title: Resistance exercise training increases lower limb speed of strength generation during stair ascent and descent in people with diabetic peripheral neuropathy.
abstract: OBJECTIVE
  To examine the effects of a 16-week resistance exercise training intervention on the speed of ankle and knee strength generation during stair ascent and descent, in people with neuropathy.
  
  
  METHODS
  A total of 43 people: nine with diabetic peripheral neuropathy, 13 with diabetes but no neuropathy and 21 healthy control subjects ascended and descended a custom-built staircase. The speed at which ankle and knee strength were generated, and muscle activation patterns of the ankle and knee extensor muscles were analysed before and after a 16-week intervention period.
  
  
  RESULTS
  Ankle and knee strength generation during both stair ascent and descent were significantly higher after the intervention than before the intervention in the people with diabetes who undertook the resistance exercise intervention (P < 0.05). Although muscle activations were altered by the intervention, there were no observable patterns that underpinned the observed changes.
  
  
  CONCLUSIONS
  The increased speed of ankle and knee strength generation observed after the intervention would be expected to improve stability during the crucial weight acceptance phase of stair ascent and descent, and ultimately contribute towards reducing the risk of falling. Improvements in muscle strength as a result of the resistance exercise training intervention are likely to be the most influential factor for increasing the speed of strength generation. It is recommended that these exercises could be incorporated into a multi-faceted exercise programme to improve safety in people with diabetes and neuropathy.
authors.affiliation: School of Healthcare Science, Manchester Metropolitan University, Manchester, UK.
authors.forename: J C
authors.initials: JC
authors.lastname: Handsaker
authors.affiliation: School of Healthcare Science, Manchester Metropolitan University, Manchester, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Brown
authors.affiliation: Faculty of Medical & Human Sciences, University of Manchester, Manchester, UK.
authors.forename: F L
authors.initials: FL
authors.lastname: Bowling
authors.affiliation: School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
authors.forename: C N
authors.initials: CN
authors.lastname: Maganaris
authors.affiliation: Faculty of Medical & Human Sciences, University of Manchester, Manchester, UK.
authors.forename: A J M
authors.initials: AJ
authors.lastname: Boulton
authors.affiliation: School of Healthcare Science, Manchester Metropolitan University, Manchester, UK.
authors.forename: N D
authors.initials: ND
authors.lastname: Reeves
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000842:Ankle; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D004185:Disability Evaluation; D015444:Exercise; D005260:Female; D005684:Gait; D006801:Humans; D007717:Knee; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology*; D055070:Resistance Training; D012684:Sensory Thresholds; D012720:Severity of Illness Index; D013997:Time Factors; D015854:Up-Regulation; D014732:Vibration