Lower extremity ulcers represent a serious and costly complication of diabetes mellitus. Many factors contribute
to the development of diabetic foot. Peripheral neuropathy and peripheral vascular disease are the main causes of foot
ulceration and contribute in turn to the growth of additional risk factors such as limited joint mobility, muscular alterations
and foot deformities. Moreover, a deficit of balance, posture and biomechanics can be present, in particular in patients at
high risk for ulceration. The result of this process may be the development of a vicious cycle which leads to abnormal distribution
of the foot's plantar pressures in static and dynamic postural conditions.
This review shows that some of these risk factors significantly improve after a few weeks of exercise therapy (ET) intervention.
Accordingly it has been suggested that ET can be an important weapon in the prevention of foot ulcer.
The aim of ET can relate to one or more alterations typically found in diabetic patients, although greater attention should
be paid to the evaluation and possible correction of body balance, rigid posture and biomechanics. Some of the most important
limitations of ET are difficult access to therapy, patient compliance and the transitoriness of the results if the training
stops. Many proposals have been made to overcome such limitations. In particular, it is important that specialized centers
offer the opportunity to participate in ET and during the treatment the team should work to change the patient’s lifestyle
by improving the execution of appropriate daily physical activity.