{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:14:12Z","timestamp":1783509252978,"version":"3.55.0"},"reference-count":132,"publisher":"MDPI AG","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Exercise is highly beneficial for persons with diabetes. Similar to many other patients, those with diabetes may be reluctant to exercise given a lack of motivation and proper instruction regarding an exercise prescription. In general, medical providers are poorly equipped to develop an exercise prescription and furnish motivation. Attempts to find activities that not only provide effective aerobic challenges but also are enjoyable to participate in are fraught with difficulty. Hiking as a potential option for a safe and enjoyable activity is discussed, including the possible downsides.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Multiple publications were reviewed using key words.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A review of the literature uncovered limited publications or controlled trials that discussed the use of hiking per se as an activity for the management of diabetes. Newer studies reviewing weightbearing exercise and diabetic polyneuropathy and those discussing the advantages of trekking poles for balance and proprioception are cited in support of the recommendation for hiking as an activity for those with diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Exercise has been shown to substantially benefit individuals with diabetes, but convincing patients with diabetes to exercise is daunting. Hiking, unlike other, more tedious exercise programs, may be an exercise option that persons with diabetes might find enjoyable. Hiking may encourage balance training and reduced ground reaction forces. These benefits may be augmented by trekking poles, which may likewise counter the concerns of the uneven surfaces that present challenges to the hiker with diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7547\/15-219","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T13:19:23Z","timestamp":1509110363000},"page":"382-392","source":"Crossref","is-referenced-by-count":5,"title":["Hiking with Diabetes"],"prefix":"10.3390","volume":"107","author":[{"given":"David W.","family":"Jenkins","sequence":"first","affiliation":[{"name":"Arizona Podiatric Medicine Program, College of Health Sciences, Midwestern University, Glendale, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Jenks","sequence":"additional","affiliation":[{"name":"Arizona School of Podiatric Medicine, Glendale, AZ. Dr. Jenks is now with West Houston Medical Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"ref711","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1055\/s-2000-3775","article-title":"Load carriage energy expenditure with and without hiking poles during inclined walking","volume":"21","author":"Jacobson","year":"2000","journal-title":"Int J Sports Med"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1310\/tsr18s01-633","article-title":"Clinical identification for the use of light touch cues with a cane in gait rehabilitation poststroke","volume":"18","author":"Boonsinsukh","year":"2011","journal-title":"Top Stoke Rehabil"},{"key":"ref1391","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.gaitpost.2013.08.027","article-title":"Plantar pressure analysis of accommodative insole in older people with metatarsalgia","volume":"39","author":"Chang","year":"2014","journal-title":"Gait Posture"},{"key":"ref1101","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.2522\/ptj.20080019","article-title":"Effect of weight-bearing activity on foot ulcer incidence in people with diabetic peripheral neuropathy: Feet First randomized controlled trial","volume":"88","author":"LeMaster","year":"2008","journal-title":"Phys Ther"},{"key":"ref331","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.2337\/diacare.27.8.1980","article-title":"Variability in activity may precede diabetic foot ulceration","volume":"27","author":"Armstrong","year":"2004","journal-title":"Diabetes Care"},{"key":"ref401","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.3109\/09638288.2014.972591","article-title":"\u201cFour legs instead of two:\u201d perspectives on a Nordic walking-based walking programme among people with arthritis","volume":"37","author":"O'Donovan","year":"2015","journal-title":"Disabil Rehabil"},{"key":"ref661","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/j.clinbiomech.2011.03.009","article-title":"Forefoot plantar pressure reduction of off-the-shelf rocker bottom provisional footwear","volume":"26","author":"Kavros","year":"2011","journal-title":"Clin Biomech"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1002\/dmrr.2488","article-title":"Changes in insulin sensitivity in response to different modalities of exercise: a review of the evidence","volume":"30","author":"Mann","year":"2014","journal-title":"Diabetes Metab Res Rev"},{"key":"ref971","doi-asserted-by":"crossref","first-page":"e0131354","DOI":"10.1371\/journal.pone.0131354","article-title":"Variation