International Journal of Diabetes Research 2014, 3(3): 41-48 DOI: 10.5923/j.diabetes.20140303.03 Effect of Twelve Weeks Supervised Aerobic Exercise on Ulcer Healing and Changes in Selected Biochemical Profiles of Diabetic Foot Ulcer Subjects Maduabuchi Joseph Nwankwo 1 , Goddy Chuba Okoye 2 , Egwuonwu Afamefuna Victor 1,* , Ezeukwu Antoninus Obinna 2 1 Department of Medical Rehabilitation, Nnamdi Azikiwe University, Nnewi Campus 2 Department of Medical Rehabilitation, University of Nigeria Enugu Campus Abstract Background and Objectives: Diabetes and diabetic complications represent a significant burden for the patients, their families and the society at large. This study evaluated the effect of aerobic exercise on diabetic ulcer healing and changes in selected biochemical profiles of individuals with diabetic foot ulcer. Methododology: The study employed a pretest-posttest randomized control trial design. Sixty one (61) subjects including 31 males and 30 females with diabetic foot ulcers were recruited to the study and were randomized using the pitcher bowl method to either receive the aerobic exercise with bicycle ergometer (Group One) or not (Group Two) but placed on their routine treatment alone. The study was carried out at Nnamdi Azikiwe University Teaching Hospital, Nnewi. Subjects reported to the clinic 3times a week and both groups were assessed for baseline data which included BMI, fasting plasma glucose, total cholesterol, and wound size area measurements. The follow up evaluations were done on a 2 weekly basis for the twelve weeks period. Initial aerobic exercise intensity was based on 60% of maximum heart rate (HR) achieved on a stress test. Each subject was progressed to 85% of the value for the twelve weeks. Results: The group one subjects had a significant decrease in wound size area after the intervention with p value = 0.001** (26.45±9.46 and 17.7±7.23) baseline for group one and two after intervention (1.97 ±4.17 and 7.93 ±4.08), the duration of diabetes were significantly correlated with percentage wound size reduction, (p = 0.37** and 0.037) after 4th week intervention. The study showed that fasting plasma glucose was significantly different but the total cholesterol level was not different in the experimental group compared to the non experimental group (p values = 0.03** and 0.56) post intervention. Conclusions: The study suggests that supervised aerobic exercise program should be an essential component of the treatment plan for patients with diabetic foot ulcer. Future studies should consider randomized control trial with a longitudinal design, incorporating sophisticated wound assessment tool, to rule out inaccurate measurements. Keywords Diabetes, Diabetic foot ulcer, Wound size area, Fasting plasma glucose, Total cholesterol level, Wound size reduction 1. Introduction Background of Study Diabetes mellitus is a group of metabolic disorders characterized by elevated levels of glucose in the blood (hyperglycemia) resulting from defects in insulin secretion, insulin action or both [1]. Diabetes results in chronic hyperglycemia and hyperlipidemia that ultimately induces diverse multiple system pathologies; increasing the risk for atherosclerosis, coronary heart disease, stroke, myocardial infarction, renal * Corresponding author: va.egwuonwu@unizik.edu.ng (Egwuonwu Afamefuna Victor) Published online at http://journal.sapub.org/diabetes Copyright © 2014 Scientific & Academic Publishing. All Rights Reserved disease and periodontitis. It is the third leading cause of death by disease in Nigeria and the sixth in the world generally and affects about 5.2% of its population [2]. People with diabetes have a 12–25% lifetime risk of developing a foot ulcer [3]. An estimated 14.6 million persons are currently diagnosed with foot ulcers. In 2005 Nigeria had 19.4 million diabetes compared to 16 million in China which comes second. According to WHO by 2025, Nigeria will have 57.2 million diabetic while China will have 37.6 million diabetic patients. The economic burden that this large number of diabetics will place on our health care system even if a fraction were to develop complications is too enormous [4]. Diabetic foot ulcers result from the simultaneous action of multiple contributing causes. The major underlying causes are noted to be peripheral neuropathy and ischemia from