients with diabetes: a systematic review. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 99-118.
35.	Morona JK, Buckley ES, Jones S, et al. Comparison of the clinical effectiveness of different off-loading devices for the treatment of neuropathic foot ulcers in patients with diabetes: a systematic review and meta-analysis. Diabetes Metab Res Rev, 2013, 29(3): 183-193.
36.	Heuch L, Streak Gomersall J. Effectiveness of offloading methods in preventing primary diabetic foot ulcers in adults with diabetes: a systematic review. JBI Database System Rev Implement Rep, 2016, 14(7): 236-265.
37.	高赟, 冉兴无. 糖尿病足病治疗进展. 实用医院临床杂志, 2014, 11(1): 10-13.
38.	Bakker K, Apelqvist J, Lipsky BA, et al. The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: development of an evidence-based global consensus. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 2-6.
39.	Jiang Y, Ran X, Jia L, et al. Epidemiology of type 2 diabetic foot problems and predictive factors for amputation in China. Int J Low Extrem Wounds, 2015, 14(1): 19-27.
40.	Larsen SB, Clemensen J, Ejskjaer N. A feasibility study of UMTS mobile phones for supporting nurses doing home visits to patients with diabetic foot ulcers. J Telemed Telecare, 2006, 12(7): 358-362.
41.	Maida V, Ennis M, Corban J. Wound outcomes in patients with advanced illness. Int Wound J, 2012, 9(6): 683-692.
42.	Dale B, Emmons KR. Palliative wound care: principles of care. Home Healthc Nurse, 2014, 32(1): 48-53.

1. Wang L, Gao P, Zhang M, et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013. JAMA, 2017, 317(24): 2515-2523.
2. 中华医学会糖尿病学分会. 中国糖尿病足防治指南 (2019 版)(Ⅰ). 中华糖尿病杂志, 2019, 11(2): 92-108.
3. 王爱红, 赵湜, 李强. 中国部分省市糖尿病足调查及医学经济学分析. 中华内分泌代谢杂志, 2005, 21(6): 496-499.
4. 班绎娟, 冉兴无, 杨川, 等. 中国部分省市糖尿病足病临床资料和住院费用等比较. 中华糖尿病杂志, 2014, 38(7): 499-503.
5. Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med, 2017, 376(24): 2367-2375.
6. Hu FB. Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes Care, 2011, 34(6): 1249-1257.
7. Armstrong DG, Kanda VA, Lavery LA, et al. Mind the gap: disparity between research funding and costs of care for diabetic foot ulcers. Diabetes Care, 2013, 36(7): 1815-1817.
8. Armstrong DG, Wrobel J, Robbins JM. Guest editorial: are diabetes-related wounds and amputations worse than cancer?. Int Wound J, 2007, 4(4): 286-287.
9. World Health Organization. International classification of functioning, disability and health. Geneva, Switzerland: World Health Organization, 2001.
10. 中国医疗保健国际交流促进会糖尿病足病分会. 中国糖尿病足诊治指南. 中华医学杂志, 2017, 97(4): 251-258.
11. Ibrahim A. IDF Clinical Practice Recommendation on the Diabetic Foot: a guide for healthcare professionals. Diabetes Res Clin Pract, 2017, 127: 285-287.
12. Johnson R, Osbourne A, Rispoli J, et al. The diabetic foot assessment. Orthop Nurs, 2018, 37(1): 13-21.
13. O’Brien T, Karem J. An initial evaluation of a proof-of-concept 128-Hz electronic tuning fork in the detection of peripheral neuropathy. J Am Podiatr Med Assoc, 2014, 104(2): 134-140.
14. Ali S, Stone MA, Peters JL, et al. The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabet Med, 2006, 23(11): 1165-1173.
15. Hoban C, Sareen J, Henriksen CA, et al. Mental health issues associated with foot complications of diabetes mellitus. Foot Ankle Surg, 2015, 21(1): 49-55.
16. Sheahan H, Canning K, Refausse N, et al. Differences in the daily activity of patients with diabetic foot ulcers compared to controls in their free-living environments. Int Wound J, 2017, 14(6): 1175-1182.
17. Goodridge D, Trepman E, Embil JM. Health-related quality of life in diabetic patients with foot ulcers: literature review. J Wound Ostomy Continence Nurs, 2005, 32(6): 368-377.
18. Dorresteijn JA, Kriegsman DM, Assendelft WJ, et al. Patient education for preventing diabetic foot ulceration. Cochrane Database Syst Rev, 2014(12): CD001488.
19. Prompers L, Huijberts M, Apelqvist J, et al. High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study. Diabetologia, 2007, 50(1): 18-25.
