DOS 2020

56 · DOS Abstracts Benefits and harms of exercise therapy for patients with diabetic foot ulcers: A systematic review Thomas Vedste Aagaard, Sahar Moeini, Søren Thorgaard Skou, Ulla Riis Madsen, Stig Brorson Department of physo- and occupational therapy, Holbaek hospital; Department of Orthopaedic Surgery, Zealand University Hospital; Department of Physiotherapy and Occupational Therapy, Naestved-Slagelse-Ringsted Hospitals; Department of Orthopaedic Surgery, Holbaek Hospital Background: One of the most feared complications of diabetes mellitus is dia- betic foot ulcers (DFU), as it can cause severe adverse consequences such as amputation or death. Patients are often required to refrain from bearing weight on their affected limb, leaving some patients immobile for weeks, months or even years. This is in direct contrast to guidelines for diabetes where exercise therapy and physical activity are core elements in the treatment. This leaves pa- tients and caretakers with a paradox. If a DFU evolves, should patients continue following the guidelines for diabetes? Even if these guidelines include recom- mendations of brisk walking and exercising at high intensity. Purpose / Aim of Study: Exercise therapy is a core element in the treatment of diabetes, but the benefits and harms for patients with a diabetic foot ulcer are unknown. We aimed to systematically review the benefits and harms of exercise therapy for patients with DFU. Materials and Methods: We searched six major databases. We performed citation and reference searches of included studies and contacted authors of ongoing trials. We included randomized controlled trials to assess potential ben- efits on health-related quality of life (HRQoL) and harms of exercise therapy. Observational studies were included to identify potential harms of exercise therapy. Findings / Results: We included 10 published publications of 9 trials and re- sults from two unpublished trials including a total of 281 individuals with DFUs receiving various forms of exercise therapy. Due to lack of HRQoL measure- ments and high heterogeneity, it was not possible to perform meta-analyses. Results on HRQoL was present in one unpublished study. Harms reported ranged from musculoskeletal problems, increased wound size, to amputation; however, no safe conclusions could be drawn from the available data due to high hetero- geneity and risk of bias in the trials. Conclusions: Protective strategies are often preferred over therapeutic exer- cise which might have unforeseen consequences for patients over time. Based on the current literature, no evidence-based recommendations can be provided on the benefits and harms of exercise therapy for patients with DFUs. Well- conducted RCTs are needed to guide rehabilitation. 46.