Special considerations in the application of medical rehabilitation for patients who have experienced lower extremity injuries in the context of diabetes mellitus

Abstract

Diabetes mellitus (DM) and lower extremity injuries are one of the global health problems. These conditions require rehabilitation measures to restore maximum functionality and quality of life of the patients. The presence of DM aggravates the recovery period after injuries, and also serves as an independent factor in poor outcomes, death, development of early and late trauma complications. In DM patients with injuries of the lower extremities it is required special attention, an integrated approach and the participation of a multidisciplinary team to create an optimal rehabilitation program aimed at prevention of the progression and development of complications, achieving a prompt and complete restoration of functions. Personalized treatment decisions, individually selected therapy methods and the use of modern technologies will help achieve the best results in the rehabilitation of patients with DM and lower extremity injuries. Basic rehabilitation strategies in DM patients with injuries of the lower extremities include: control of glucose levels and metabolic disorders; inspection and care of damaged tissues to prevent the development of ulcers and infections; gradual increase in physical activity; rehabilitation goals must be realistic and take into account the individual characteristics of the patient; the use of physiotherapy methods to improve microcirculation and activate tissue regeneration (transcutaneous electrical nerve stimulation, electrophoresis, magnetic fields, ultratonotherapy, cryotherapy, laser therapy, darsonvalization, pulsed electric fields, ultrasound therapy, ozokerite therapy and peloid therapy); the use of mechanotherapy with biofeedback and robotic systems to increase endurance, strength, improve balance function and form the correct walking stereotype (rehabilitation track with visual feedback about walking C-Mill).