in foot strike patterns among habitually barefoot and shod Runners in Kenya","volume":"10","author":"Lieberman","year":"2015","journal-title":"PLoS One"},{"key":"ref1151","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.2337\/dc13-2302","article-title":"Physical activity at altitude: challenges for people with diabetes","volume":"37","author":"De Mol","year":"2014","journal-title":"Diabetes Care"},{"key":"ref211","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1159\/000371846","article-title":"Sensor-based interactive balance training with visual joint movement feedback for improving postural stability in diabetics with peripheral neuropathy: a randomized controlled trial","volume":"61","author":"Grewal","year":"2015","journal-title":"Gerontology"},{"key":"ref691","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1249\/00005768-199504000-00021","article-title":"Energy expenditure during submaximal walking with Exerstriders","volume":"27","author":"Rodgers","year":"1995","journal-title":"Med Sci Sports Exerc"},{"key":"ref601","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1249\/01.mss.0000240328.31276.fc","article-title":"Effects of hiking downhill using trekking poles while carrying external loads","volume":"39","author":"Bohne","year":"2007","journal-title":"Med Sci Sports Exerc"},{"key":"ref631","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1080\/02701367.2011.10599795","article-title":"Nordic walking practice might improve plantar pressure distribution","volume":"82","author":"Perez-Soriano","year":"2011","journal-title":"Res Quart Exerc Sport"},{"key":"ref271","first-page":"561","article-title":"The effects of ten weeks of lower-body unstable surface training on markers of athletic performance","volume":"21","author":"Cressey","year":"2007","journal-title":"J Strength Cond Res"},{"key":"ref471","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.gaitpost.2014.05.063","article-title":"Elevated plantar pressure in diabetic patients and its relationship with their gait features","volume":"40","author":"Amemiya","year":"2014","journal-title":"Gait Posture"},{"key":"ref891","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/j.metabol.2011.01.006","article-title":"The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus","volume":"60","author":"Jorge","year":"2011","journal-title":"Metabolism"},{"key":"ref1231","doi-asserted-by":"crossref","first-page":"380","DOI":"10.7547\/1030380","article-title":"Low long-term risk of foot ulcer recurrence after nerve decompression in a diabetes neuropathy cohort","volume":"103","author":"Nickerson","year":"2013","journal-title":"JAPMA"},{"key":"ref951","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/PHM.0000000000000052","article-title":"Exercise interventions, gait, and balance in older subjects with distal symmetric polyneuropathy","volume":"93","author":"Quigley","year":"2014","journal-title":"Am J Phys Med Rehabil"},{"key":"ref541","doi-asserted-by":"crossref","first-page":"281","DOI":"10.7547\/1030281","article-title":"How effective is orthotic treatment in patients with recurrent diabetic foot ulcers?","volume":"103","author":"Fernandez","year":"2013","journal-title":"JAPMA"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.2522\/ptj.20080019","article-title":"Effect of weight-bearing activity on foot ulcer incidence in people with diabetic peripheral neuropathy: Feet First randomized controlled trial","volume":"88","author":"LeMaster","year":"2008","journal-title":"Phys Ther"},{"key":"ref481","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.2337\/diacare.27.7.1783","article-title":"Focal entrapment neuropathies in diabetes","volume":"27","author":"Vinik","year":"2004","journal-title":"Diabetes Care"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.2337\/dc13-2302","article-title":"Physical activity at altitude: challenges for people with diabetes","volume":"37","author":"De Mol","year":"2014","journal-title":"Diabetes Care"},{"key":"ref301","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1177\/107110079001100303","article-title":"Shoes for the insensitive foot: the effect of a \u201crocker bottom\u201d shoe modification on plantar pressure distribution","volume":"11","author":"Schaff","year":"1990","journal-title":"Foot Ankle"},{"key":"ref441","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1007\/s00415-008-0872-0","article-title":"Early diabetic neuropathy: thermal thresholds and intraepidermal nerve fibre density in patients with normal nerve conduction studies","volume":"255","author":"L\u00f8seth","year":"2008","journal-title":"J Neurol"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4103\/0019-557X.128165","article-title":"Non-adherence to life-style modification and its factors among type 2 diabetic patients","volume":"58","author":"Mumu","year":"2014","journal-title":"Indian J Public Health"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1097\/00005768-200011000-00016","article-title":"Surface effects on ground reaction forces and lower extremity