Therapeutic effects of connective tissue manipulation on wound healing and bacterial colonization count among patients with diabetic foot ulcer

Leonard Henry Joseph; Aatit Paungmali; John Dixon; Liz Holey; Amaramalar Selvi Naicker; Ohnmar Htwe

doi:10.1016/j.jbmt.2016.01.010

Therapeutic effects of connective tissue manipulation on wound healing and bacterial colonization count among patients with diabetic foot ulcer

J Bodyw Mov Ther. 2016 Jul;20(3):650-6. doi: 10.1016/j.jbmt.2016.01.010. Epub 2016 Feb 2.

Authors

Leonard Henry Joseph¹, Aatit Paungmali², John Dixon³, Liz Holey³, Amaramalar Selvi Naicker⁴, Ohnmar Htwe⁴

Affiliations

¹ Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand; Physiotherapy Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. Electronic address: leonardjoseph85@hotmail.com.
² Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand.
³ Health and Social Care Institute, School of Health and Social Care, Teesside University, Middlesbrough, United Kingdom.
⁴ Department of Orthopedics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.

PMID: 27634091
DOI: 10.1016/j.jbmt.2016.01.010

Abstract

This study investigated the therapeutic effects of connective tissue manipulation (CTM) in diabetic foot ulcer (DFU). A total of 20 participants (10 in CTM group and 10 in conventional treatment group (CG)) with DFU underwent the conventional DFU treatment. In addition, the CTM group received CTM twice per week for 6 weeks. The percentage wound area reduction (PWAR) and bacterial colonization count (BCC) in log10 colony-forming units (CFU) per ml wound fluid was evaluated at baseline and six weeks. Results showed a significant change in PWAR in CTM (p < 0.05, t = 3.82, Df = 9, CI L = 0.98 U = 3.81) and CG (p < 0.05, t = 2.97, Df = 9,CI L = 0.26 U = 1.98). Mean reduction of BCC showed a significant reduction (p < 0.05), with percentage of BCC reduction higher in CTM group (6.45%) than CG (3.55%). The findings suggest CTM as an effective adjunct therapy for DFU to enhance conventional treatments.

Keywords: Connective tissue manipulation; Diabetes; Physiotherapy; Rehabilitation; Ulcer.

Publication types

Randomized Controlled Trial

MeSH terms

Connective Tissue / physiology*
Diabetic Foot / therapy*
Female
Humans
Male
Middle Aged
Musculoskeletal Manipulations / methods*
Wound Healing / physiology*