New research to help combat diabetic foot condition

Vasileios Lepesis, Lecturer in Podiatry at the University of Plymouth

Loss of feeling and joint stiffness caused by diabetes are two of the most common causes of foot ulceration and amputation, both of which have a huge impact on people’s lives. My research is investigating a possible way of alleviating the problems.

Could mobilising the ankle and big toe lower the chances of people with diabetes developing foot ulcers?

Vasileios Lepesis, Lecturer in Podiatry at the University of Plymouth, has received funding from Chartered Society of Physiotherapy Charitable Trust to find out. 

He will be measuring the effectiveness of mobilisations on joint movement in the ankle and big toe in people with diabetes suffering from loss of feeling (known as neuropathy) and joint stiffness (known as limited joint mobility syndrome) in the feet. 

Mobilisation is a safe, gentle, pain free hands-on treatment technique in which a trained therapist pushes the stiff joint with their hands to free up the movement. Improving joint movement could help lower the load under the foot when walking, which could prevent the risk of foot ulceration. 

The purpose of the study is to test the effect of mobilisation on ankle and big toe joint movement whilst standing and walking, and its effect on the load under the foot when walking. 

To do this, the study will compare the joint movements and loads under the feet in two groups of people; one group who have had mobilisation and a home programme of stretches and one group who have not.

Although existing research suggests that foot and ankle mobilisation could help increase the available range in these joints, no evidence is currently available on the effectiveness of these techniques when applied in the diabetic population. 

Mr Lepesis has received £24,950 from the Chartered Society of Physiotherapy Charitable Trust to undertake the two-year study, and is currently looking for people with diabetic peripheral neuropathy to take part. 

He said: 

“Loss of feeling and joint stiffness caused by diabetes are two of the most common causes of foot ulceration and amputation, both of which have a huge impact on people’s lives. There is evidence available to suggest that mobilisations and regular stretching can help the bones in the foot and ankle move more effectively together; however the association between range of motion and decreases of plantar pressure have not been investigated in people with diabetes.

“If anyone suffers from loss of feeling in their feet and attends regular podiatric NHS appointments, I would really like to hear from you as I want to measure the effectiveness of this treatment technique in as many people as possible. Preventing foot ulcers by carrying out quality research is a key part of the Podiatry department here at the University of Plymouth.”

To take part in the study or to ask for an information sheet, email vasileios.lepesis@plymouth.ac.uk 


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