Sensorimotor and gait training improves proprioception, nerve function, and muscular activation in patients with diabetic peripheral neuropathy: a randomized control trial.

People with diabetic peripheral neuropathy often lose proprioception (the sense of limb position) and have altered nerve function and muscle activation, which affects balance and walking. This small randomized trial compared eight weeks of sensorimotor and gait training plus diabetes and foot care education against education alone in 38 participants, to see whether such training could change these underlying measures. The training group showed significant improvements over time, and significant differences in the pattern of change compared to the education-only group, in proprioception across all directions tested and in peroneal nerve conduction velocity. Muscle activation findings were more mixed, with clearer interaction effects during standing than during walking.

Because the trial was small and the comparison group received only education rather than a matched active intervention, extra attention from the training sessions themselves may have contributed to some of the benefit, and these physiological changes have not yet been linked to functional outcomes like falls or mobility in daily life.

If you live with diabetic peripheral neuropathy, you may have noticed that it is harder to sense where your feet are or to keep your balance, especially with your eyes closed. This study tested whether a structured program combining sensorimotor and gait training, given three times a week for eight weeks alongside diabetes and foot care education, could improve these problems compared to education alone. The people who did the training showed improvements in their sense of foot and ankle position, and in a nerve conduction measure for one of the leg nerves, more than those who only received education.

Some muscles around the ankle and in the lower back also showed changes, though results were less consistent during walking than during standing. This was a small study with only 38 participants, so the findings are an early signal rather than a confirmed treatment effect. It also did not test whether these changes translate into fewer falls or easier daily walking, and the education-only group had less supervised contact overall, which could partly explain some of the difference.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This trial addresses whether a targeted sensorimotor and gait training program can modify the underlying sensory, nerve, and neuromuscular deficits seen in diabetic peripheral neuropathy, rather than only addressing symptoms through general education. Thirty-eight participants (25 male, 13 female) were randomized to eight weeks of sensorimotor and gait training plus diabetes and foot care education, or education alone, with outcomes including joint position sense in four directions, peroneal and tibial nerve conduction studies, and electromyographic activation of ankle muscles and multifidus during standing (eyes open and closed) and treadmill walking. The training group showed significant time-by-group interactions for proprioception in all directions and for peroneal nerve conduction velocity (p=0.022), alongside interaction effects for medial gastrocnemius and multifidus during standing (p≤0.004).

Notably, only multifidus showed a significant group effect during walking, while other muscle activation findings during gait were less robust, an isolated pattern that should be interpreted cautiously given the small sample and multiple comparisons. The design does not establish that these physiological changes translate into improved fall risk, functional mobility, or quality of life, and because the comparator received education only without a matched attention-control, some benefit may reflect increased therapist contact rather than the specific training content. The abstract does not report adverse events or whether registration was prospective or retrospective.