Despite some of the positive findings in this study there were a few important gaps. There were no control subjects to compare the DPN subjects to (no non-diabetic subjects or diabetic subjects without DPN). Therefore it was not a randomized study and there was no placebo. The participants were all older individuals with a wide range of a duration of diabetes (12.2 years). They also did not define what stage of neuropathy the patients were experiencing. Also, there was no specific regimen on what equipment was used for exercise training. Although it was a supervised exercise intervention, the subjects were allowed to choose from a variety of options and were only encourages to utilize different equipment. Nerve conduction study was used to test conduction velocity, motor action potential, and amplitude but not significant changes were found. Lastly, skin biopsies were used to test intraepidermal nerve fiber density and epidermal axon branching. There was only a significant difference in nerve fiber branching at the proximal biopsy site.
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