Fisioterapia nos cuidados da ferida e na prevenção da amputação do pé diabético: Uma revisão narrativa
DOI:
https://doi.org/10.62827/fb.v27i7.1244Palabras clave:
Pé Diabético; Modalidades de Fisioterapia; Cicatrização; Neuropatias Diabéticas; Prevenção Secundária.Resumen
Introdução: A úlcera do pé antecede a maior parte das amputações não traumáticas de membro inferior em pessoas com diabetes, mas a contribuição da fisioterapia é descrita de forma fragmentada. Objetivo: Descreveu-se o papel da fisioterapia no cuidado da ferida e na prevenção da amputação do pé diabético. Métodos: Revisão narrativa descritiva e qualitativa, com busca estruturada realizada entre junho e agosto de 2026 na base Medical Literature Analysis and Retrieval System Online, acessada por meio do PubMed, com consulta a diretrizes e rastreamento de referências. Utilizaram-se termos livres em inglês combinados pelos operadores AND e OR, priorizando publicações de 2021 a 2026, em português e inglês. Incluíram-se ensaios randomizados, revisões, estudos observacionais e diretrizes com interface fisioterapêutica; excluíram-se relatos de caso, editoriais, cartas e resumos de eventos. A seleção ocorreu em duas etapas e os estudos foram analisados de forma descritiva, por eixos temáticos. Resultados: Foram incluídos 69 estudos. A evidência mais robusta sustenta os dispositivos de descarga não removíveis; o calçado terapêutico apresenta efeito favorável, enquanto a educação estruturada mostra direção favorável, com certeza baixa a muito baixa. Nos ensaios de exercício de pé e tornozelo houve melhora de função, amplitude e marcha, sem incidência de úlcera como desfecho. Os recursos eletrofísicos apresentam direção favorável com certeza baixa, e a reabilitação após a amputação apoia-se em base de evidência extremamente escassa. Conclusão: A contribuição da fisioterapia concentra-se no manejo da carga mecânica e da função ao longo do ciclo da doença, e não em recursos aplicados à ferida.
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