{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:36:18Z","timestamp":1776270978290,"version":"3.50.1"},"reference-count":30,"publisher":"BMJ","issue":"5","funder":[{"name":"the Andrea and Lawrence A. Wolfe Brain Health Initiative Fund","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"the NeuroNetwork for Emerging Therapies","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K01DK135799"],"award-info":[{"award-number":["K01DK135799"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R00DK129785"],"award-info":[{"award-number":["R00DK129785"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK115687"],"award-info":[{"award-number":["R01DK115687"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK129320"],"award-info":[{"award-number":["R01DK129320"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK130913"],"award-info":[{"award-number":["R01DK130913"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Sinai Medical Staff Foundation","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"the Nathan and Rose Milstein Research Fund","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/W002388\/1"],"award-info":[{"award-number":["MR\/W002388\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Richard and Jane Manoogian Foundation","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Dr. John H. Doran Neuropathy Research Initiative","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"accepted":{"date-parts":[[2026,2,9]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical guidelines recommend physical activity (PA) to prevent diabetic peripheral neuropathy (DPN). However, these recommendations lack specificity in terms of optimal PA intensity and duration. We aimed to determine associations between PA, DPN and painful DPN (pDPN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a cross-sectional study of persons with diabetes, PA was assessed with a wrist-worn accelerometer, recording time spent at different milli-gravity (mG) intensity levels with categories set as light (45\u2013100\u2009mG), moderate (100\u2013400\u2009mG), or vigorous (&gt;400\u2009mG). DPN was defined by Michigan Neuropathy Screening Instrument questionnaire and pDPN by presence of bilateral foot pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2878 participants (mean (SD) age: 58.6 (7.1) years, 39.1% female), time spent above 75\u2009mG decreased DPN odds (OR, 95%\u2009CI) (0.97, 0.95 to 0.997). Further, more time spent performing moderate (0.95, 0.91 to 0.99) or vigorous (0.40, 0.22 to 0.70)\u2009PA decreased DPN odds. Overall, PA did not affect pDPN; however, among females, more time spent above 50\u2009mG (0.92, 0.87 to 0.98) decreased pDPN odds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increased PA decreased DPN likelihood, and in females, pDPN likelihood. Whether lack of PA occurs secondary to the presence of DPN or contributes to DPN remains to be determined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnnp-2025-337592","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T18:20:22Z","timestamp":1772648422000},"page":"464-468","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Physical activity decreases the likelihood of peripheral neuropathy in persons with diabetes"],"prefix":"10.1136","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0138-8436","authenticated-orcid":false,"given":"Evan L","family":"Reynolds","sequence":"first","affiliation":[{"name":"Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Russman","sequence":"additional","affiliation":[{"name":"Neurology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Baskozos","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Eid","sequence":"additional","affiliation":[{"name":"Neurology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva L","family":"Feldman","sequence":"additional","affiliation":[{"name":"Neurology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David L H","family":"Bennett","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8885-6748","authenticated-orcid":false,"given":"Brian C","family":"Callaghan","sequence":"additional","affiliation":[{"name":"Neurology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"2026041508350821000_97.5.464.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00188-0"},{"key":"2026041508350821000_97.5.464.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2019.12.005"},{"key":"2026041508350821000_97.5.464.3","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1093\/brain\/awab079","article-title":"Painful and non-painful diabetic neuropathy, diagnostic challenges and implications for future management","volume":"144","author":"Jensen","year":"2021","journal-title":"Brain (Bacau)"},{"key":"2026041508350821000_97.5.464.4","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-021-01596-6"},{"key":"2026041508350821000_97.5.464.5","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.2337\/dc23-0937","article-title":"Leisure-Time Physical Activity and Risk of Microvascular Complications in Individuals With Type 2 Diabetes: A UK Biobank Study","volume":"46","author":"Kristensen","year":"2023","journal-title":"Diabetes Care"},{"key":"2026041508350821000_97.5.464.