{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T03:54:03Z","timestamp":1783137243862,"version":"3.54.6"},"reference-count":48,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:00:00Z","timestamp":1672876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Exercise therapy helps improve glycaemic control and insulin sensitivity and may be relevant in treating patients with diabetic foot ulcers (DFUs). This study describes the development of a 12-week exercise therapy program for patients with DFUs and the preliminary feasibility of the program focusing on the program's inclusion, adherence, and safety. The development process is built on knowledge from a published systematic review on exercise for people with DFUs and a grounded theory study on the main concerns of people with DFUs regarding physical activity. The development involved doctors, wound care nurses, podiatrists, and feedback from patients and physical therapists using semi-structured interviews. The program was designed as a combination of aerobic and resistance training exercises. The aerobic exercise phase on the stationary bike of 30-minute duration was aimed at a moderate intensity. Resistance exercises were conducted with a 15-repetition maximum approach (four to five sets per trial) throughout the 12-week period. Three patients were included and received the exercise intervention. Except for recruitment and retention rates, acceptance levels were met for all other research progression criteria. Patients found the intervention relevant, wanted further guidance on continuing exercising, and would have liked the intervention closer to their home for example, a municipality setting. Although the exercise therapy program for patients with DFUs was developed in a thorough process with the inclusion of available evidence and the involvement of patients and other stakeholders conclusions on feasibility are limited due to the low recruitment rate. A reconsideration of the setting is needed in future exercise intervention studies.<\/jats:p>","DOI":"10.1177\/15347346221149786","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T02:08:42Z","timestamp":1672970922000},"page":"1253-1260","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["A 12-Week Supervised Exercise Therapy Program for Patients with Diabetic Foot Ulcers: Program Development and Preliminary Feasibility"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5098-5982","authenticated-orcid":false,"given":"Thomas Vedste","family":"Aagaard","sequence":"first","affiliation":[{"name":"Holbaek Hospital"},{"name":"Holbaek Hospital"},{"name":"Department of Orthopaedic Surgery, Centre for Evidence-Based Orthopaedics, Zealand University Hospital, Koge, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kajsa","family":"Lindberg","sequence":"additional","affiliation":[{"name":"Health and Rehabilitation Centre Vanloese, Copenhagen Municipality, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5337-758X","authenticated-orcid":false,"given":"Stig","family":"Brorson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Centre for Evidence-Based Orthopaedics, Zealand University Hospital, Koge, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla Riis","family":"Madsen","sequence":"additional","affiliation":[{"name":"Holbaek Hospital"},{"name":"REHPA, Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4336-7059","authenticated-orcid":false,"given":"S\u00f8ren T.","family":"Skou","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Naestved-Slagelse-Ringsted Hospitals, Slagelse, Denmark"},{"name":"Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,1,5]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.2.491"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0940-0"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2737"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0965-206X(03)80025-6"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2337\/cd16-0067"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2019.28.1.30"},{"key":"e_1_3_2_8_2","unstructured":"International Working Group on the Diabetic Foot. IWGDF Guidelines on the prevention and management of diabetic foot disease. International Working Group on the Diabetic Foot [Internet]. 2019; Available from: https:\/\/iwgdfguidelines.org\/wp-content\/uploads\/2019\/05\/IWGDF-Guidelines-2019.pdf."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002968.pub2"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.02.020"},{"issue":"1","key":"e_1_3_2_11_2","first-page":"21","article-title":"Diabetic foot prevention: The role of exercise therapy in the treatment of limited joint mobility, muscle weakness and reduced gait speed","volume":"120","author":"Francia P","year":"2015","unstructured":"Francia P, Anichini R, De Bellis A, et al. Diabetic foot prevention: The role of exercise therapy in the treatment of limited joint mobility, muscle weakness and reduced gait speed. Ital J Anat Embryol. 2015;120(1):21\u201032.","journal-title":"Ital J Anat Embryol"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/60.11.1432"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12885"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.16089"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12571"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-1728"},{"key":"e_1_3_2_17_2","article-title":"Implementing low-cost, community-based exercise programs for middle-aged and older patients with type 2 diabetes: What are the benefits for glycemic control and cardiovascular risk?","author":"Mendes R","unstructured":"Mendes R, Sousa N, Reis VM, Themudo-Barata JL. Implementing low-cost, community-based exercise programs for middle-aged and older patients with type 2 diabetes: What are the benefits for glycemic control and cardiovascular risk? Int J Environ Res Public Health. 2017 Sep 13;14(9):1057.","journal-title":"Int J Environ Res Public Health"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008836325782"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602700408"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2007.02.001"},{"key":"e_1_3_2_21_2","article-title":"Benefits and harms of exercise therapy for patients with diabetic foot ulcers: A systematic review","author":"Aagaard TV","unstructured":"Aagaard TV, Moeini S, Skou ST, Madsen UR, Brorson S. Benefits and harms of exercise therapy for patients with diabetic foot ulcers: A systematic review. Int J Low Extrem Wounds. 