20. Hingorani A, LaMuraglia GM, Henke P, et al. The management of diabetic foot: a clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine. J Vasc Surg, 2016, 63(2 Suppl): 3s-21s.
21. Umpierre D, Ribeiro PA, Kramer CK, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA, 2011, 305(17): 1790-1799.
22. Klein EE, Crews RT, Wu SC, et al. CLEAR Cleat: a proof-of-concept trial of an aerobic activity facilitator to reduce plantar forefoot pressures and their potential in those with foot ulcers. J Am Podiatr Med Assoc, 2008, 98(4): 261-267.
23. Colberg SR, Albright AL, Blissmer BJ, et al. Exercise and type 2 diabetes: American College of Sports Medicine and the American Diabetes Association: joint position statement. Exercise and type 2 diabetes. Med Sci Sports Exerc, 2010, 42(12): 2282-2303.
24. Kluding PM, Pasnoor M, Singh R, et al. Safety of aerobic exercise in people with diabetic peripheral neuropathy: single-group clinical trial. Phys Ther, 2015, 95(2): 223-234.
25. Morrison S, Colberg SR, Parson HK, et al. Exercise improves gait, reaction time and postural stability in older adults with type 2 diabetes and neuropathy. J Diabetes Complications, 2014, 28(5): 715-722.
26. Singleton JR, Marcus RL, Lessard MK, et al. Supervised exercise improves cutaneous reinnervation capacity in metabolic syndrome patients. Ann Neurol, 2015, 77(1): 146-153.
27. Amiri S, Behnezhad S. Diabetes and anxiety symptoms: a systematic review and meta-analysis. Int J Psychiatry Med, 2019: 91217419837407.
28. Richardson C, Adams N, Poole H. Psychological approaches for the nursing management of chronic pain: part 2. J Clin Nurs, 2006, 15(9): 1196-1202.
29. Zhao D, Luo S, Xu W, et al. Efficacy and safety of hyperbaric oxygen therapy used in patients with diabetic foot: a meta-analysis of randomized clinical trials. Clin Ther, 2017, 39(10): 2088-2094.
30. Kranke P, Bennett MH, Martyn-St James M, et al. Hyperbaric oxygen therapy for chronic wounds. Cochrane Database Syst Rev, 2015(6): CD004123.
31. Picard F, Hersant B, Bosc R, et al. The growing evidence for the use of platelet-rich plasma on diabetic chronic wounds: a review and a proposal for a new standard care. Wound Repair Regen, 2015, 23(5): 638-643.
32. Ahmed M, Reffat SA, Hassan A, et al. Platelet-rich plasma for the treatment of clean diabetic foot ulcers. Ann Vasc Surg, 2017, 38: 206-211.
33. Kuffler DP. Platelet-rich plasma promotes axon regeneration, wound healing, and pain reduction: fact or fiction. Mol Neurobiol, 2015, 52(2): 990-1014.
34. Bus SA, van Deursen RW, Armstrong DG, et al. Footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in patients with diabetes: a systematic review. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 99-118.
35. Morona JK, Buckley ES, Jones S, et al. Comparison of the clinical effectiveness of different off-loading devices for the treatment of neuropathic foot ulcers in patients with diabetes: a systematic review and meta-analysis. Diabetes Metab Res Rev, 2013, 29(3): 183-193.
36. Heuch L, Streak Gomersall J. Effectiveness of offloading methods in preventing primary diabetic foot ulcers in adults with diabetes: a systematic review. JBI Database System Rev Implement Rep, 2016, 14(7): 236-265.
37. 高赟, 冉兴无. 糖尿病足病治疗进展. 实用医院临床杂志, 2014, 11(1): 10-13.
38. Bakker K, Apelqvist J, Lipsky BA, et al. The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: development of an evidence-based global consensus. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 2-6.
39. Jiang Y, Ran X, Jia L, et al. Epidemiology of type 2 diabetic foot problems and predictive factors for amputation in China. Int J Low Extrem Wounds, 2015, 14(1): 19-27.
40. Larsen SB, Clemensen J, Ejskjaer N. A feasibility study of UMTS mobile phones for supporting nurses doing home visits to patients with diabetic foot ulcers. J Telemed Telecare, 2006, 12(7): 358-362.
41. Maida V, Ennis M, Corban J. Wound outcomes in patients with advanced illness. Int Wound J, 2012, 9(6): 683-692.
42. Dale B, Emmons KR. Palliative wound care: principles of care. Home Healthc Nurse, 2014, 32(1): 48-53.

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