kinematics in running","volume":"32","author":"Dixon","year":"2000","journal-title":"Med Sci Sports Exerc"},{"key":"ref1211","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1580\/1080-6032(2003)14[161:BP]2.0.CO;2","article-title":"Backpacking-induced paresthesias","volume":"14","author":"Boulware","year":"2003","journal-title":"Wilderness Environ Med"},{"key":"ref1351","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1080\/02701367.2011.10599795","article-title":"Nordic walking practice might improve plantar pressure distribution","volume":"82","author":"Perez-Soriano","year":"2011","journal-title":"Res Quart Exerc Sport"},{"key":"ref1251","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1177\/107110070502601012","article-title":"The effect of terrain on foot pressures during walking","volume":"26","author":"Mohamed","year":"2005","journal-title":"Foot Ankle Int"},{"key":"ref1041","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.2337\/dc13-2470","article-title":"Risk factors for plantar foot ulcer recurrence in neuropathic diabetic patients","volume":"37","author":"Waaijman","year":"2014","journal-title":"Diabetes Care"},{"key":"ref921","doi-asserted-by":"crossref","first-page":"9800","DOI":"10.1007\/s11357-015-9800-2","article-title":"Exercise interventions in polypathological aging patients that coexist with diabetes mellitus: improving functional status and quality of life","volume":"37","author":"Cadore","year":"2015","journal-title":"Age (Dordr)"},{"key":"ref341","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/JES.0b013e31825f7483","article-title":"Select exercise modalities may reverse movement dysfunction because of peripheral neuropathy","volume":"40","author":"Li","year":"2012","journal-title":"Exerc Sport Sci Rev"},{"key":"ref191","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/PHM.0b013e31802ee1d1","article-title":"Falls and gait characteristics among older persons with peripheral neuropathy","volume":"86","author":"Demott","year":"2007","journal-title":"Am J Physical Med Rehabil"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/PHM.0000000000000052","article-title":"Exercise interventions, gait, and balance in older subjects with distal symmetric polyneuropathy","volume":"93","author":"Quigley","year":"2014","journal-title":"Am J Phys Med Rehabil"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1186\/1471-2458-14-431","article-title":"Non-adherence to self-care practices & medication and health related quality of life among patients with type 2 diabetes: a cross-sectional study","volume":"14","author":"Saleh","year":"2014","journal-title":"BMC Public Health"},{"key":"ref1131","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1080\/16078055.2014.903732","article-title":"Dog walking: a leisurely solution to pediatric and adult obesity?","volume":"56","author":"Boisvert","year":"2014","journal-title":"World Leisure J"},{"key":"ref411","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1080\/16078055.2014.903732","article-title":"Dog walking: a leisurely solution to pediatric and adult obesity?","volume":"56","author":"Boisvert","year":"2014","journal-title":"World Leisure J"},{"key":"ref931","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1159\/000371846","article-title":"Sensor-based interactive balance training with visual joint movement feedback for improving postural stability in diabetics with peripheral neuropathy: a randomized controlled trial","volume":"61","author":"Grewal","year":"2015","journal-title":"Gerontology"},{"key":"ref1031","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/j.clinbiomech.2011.03.009","article-title":"Forefoot plantar pressure reduction of off-the-shelf rocker bottom provisional footwear","volume":"26","author":"Kavros","year":"2011","journal-title":"Clin Biomech"},{"key":"ref1261","doi-asserted-by":"crossref","first-page":"281","DOI":"10.7547\/1030281","article-title":"How effective is orthotic treatment in patients with recurrent diabetic foot ulcers?","volume":"103","author":"Fernandez","year":"2013","journal-title":"JAPMA"},{"key":"ref1301","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.apmr.2004.04.023","article-title":"Assistive devices for balance and mobility: benefits, demands, and adverse consequences","volume":"86","author":"Bateni","year":"2005","journal-title":"Arch Phys Med Rehabil"},{"key":"ref991","first-page":"561","article-title":"The effects of ten weeks of lower-body unstable surface training on markers of athletic performance","volume":"21","author":"Cressey","year":"2007","journal-title":"J Strength Cond Res"},{"key":"ref1011","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1123\/jsr.2014-0245","article-title":"The effects of a multimodal rehabilitation program on symptoms and ground reaction forces in runners with patellofemoral pain syndrome","volume":"25","author":"Esculier","year":"2016","journal-title":"J Sport Rehabil"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1123\/jsr.2014-0245","article-title":"The effects of a multimodal