Can My Patient With Diabetic Neuropathy Exercise? Will This Increase Risk? Results of New Study

Effect of selected exercises on in-shoe plantar… [Foot (Edinb). 2012] – PubMed – NCBI:

New data from our friend and colleague Prof. Mike Mueller and team from Washington University.

Bottom line: walking, stair climbing, sit to stands, cycling, balance ball training do not significantly increase plantar pressure in our high risk patients. Let’s  consider monitored exercise programs, no?


Movement Science Program, Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA.



In people with diabetes and peripheral neuropathy (DM+PN), injury risk is not clearly known for weight bearing (WB) vs. non-weight bearing (NWB) exercise. In-shoe peak plantar pressures (PPP) often are used as a surrogate indicator of injury to the insensitive foot.


Compare PPPs in people with DM+PN during selected WB and NWB exercises.


Fifteen subjects with DM+PN participated. PPPs were recorded for the forefoot, midfoot, and heel during level walking and compared to; WB exercises–treadmill walking, heel and toe raises, sit to stands, stair climbing, single leg standing; and NWB exercises–stationary bicycling, balance ball exercise and plantar flexion exercise.


Compared to level walking; mean forefoot PPP during treadmill walking was 13% higher, but this difference was eliminated when walking speed was used as a covariate. Mean PPPs were similar or substantially lower for other exercises, except for higher forefoot PPP with heel raise exercises.


Slow progression and regular monitoring of insensitive feet are recommended for all exercises, but especially for heel raises, and increases in walking speed. The remaining WB and NWB exercises pose no greater risk to the insensitive foot due to increases in PPP compared to level walking.

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