Peripheral neuropathy is nerve damage in the feet (extremities can be hands) causing loss of distal sensation (Colberg, 2001). Compromises must be made to any form of exercise or physical intervention programme, limiting weighting bearing activities and increasing the duration of warm up.

The extent of sensation loss must be investigated before any exercise commences in the consultation or by a doctor as the client may not recognise damage is occurring (Burke et al., 2002). The client should examine their own feet daily and footwear must be discussed so it is appropriate for the activity. Reduced forefoot plantar pressure Peirce (1999) reports a 50% reduction in foot damage if the training shoe is worn for the majority of the day, even when not exercising.

The type of activity prescribed will influence the types of training shoe available, some companies now have ‘specialised’ shoes for diabetics but remember this is not a quick fix and can be expensive! Impaired proprioception, meaning the bodies ability to be aware of its physical and spatial positioning in any given activity. This further increases the risk of injury so recommendations must be followed to ensure the clients well being. Bhaskarabhatia et al. (2004) states that silica gel in the soles of shoes and polyester socks are recommended to keep feet dry and prevent blisters.

Clients with any stage of peripheral neuropathy should have been diagnosed by the doctor, if you have any concerns please refer your client back to their doctor.

For further information on this issue and references please contact Victoria Clout (Student Support Manager at Discovery Learning).

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