CSP Charitable Trust awards £27,000 for research into mobilisation in diabetic peripheral neuropathy

Physiotherapy lecturer Vasileios Lepesis has received a CSP Charitable Trust award of £27,000 to help complete his research into improving foot and ankle mobilisation in people with diabetic peripheral neuropathy.


Vasileios Lepesis, podiatry and physiotherapy lecturer at Plymouth University

Mr Lepesis, podiatry and physiotherapy lecturer at Plymouth University, said it's well know that people with the condition have a high risk of foot ulceration. He told Frontline people with diabetes can also present with reduced movement at joints caused by glycosylation which is linked to limited joint mobility syndrome; one of the most common musculoskeletal complications in diabetes.

The resultant reductions in ankle and big toe movement lead to increases in peak pressures over the plantar aspect of the forefoot when walking, which is a risk factor for ulceration.

‘The study will assess whether ankle and big toe joint mobilisations combined with a home program of stretches in people with diabetic peripheral neuropathy improves joint range of motion and reduces forefoot peak plantar pressures,’ he said.


Some 58 people with diabetic peripheral neuropathy recruited from a local podiatry clinic will take part in the study with half assigned to an intervention and half to a control group. Baseline and three-month outcome measures will be taken to assess ankle range while walking, as well as a series of other measurements.

The intervention group will be treated using mobilisation, which Mr. Lepeisis says 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’. He said that improving joint movement could help lower the load under the foot when walking, which could prevent the risk of foot ulceration.

Mr Lepesis thanked the Charitable Trust for the award: ‘This money will be used to support my PhD work when I have to take time off from the university job so I am very grateful.’

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