Diabetes mellitus (DM) is a metabolic disorder that affects the production or action of insulin. Complications (e.g., diabetic foot, characterized by infection, ulcer, and/or soft tissue destruction) may occur in different ways and severities. In more severe cases, individuals may present neurological disorders and peripheral artery disease in the lower limbs. In this sense, physiotherapy becomes important for prevention and treatment, given the number of individuals who do not reach adequate healing.

To perform a literature search to identify the main physiotherapy interventions for the diabetic foot.

This narrative study was conducted in November 2022 in PubMed, Scientific Electronic Library Online (SciELO), Physiotherapy Evidence Database (PEDro), and Cochrane Library databases using the Boolean operator AND and the following descriptors: diabetic foot, physiotherapy, and treatment. We included full-text articles published in Portuguese and English that conducted randomized clinical trials or systematic reviews; the studies should have been published and indexed in the databases mentioned above in the last 14 years. Exclusion criteria comprised theoretical reviews, monographs, dissertations, theses, and studies that included animals or did not have available abstracts. The search resulted in 151 articles (PubMed = 121, Cochrane Library = 27, PeDro = 2, and SciELO = 1); 17 articles were selected after reading titles and abstracts, and 4 were selected after full-text reading.

Several physiotherapy interventions were found, such as lower limb exercises to heal wounds in patients with type 2 DM and physical resources physical resources associated with phototherapy through light-emitting diodes. The safety and efficacy of photobiomodulation at home for treating diabetic foot ulcers and topical ozone therapy were also observed as adjuvant treatments.

We analyzed physiotherapy interventions with different protocols for diabetic foot: guidance, active exercises, isolated movements for lower limbs, and physical resources (e.g., photobiomodulation, laser therapy, and ozone therapy). These interventions also improved the blood supply to lower limbs, which may have prevented wounds, increased the chance and speed of healing, and avoided amputations.

Physiotherapy interventions are fundamental to prevent and treat complications, improving the quality of life of patients with diabetic foot ulcers and reinserting them in society.