2022 Sep;21(3):219-233.","journal-title":"Int J Low Extrem Wounds"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-021-00456-w"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.108733"},{"key":"e_1_3_2_24_2","article-title":"Developing and evaluating complex interventions: The new medical research council guidance","volume":"337","author":"Craig P","year":"2008","unstructured":"Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: The new medical research council guidance. Br Med J. 2008;(337):a1655.","journal-title":"Br Med J."},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-033516"},{"key":"e_1_3_2_26_2","article-title":"CONSORT 2010 statement: Extension to randomised pilot and feasibility trials","author":"Eldridge SM","unstructured":"Eldridge SM, Chan CL, Campbell MJ, et al. CONSORT 2010 statement: Extension to randomised pilot and feasibility trials. Pilot Feasibility Stud. 2016;(2):64.","journal-title":"Pilot Feasibility Stud"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-014-0207-5"},{"key":"e_1_3_2_28_2","article-title":"Exercise and manual therapy for diabetic peripheral neuropathy: A systematic review","author":"Hern\u00e1ndez-Secor\u00fan M","unstructured":"Hern\u00e1ndez-Secor\u00fan M, Vidal-Peracho C, M\u00e1rquez-Gonzalvo S, et al. Exercise and manual therapy for diabetic peripheral neuropathy: A systematic review. Applied Sciences. 2021;11(12):5665.","journal-title":"Applied Sciences"},{"key":"e_1_3_2_29_2","article-title":"The management of diabetic foot ulcers in Danish hospitals is not optimal","author":"Kirketerp-M\u00f8ller K","unstructured":"Kirketerp-M\u00f8ller K, Svendsen OL, Jansen RB. The management of diabetic foot ulcers in Danish hospitals is not optimal. Dan Med J. 2015 Jun;62(6):A5097.","journal-title":"Dan Med J"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis460"},{"issue":"1","key":"e_1_3_2_31_2","article-title":"Definitions and criteria for diabetic foot disease","volume":"36","author":"van Netten JJ","year":"2020","unstructured":"van Netten JJ, Bus SA, Apelqvist J, et al. Definitions and criteria for diabetic foot disease. Diabetes Metab Res Rev. 2020;36(Suppl 1):e3268.","journal-title":"Diabetes Metab Res Rev"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/pst.185"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1499-4046(06)60097-3"},{"key":"e_1_3_2_34_2","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g1687","article-title":"Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide","volume":"348","author":"Hoffmann TC","year":"2014","unstructured":"Hoffmann TC, Glasziou PP, Boutron I, et al. Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide. Br Med J. 2014;(348):g1687.","journal-title":"Br Med J."},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096651"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.22271\/ortho.2021.v7.i2g.2666"},{"issue":"2","key":"e_1_3_2_37_2","first-page":"36","article-title":"Effects of aerobic exercise on vibration perception threshold in type 2 diabetic peripheral neuropathy population using 3-sites method: Single-blind randomized controlled trial","volume":"25","author":"Dixit S","year":"2019","unstructured":"Dixit S, Maiya A, Shastry BA. Effects of aerobic exercise on vibration perception threshold in type 2 diabetic peripheral neuropathy population using 3-sites method: Single-blind randomized controlled trial. Altern Ther Health Med. 2019;25(2):36\u201041.","journal-title":"Altern Ther Health Med"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40798-015-0038-4"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-015-0085-6"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-002-0681-6"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3181915670"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1097\/WON.0000000000000405"},{"key":"e_1_3_2_43_2","article-title":"An exercise program for people with severe peripheral neuropathy and diabetic foot ulcers - a case series on feasibility and safety","author":"Lindberg K","unstructured":"Lindberg K, Moller BS, Kirketerp-Moller K, Kristensen MT. An exercise program for people with severe peripheral neuropathy and diabetic foot ulcers - a case series on feasibility and safety. Disabil Rehabil. 2020 Jan;42(2):183-189.","journal-title":"Disabil Rehabil"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216307087319"},{"key":"e_1_3_2_45_2","article-title":"Putting the pieces together: A qualitative study exploring perspectives on self-management and exercise behavior among people living with multimorbidity, healthcare professionals, relatives, and patient advocates","author":"J\u00e4ger M","unstructured":"J\u00e4ger M, Lindhardt MC, Pedersen JR, et al. Putting the pieces together: A qualitative study exploring perspectives on self-management and exercise behavior among people living with multimorbidity, healthcare professionals, relatives, and patient advocates. J Multimorb Comorb. 2022 May 20;(12):26335565221100172.","journal-title":"J Multimorb Comorb"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocpiqo.2021.01.006"},{"key":"e_1_3_2_47_2","article-title":"A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance","author":"Skivington K","unstructured":"Skivington K, Matthews L, Simpson SA, et al. A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance. Br Med J. 2021 Sep 30;(374):n2061","journal-title":"Br Med J."},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2017.12.001"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14664"}],"container-title":["The International Journal of Lower Extremity Wounds"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15347346221149786","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15347346221149786","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15347346221149786","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:05:35Z","timestamp":1777457135000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15347346221149786"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,5]]},"references-count":48,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/15347346221149786"],"URL":"https:\/\/doi.org\/10.1177\/15347346221149786","relation":{},"ISSN":["1534-7346","1552-6941"],"issn-type":[{"value":"1534-7346","type":"print"},{"value":"1552-6941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,5]]}}}