Diabetic Neuropathy Associated With Slower Ankle, Knee Strength Generation

(HealthDay News) — When walking up and down stairs, patients with diabetic peripheral neuropathy are slower at generating strength at the ankle and knee compared with control participants, which may increase the risk for falls, according to a study published in Diabetes Care.

Joseph C. Handsaker, from the Manchester Metropolitan University in the United Kingdom, and colleagues examined 63 participants (21 patients with diabetic peripheral neuropathy, 21 controls with diabetes and 21 healthy controls) walking up and down a custom-built staircase. 

Analysis included assessment of speed of strength generation at the ankle and knee and muscle activation patterns of the ankle and knee extensor muscles.

Patients with neuropathy displayed significantly slower ankle and knee strength generation than healthy controls during stair ascent and descent (P<.05), according to the researchers. Ankle and knee extensor muscles were activated significantly later by patients with neuropathy during ascent and they also took longer to reach peak activation (P<.05). 

Patients with neuropathy activated the ankle extensors significantly earlier during descent, while ankle and knee extensors took significantly longer to reach peak activation (P<.05).

“These changes, which are likely caused by altered activations of the extensor muscles, increase the likelihood of instability and may be important contributory factors for the increased risk of falling,” the researchers wrote. 

“Resistance exercise training may be a potential clinical intervention for improving these aspects and thereby potentially reducing fall risk.”


  1. Handsaker JC et al. Diabetes Care. 2014;doi:10.2337/dc14-0955.