Early mobilization program with nonweight-bearing brace improves functional capacity after diabetic foot ulcer surgery: a randomized controlled trial

Abstract

Purpose: This study aimed to evaluate the effectiveness of early mobilization program with nonweight-bearing braces in improving functional outcomes and clinical indicators after diabetic foot ulcer surgery. Methods: We conducted a randomized trial involving patients with diabetic foot ulcers (DFUs) who underwent surgery at a tertiary university hospital. Participants were randomized to receive either early mobilization with nonweight-bearing braces or standard rehabilitation care. The primary outcome was the ability to walk a distance of three meters without human assistance upon hospital discharge. Secondary outcomes included activity of daily living (ADL), measured by the Barthel Index survey; reduction in lean body mass, assessed via thigh circumference on postoperative day 10 (POD 10); length of stay (LOS); and the incidence of postoperative complications such as deep venous thrombosis (DVT), pain, and wound dehiscence. Results: A total of 46 patients were enrolled, with 23 assigned to the early mobilization program with nonweight-bearing braces (intervention group) and 23 to the standard rehabilitation care group (control group). The primary outcome was achieved in 16 patients (69.6%) in the intervention group and 6 patients (26.1%) in the control group [RD43.5%, 95%CI (17.5%,69.5%); P = 0.003]. The intervention group demonstrated improved outcomes in ADL. Additionally, the intervention facilitated earlier discharge with a LOS of 12 days in the intervention group compared to 18 days in the control group. Conclusion: An early postoperative mobilization program with nonweight-bearing brace is demonstrated to be feasible and effective in improving functional capacity in patients with diabetic foot ulcers undergoing surgery.