Muscle force distribution of the lower limbs during walking in diabetic individuals with and without polyneuropathy.

The study used a computer model to estimate muscle forces. It did not directly measure muscle forces, and the neuropathy model was adjusted using assumed reductions in maximum muscle force rather than individual measurements. The sample was small and cross-sectional, and some tables list 12 neuropathy participants while the methods say 10, so the analysed group size is unclear. Participants had to walk independently without pain or assistive device and had no major foot or limb complications, so results may not apply to more severe diabetic impairment. Multiple statistical comparisons could increase false-positive findings, and the chosen optimization method can affect estimated forces. No intervention was tested, so the paper cannot show that strengthening or gait training changes walking, function, or injury risk.

Funded by Fundação de Amparo à Pesquisa do Estado de São Paulo and Conselho Nacional de Desenvolvimento Científico e Tecnológico. The supplied text does not state author conflicts of interest.

Do not conclude that diabetic neuropathy causes a simple hip strategy or that proximal muscle training will fix gait. The model did not find significant increases in hip flexor peak force, and the study did not test a rehabilitation programme.