Physical therapy in comprehensive treatment of peripheral artery disease and diabetes mellitus

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Abstract

Peripheral artery disease (PAD) and diabetes mellitus (DM) are serious medical and social issues that pose a significant risk of cardiovascular complications, amputations, and disability. The coexistence of these conditions worsens both survival and limb preservation, increases the severity of lower limb ischemia, and promotes trophic tissue disorders of the foot, including diabetic foot. The modern management of patients with PAD and DM relies on a multidisciplinary strategy, with physical therapists playing a key role. Their expertise encompasses improving physical activity, preventing complications, managing chronic wounds, and providing rehabilitation after vascular reconstructive surgery. This review summarizes current physical therapy approaches, including supervised exercise therapy (SET) for intermittent claudication, preoperative conditioning, early mobilization protocols, and restoration of motor activity following amputation or ulcer healing. Special emphasis is placed on offloading strategies for affected foot regions, physiotherapeutic techniques (laser therapy, magnetotherapy), and personalized exercise therapy programs for patients with DM. Furthermore, the review discusses barriers to SET implementation, including limited accessibility of programs, shortage of trained specialists, and patient referral challenges, as well as the need for educational and certification programs in chronic wound care for physical therapy and rehabilitation professionals. Clinical evidence suggests that integrating physical therapy into comprehensive treatment of patients with PAD and DM can improve limb function, reduce complication rates, and enhance quality of life.

About the authors

Aliya R. Kasymova

Kazan State Medical University

Email: alia18032003@yandex.ru
ORCID iD: 0009-0004-5647-849X
Russian Federation, Kazan

Timerkhan R. Zamaletdinov

Kazan State Medical University

Email: timerhan200209@gmail.com
ORCID iD: 0009-0007-1112-5406
Russian Federation, Kazan

Adelina E. Bikmetova

Bashkir State Medical University

Author for correspondence.
Email: ktrnkzhvnkv@gmail.com
ORCID iD: 0009-0001-3147-0852
Russian Federation, Ufa

Elina R. Sultanova

Bashkir State Medical University

Email: elinasultanova2001@mail.ru
ORCID iD: 0009-0006-6695-9304
Russian Federation, Ufa

Liliya I. Bilalova

Bashkir State Medical University

Email: liliabilalova98@gmail.com
ORCID iD: 0009-0006-5071-4038
Russian Federation, Ufa

Ekaterina E. Sedakova

Bashkir State Medical University

Email: ekaterina.sedakovaa@mail.ru
ORCID iD: 0009-0001-5190-0047
Russian Federation, Ufa

Kiriena M. Shaikhutdinova

Bashkir State Medical University

Email: shaikhutdinovakira@gmail.com
ORCID iD: 0009-0001-3062-5023
Russian Federation, Ufa

Zaripat K. Abdulmedzhidova

Astrakhan State Medical University

Email: zabdulmedzhidova2003@mail.ru
ORCID iD: 0009-0008-7496-4001
Russian Federation, Astrakhan

Anna S. Antipina

Astrakhan State Medical University

Email: aniuta.antipina2018@yandex.ru
ORCID iD: 0009-0008-2448-7788
Russian Federation, Astrakhan

Aminat A. Bidzhieva

Rostov State Medical University

Email: aminabidzieva59@gmail.com
ORCID iD: 0009-0003-5465-9257
Russian Federation, Rostov-on-Don

Danila V. Tupikov

Rostov State Medical University

Email: tupikov-danila@mail.ru
ORCID iD: 0009-0009-8051-9147
Russian Federation, Rostov-on-Don

Rolan R. Dolaev

Rostov State Medical University

Email: rolan.dolaev@mail.ru
ORCID iD: 0009-0002-8598-1962
Russian Federation, Rostov-on-Don

Rashid R. Dzhatdoev

Rostov State Medical University

Email: dzhatdoev.rashid@mail.ru
ORCID iD: 0009-0007-0946-7837
Russian Federation, Rostov-on-Don

Rada R. Edieva

Rostov State Medical University

Email: rada.edieva@gmail.com
ORCID iD: 0009-0000-8959-915X
Russian Federation, Rostov-on-Don

Natalya A. Fedosova

Orenburg State Medical University

Email: nata.fed2003@yandex.ru
ORCID iD: 0009-0006-5792-1152
SPIN-code: 1645-4567
Russian Federation, Orenburg

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