rehabilitation program on symptoms and ground reaction forces in runners with patellofemoral pain syndrome","volume":"25","author":"Esculier","year":"2016","journal-title":"J Sport Rehabil"},{"key":"ref1221","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1580\/08-WEME-OR-196R2.1","article-title":"The impact of footwear and packweight on injury illness among long-distance hikers","volume":"20","author":"Anderson","year":"2009","journal-title":"Wilderness Environ Med"},{"key":"ref1361","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S1067-2516(99)80066-0","article-title":"The effect of regular callus removal on foot pressures","volume":"38","author":"Pitei","year":"1999","journal-title":"J Foot Ankle Surg"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"e0131354","DOI":"10.1371\/journal.pone.0131354","article-title":"Variation in foot strike patterns among habitually barefoot and shod Runners in Kenya","volume":"10","author":"Lieberman","year":"2015","journal-title":"PLoS One"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.2337\/diacare.27.5.1218","article-title":"A systematic review of adherence with medication for diabetes","volume":"32","author":"Cramer","year":"2004","journal-title":"Diabetes Care"},{"key":"ref1051","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.2337\/diacare.27.8.1980","article-title":"Variability in activity may precede diabetic foot ulceration","volume":"27","author":"Armstrong","year":"2004","journal-title":"Diabetes Care"},{"key":"ref861","doi-asserted-by":"crossref","first-page":"2883","DOI":"10.1519\/JSC.0b013e318242a61e","article-title":"Workload comparison between hiking and indoor physical activity","volume":"26","author":"Fattorini","year":"2012","journal-title":"J Strength Conditioning Res"},{"key":"ref941","first-page":"CD009848","article-title":"Exercise for reducing fear of falling in older people living in the community","volume":"11","author":"Kendrick","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"ref1291","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1310\/tsr18s01-633","article-title":"Clinical identification for the use of light touch cues with a cane in gait rehabilitation poststroke","volume":"18","author":"Boonsinsukh","year":"2011","journal-title":"Top Stoke Rehabil"},{"key":"ref221","first-page":"CD009848","article-title":"Exercise for reducing fear of falling in older people living in the community","volume":"11","author":"Kendrick","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"ref1401","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1080\/02701367.1997.10607992","article-title":"The physiological responses to walking with and without Power Poles on treadmill exercise","volume":"68","author":"Porcari","year":"1997","journal-title":"Res Q Exerc Sport"},{"key":"ref201","doi-asserted-by":"crossref","first-page":"9800","DOI":"10.1007\/s11357-015-9800-2","article-title":"Exercise interventions in polypathological aging patients that coexist with diabetes mellitus: improving functional status and quality of life","volume":"37","author":"Cadore","year":"2015","journal-title":"Age (Dordr)"},{"key":"ref761","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.2337\/diacare.27.5.1218","article-title":"A systematic review of adherence with medication for diabetes","volume":"32","author":"Cramer","year":"2004","journal-title":"Diabetes Care"},{"key":"ref731","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1002\/dmrr.2488","article-title":"Changes in insulin sensitivity in response to different modalities of exercise: a review of the evidence","volume":"30","author":"Mann","year":"2014","journal-title":"Diabetes Metab Res Rev"},{"key":"ref1191","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.gaitpost.2014.05.063","article-title":"Elevated plantar pressure in diabetic patients and its relationship with their gait features","volume":"40","author":"Amemiya","year":"2014","journal-title":"Gait Posture"},{"key":"ref1311","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1580\/1080-6032(1996)007[0258:LTTE]2.3.CO;2","article-title":"Hiking sticks in mountaineering","volume":"7","author":"Roeggla","year":"1996","journal-title":"Wilderness Environ Med"},{"key":"ref1001","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1519\/JSC.0b013e31818eb0c5","article-title":"Does core strength training influence running kinetics, lower-extremity stability, and 5000-M performance in runners?","volume":"23","author":"Sato","year":"2009","journal-title":"J Strength Cond Res"},{"key":"ref1241","article-title":"Gaiters: how to choose","author":"Tischler","year":"2014","journal-title":"REI Web site"},{"key":"ref91","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1136\/pgmj.2003.010553","article-title":"Barriers to physical activity in patients with diabetes","volume":"80","author":"Thomas","year":"2004","journal-title":"Postgrad Med J"},{"key":"ref1171","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.2337\/diacare.21.10.1714","article-title":"Role of neuropathy and high foot pressures