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004135","article-title":"Healthy lifestyle behaviors, mediating biomarkers, and risk of microvascular complications among individuals with type 2 diabetes: A cohort study","volume":"20","author":"Geng","year":"2023","journal-title":"PLoS Med"},{"key":"2026041508350821000_97.5.464.7","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-2277"},{"key":"2026041508350821000_97.5.464.8","unstructured":"Exercise may reduce neuropathic pain. Foundation for Peripheral Neuropathy. n.d. Available: https:\/\/www.foundationforpn.org\/lifestyles\/exercise-physical-therapy\/"},{"key":"2026041508350821000_97.5.464.9","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-2042"},{"key":"2026041508350821000_97.5.464.10","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.17.11.1281"},{"key":"2026041508350821000_97.5.464.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2012.03644.x"},{"key":"2026041508350821000_97.5.464.12","doi-asserted-by":"crossref","unstructured":"PNS Abstracts 2024. J Peripheral Nervous Sys 2024;29. doi:10.1111\/jns.12648","DOI":"10.1111\/jns.12648"},{"key":"2026041508350821000_97.5.464.13","unstructured":"Biobank U . Pain web questionnaire version 2.1. 2022."},{"key":"2026041508350821000_97.5.464.14","unstructured":"Biobank U . physical activity monitor (accelerometer) version 1.0. 2016."},{"key":"2026041508350821000_97.5.464.15","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-016-0604-8"},{"key":"2026041508350821000_97.5.464.16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0169649","article-title":"Large Scale Population Assessment of Physical Activity Using Wrist Worn Accelerometers: The UK Biobank Study","volume":"12","author":"Doherty","year":"2017","journal-title":"PLoS One"},{"key":"2026041508350821000_97.5.464.17","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00421.2014"},{"key":"2026041508350821000_97.5.464.18","doi-asserted-by":"crossref","unstructured":"Hammerla NY , Kirkham R , Andras P , et al . On preserving statistical characteristics of accelerometry data using their empirical cumulative distribution. Proceedings of the 2013 International Symposium on Wearable Computers; 2013:65\u20138. Available: https:\/\/dl.acm.org\/doi\/proceedings\/10.1145\/2493988","DOI":"10.1145\/2493988.2494353"},{"key":"2026041508350821000_97.5.464.19","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.121.023290","article-title":"Prospective Associations of Accelerometer-Assessed Physical Activity With Mortality and Incidence of Cardiovascular Disease Among Adults With Hypertension: The UK Biobank Study","volume":"11","author":"Del Pozo Cruz","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"2026041508350821000_97.5.464.20","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000289"},{"key":"2026041508350821000_97.5.464.21","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-2448"},{"key":"2026041508350821000_97.5.464.22","doi-asserted-by":"crossref","unstructured":"AlKhotani RY , Al-Dubai SA , Almeshaly MS , et al . The Association Between Physical Activity and Peripheral Neuropathy in Diabetic Patients: A Cross-Sectional Multicenter Study From Saudi Arabia. Cureus 2023;15. doi:10.7759\/cureus.34504","DOI":"10.7759\/cureus.34504"},{"key":"2026041508350821000_97.5.464.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2013.08.008"},{"key":"2026041508350821000_97.5.464.24","doi-asserted-by":"crossref","first-page":"e615","DOI":"10.1016\/S2589-7500(22)00111-X","article-title":"Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses","volume":"4","author":"Ferguson","year":"2022","journal-title":"Lancet Digit Health"},{"key":"2026041508350821000_97.5.464.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2019.03.005"},{"key":"2026041508350821000_97.5.464.26","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx246"},{"key":"2026041508350821000_97.5.464.27","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1123\/jpah.2015-0703","article-title":"Examination of Accelerometer Reactivity Among a Population Sample of Children, Adolescents, and Adults","volume":"13","author":"Davis","year":"2016","journal-title":"J Phys Act Health"},{"key":"2026041508350821000_97.5.464.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.08.016"},{"key":"2026041508350821000_97.5.464.29","doi-asserted-by":"crossref","first-page":"3115","DOI":"10.1002\/acn3.52218","article-title":"Comparison of intraepidermal nerve fiber density and confocal corneal microscopy for neuropathy","volume":"11","author":"Reynolds","year":"2024","journal-title":"Ann Clin Transl Neurol"},{"key":"2026041508350821000_97.5.464.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2018.01.003"}],"container-title":["Journal of Neurology, Neurosurgery &amp; Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnnp-2025-337592","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T15:35:21Z","timestamp":1776267321000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnnp.bmj.com\/lookup\/doi\/10.1136\/jnnp-2025-337592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,4]]},"references-count":30,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,4,15]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1136\/jnnp-2025-337592"],"URL":"https:\/\/doi.org\/10.1136\/jnnp-2025-337592","relation":{},"ISSN":["0022-3050","1468-330X"],"issn-type":[{"value":"0022-3050","type":"print"},{"value":"1468-330X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,4]]}}}