Exercise-Based Physiotherapy in Diabetic Foot Ulcer: A Case Report

Abstrak

Background: Diabetic Foot Ulcer (DFU) is a serious complication of diabetes mellitus associated with pain, impaired mobility, functional limitation, and increased risk of amputation. Physiotherapy may support safe mobilization and functional recovery in patients with active DFU; however, evidence regarding exercise-based physiotherapy during acute DFU management remains limited.
Objective: To evaluate the short-term clinical outcomes of exercise-based physiotherapy intervention in a patient with DFU.
Methods: This case report followed the CARE guideline and involved a 60-year-old female patient with DFU treated at PKU Muhammadiyah Hospital, Yogyakarta, Indonesia. The patient received four physiotherapy sessions consisting of active range of motion exercise, quadriceps setting exercise, stretching, ankle pump exercise, and diaphragmatic breathing exercise. Outcomes were evaluated using the Numeric Rating Scale (NRS), goniometric range of motion (ROM) measurement, Manual Muscle Testing (MMT), sensory examination, and Barthel Index.
Results: Movement pain decreased from 4/10 to 1/10 on the NRS. Hip flexion ROM improved from 100° to 120°, while knee flexion ROM increased from 85° to 90°. Muscle strength remained stable at MMT grade 4/5, and sensory examination findings remained hypoesthetic. Although the Barthel Index score remained 25, the patient demonstrated improved independent sitting ability. No adverse events were identified during intervention.
Conclusion: Exercise-based physiotherapy demonstrated positive short-term clinical outcomes in reducing pain, improving joint mobility, and supporting early functional mobility in a patient with DFU. Further studies with objective wound-healing parameters and longer follow-up periods are recommended.