Fall and balance outcomes after an intervention to promote leg strength, balance, and walking in people with diabetic peripheral neuropathy: "feet first" randomized controlled trial

Background. Weight-bearing exercise has been discouraged for people with diabetes mellitus and peripheral neuropathy (DMPN). However, people with dia-betes mellitus and insensate feet have an increased risk of falling. Lower-extremity exercise and balance training reduce fall risk in some older adults. It is unknown whether those with neuropathy experience similar benefits. Objective. As part of a study of the effects of weight-bearing exercise on foot ulceration in people with DMPN, the effects of a lower-extremity exercise and walking intervention on balance, lower-extremity strength (force-generating capac-ity), and fall incidence were determined. Design. The study was an observer-masked, 12-month randomized controlled trial. Setting. Part 1 of the intervention took place in physical therapy offices, and part 2 took place in the community. Patients. The participants were 79 people who were mostly sedentary, who had DMPN, and who were randomly assigned to either a control group (n38) or an intervention group (n41)