Lower-limb joint moments during gait in individuals with diabetes with and without peripheral neuropathy – A systematic review with meta-analysis

Evidence indicates reduced plantar flexor and second peak knee flexor moments in people with diabetes, without clear exacerbation by clinically defined neuropathy. This pattern is consistent with gait alterations emerging early in the disease course and suggests that muscular and neuropathy-related kinetic changes may be subtle or not consistently captured by current study methods. Non-significant hip joint moment differences leave competing flexor versus extensor hip strategy explanations unresolved.