Aim To examine whether a nurse‐led foot‐ankle flexibility and resistance exercise programme, delivered alongside usual care, was associated with changes in neuropathy symptoms and diabetic‐foot risk/self‐care indicators among adults with diabetes. Background Diabetic peripheral neuropathy (DPN) contributes to reduced protective sensation, limited joint mobility and impaired self‐care, increasing DFU risk. Low‐cost exercise programmes targeting foot‐ankle mobility and strength may improve neuropathy‐related symptoms and modifiable DFU risk factors, but practice‐based evidence in routine nursing settings remains limited. Design Quasiexperimental, nonrandomized, nonequivalent control‐group pre–post study. Methods Adults with Type 1 or Type 2 diabetes attending an outpatient diabetes clinic were recruited by convenience sampling ( N = 60) and allocated to an intervention group (usual care plus structured exercise education and supervised practice; n = 30) or a control group (usual care; n = 30). Outcomes were assessed at baseline and 1 month using the Neuropathy Total Symptom Score‐6 (NTSS‐6) and the Diabetes Foot Assessment/Risk Screening scale. Because allocation was nonrandomized and outcomes were analysed in categories, inferential analyses were exploratory and based on chi‐square/Fisher’s exact tests with Cramer’s V effect sizes. Results At 1 month, neuropathy symptom severity categories differed significantly between groups ( χ 2 = 34.236 and p < 0.001; V = 0.76), with a greater proportion of participants in the intervention group shifting to lower symptom‐severity categories. Diabetes Foot Assessment/Risk Screening categories also favoured the intervention group ( χ 2 = 30.762 and p < 0.001; V = 0.72). Given the quasiexperimental design and unadjusted categorical analyses, these findings should be interpreted as associations rather than causal estimates. Conclusions In this practice‐based quasiexperimental study, a brief nurse‐led foot‐ankle flexibility and resistance exercise programme was associated with improved neuropathy symptom categories and more favourable diabetic‐foot risk/self‐care indicators over 1 month. The findings support feasibility within nursing practice, but causal inference is limited by nonrandom allocation, the use of categorical unadjusted analyses and the use of a study‐specific foot‐risk/self‐care measure. Relevance to Clinical Practice Nurses can integrate brief foot screening with structured foot‐ankle exercise education and demonstration during outpatient diabetes visits as an adjunct to, not a replacement for, standard diabetic‐foot surveillance and self‐management support.
Khider et al. (Thu,) studied this question.