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Peer-reviewedCC BY-NC-ND 4.0Research in Nursing & Health

Feasibility and Exploratory Outcomes of Foot‐Ankle and Walking Exercises for Diabetic Neuropathy, Stress, and Quality of Life: A Pilot Randomized Controlled Trial

  • Siti Fadlilah1,2
  • Wahyu Rochdiat Murdhiono2
  • Ariyanto Nugroho3
  • Yohanes Andy Rias4
  • Shih Hsin Hsiao5,6
  • Kai Ling Lee5,6
  • Po Hao Feng7
  • Hsiu Ting Tsai1,8,9
9 affiliations
  1. 1School of Nursing, College of Nursing Taipei Medical University Taipei Taiwan, R.O.C.
  2. 2Program Study of Nursing Universitas Respati Yogyakarta Yogyakarta Indonesia
  3. 3Public Health Magister Programme Universitas Respati Yogyakarta Yogyakarta Indonesia
  4. 4Institut Ilmu Kesehatan Bhakti Wiyata Kediri, College of Nursing, Faculty of Health Kediri Indonesia
  5. 5School of Respiratory Therapy, College of Medicine Taipei Medical University Taipei Taiwan, R.O.C.
  6. 6Department of Internal Medicine Division of Pulmonary Medicine, Taipei Medical University Hospital Taipei Taiwan, R.O.C.
  7. 7Department of Internal Medicine, Division of Pulmonary Medicine, Shuang‐Ho Hospital Taipei Medical University Taipei Taiwan, R.O.C.
  8. 8Center of Excellence for Enhancing Well‐being in Vulnerable and Chronic Illness Populations, Faculty of Nursing Chulalongkorn University Bangkok Thailand
  9. 9Post‐Baccalaureate Program in Nursing, College of Nursing Taipei Medical University Taipei Taiwan, R.O.C.
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Abstract

Foot–ankle and walking exercises have been proposed as potential strategies for managing symptoms in people with diabetic peripheral neuropathy (DPN), yet evidence from primary care remains limited. This pilot study assessed the feasibility and acceptability of these interventions and explored preliminary outcome patterns in DPN, stress, and quality of life (QoL). A three‐arm pilot randomized controlled trial was conducted in three public health centers in Yogyakarta, Indonesia (n = 108; 36 per group). The control group received usual care and health education. The foot‐ankle group received education, leaflets, demonstrations, and guided practice, while the walking group received education and leaflets supporting a structured walking routine. Participants in the intervention groups then performed the exercises independently for 12 weeks. Outcomes were assessed at baseline, week 6, and week 12. Feasibility included recruitment, retention, data completeness, adherence, and adverse events. Adherence to the ≥ 150 min/week activity target was assessed using participant‐reported exercise logs. Acceptability was explored through open‐ended questions. Exploratory outcomes were analyzed using generalized estimating equations under an intention‐to‐treat approach. Feasibility indicators were favorable, with retention > 90%, minimal adverse events, and ≥ 80% adherence. Exploratory analyses suggested possible trends toward changes in DPN indicators, diabetes‐related distress, QoL barriers, fasting blood glucose, blood pressure, and ankle–brachial index in the intervention groups compared with controls. These findings suggest that the interventions are feasible and acceptable in primary care and provide preliminary estimates to inform a future fully powered randomized trial.

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Cite

BibTeXRIS
BibTeX
@article{fadlilah2026feasibility,
  title = {{Feasibility and Exploratory Outcomes of Foot‐Ankle and Walking Exercises for Diabetic Neuropathy, Stress, and Quality of Life: A Pilot Randomized Controlled Trial}},
  author = {Siti Fadlilah and Wahyu Rochdiat Murdhiono and Ariyanto Nugroho and Yohanes Andy Rias and Shih Hsin Hsiao and Kai Ling Lee and Po Hao Feng and Hsiu Ting Tsai},
  journal = {Research in Nursing \& Health},
  year = {2026},
  month = aug,
  doi = {10.1002/nur.70116},
  url = {https://doi.org/10.1002/nur.70116},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Feasibility and Exploratory Outcomes of Foot‐Ankle and Walking Exercises for Diabetic Neuropathy, Stress, and Quality of Life: A Pilot Randomized Controlled Trial
AU  - Siti Fadlilah
AU  - Wahyu Rochdiat Murdhiono
AU  - Ariyanto Nugroho
AU  - Yohanes Andy Rias
AU  - Shih Hsin Hsiao
AU  - Kai Ling Lee
AU  - Po Hao Feng
AU  - Hsiu Ting Tsai
PY  - 2026
DA  - 2026/08/10
JO  - Research in Nursing & Health
DO  - 10.1002/nur.70116
UR  - https://doi.org/10.1002/nur.70116
AB  - Foot–ankle and walking exercises have been proposed as potential strategies for managing symptoms in people with diabetic peripheral neuropathy (DPN), yet evidence from primary care remains limited. This pilot study assessed the feasibility and acceptability of these interventions and explored preliminary outcome patterns in DPN, stress, and quality of life (QoL). A three‐arm pilot randomized controlled trial was conducted in three public health centers in Yogyakarta, Indonesia (n = 108; 36 per group). The control group received usual care and health education. The foot‐ankle group received education, leaflets, demonstrations, and guided practice, while the walking group received education and leaflets supporting a structured walking routine. Participants in the intervention groups then performed the exercises independently for 12 weeks. Outcomes were assessed at baseline, week 6, and week 12. Feasibility included recruitment, retention, data completeness, adherence, and adverse events. Adherence to the ≥ 150 min/week activity target was assessed using participant‐reported exercise logs. Acceptability was explored through open‐ended questions. Exploratory outcomes were analyzed using generalized estimating equations under an intention‐to‐treat approach. Feasibility indicators were favorable, with retention > 90%, minimal adverse events, and ≥ 80% adherence. Exploratory analyses suggested possible trends toward changes in DPN indicators, diabetes‐related distress, QoL barriers, fasting blood glucose, blood pressure, and ankle–brachial index in the intervention groups compared with controls. These findings suggest that the interventions are feasible and acceptable in primary care and provide preliminary estimates to inform a future fully powered randomized trial.
SN  - 0160-6891
SN  - 1098-240X
ER  -