in diabetic foot ulceration","volume":"21","author":"Frykberg","year":"1998","journal-title":"Diabetes Care"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.apmr.2004.04.023","article-title":"Assistive devices for balance and mobility: benefits, demands, and adverse consequences","volume":"86","author":"Bateni","year":"2005","journal-title":"Arch Phys Med Rehabil"},{"key":"ref1331","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1097\/00005768-200012000-00020","article-title":"Muscular and metabolic costs of uphill backpacking: are hiking poles beneficial?","volume":"32","author":"Knight","year":"2000","journal-title":"Med Sci Sports Exerc"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1242\/jeb.106518","article-title":"Biomechanics and energetics of running on uneven terrain","volume":"218","author":"Voloshina","year":"2015","journal-title":"J Exp Biol"},{"key":"ref01","doi-asserted-by":"crossref","first-page":"2282","DOI":"10.1249\/MSS.0b013e3181eeb61c","article-title":"Exercise and type 2 diabetes: American College of Sports Medicine and the American Diabetes Association: joint position statement: exercise and type 2 diabetes","volume":"42","author":"Colberg","year":"2010","journal-title":"Med Sci Sports Exerc"},{"key":"ref721","doi-asserted-by":"crossref","first-page":"2282","DOI":"10.1249\/MSS.0b013e3181eeb61c","article-title":"Exercise and type 2 diabetes: American College of Sports Medicine and the American Diabetes Association: joint position statement: exercise and type 2 diabetes","volume":"42","author":"Colberg","year":"2010","journal-title":"Med Sci Sports Exerc"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1249\/01.MSS.0000074459.41029.75","article-title":"Daily weight-bearing activity does not increase the risk of diabetic foot ulcers","volume":"35","author":"LeMaster","year":"2003","journal-title":"Med Sci Sports Exerc"},{"key":"ref1421","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1249\/MSS.0b013e318167228a","article-title":"Effects of hiking pole inertia on energy and muscular costs during uphill walking","volume":"40","author":"Foissac","year":"2008","journal-title":"Med Sci Sports Exerc"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"2883","DOI":"10.1519\/JSC.0b013e318242a61e","article-title":"Workload comparison between hiking and indoor physical activity","volume":"26","author":"Fattorini","year":"2012","journal-title":"J Strength Conditioning Res"},{"key":"ref751","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1016\/j.socscimed.2009.02.028","article-title":"The effects of exercise interventions on quality of life in clinical and healthy populations; a meta-analysis","volume":"68","author":"Gillison","year":"2009","journal-title":"Soc Sci Med"},{"key":"ref871","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1242\/jeb.106518","article-title":"Biomechanics and energetics of running on uneven terrain","volume":"218","author":"Voloshina","year":"2015","journal-title":"J Exp Biol"},{"key":"ref421","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/00129334-200201000-00011","article-title":"Diabetic foot ulcers and infections: current concepts","volume":"15","author":"Calhoun","year":"2002","journal-title":"Adv Skin Wound Care"},{"key":"ref531","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1177\/107110070502601012","article-title":"The effect of terrain on foot pressures during walking","volume":"26","author":"Mohamed","year":"2005","journal-title":"Foot Ankle Int"},{"key":"ref521","article-title":"Gaiters: how to choose","author":"Tischler","year":"2014","journal-title":"REI Web site"},{"key":"ref1081","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/S0268-0033(03)00118-9","article-title":"Comparison of physical activity and cumulative plantar tissue stress among subjects with and without diabetes mellitus and a history of recurrent plantar ulcers","volume":"18","author":"Maluf","year":"2003","journal-title":"Clin Biomech"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"357","DOI":"10.7326\/0003-4819-147-6-200709180-00005","article-title":"Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial","volume":"147","author":"Sigal","year":"2007","journal-title":"Ann Intern Med"},{"key":"ref671","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.gaitpost.2013.08.027","article-title":"Plantar pressure analysis of accommodative insole in older people with metatarsalgia","volume":"39","author":"Chang","year":"2014","journal-title":"Gait Posture"},{"key":"ref881","doi-asserted-by":"crossref","first-page":"357","DOI":"10.7326\/0003-4819-147-6-200709180-00005","article-title":"Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial","volume":"147","author":"Sigal","year":"2007","journal-title":"Ann Intern Med"},{"key":"ref701","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1249\/MSS.0b013e318167228a","article-title":"Effects of hiking pole inertia on energy and muscular costs during uphill walking","volume":"40","author":"Foissac","year":"2008","journal-title":"Med Sci Sports Exerc"},{"key":"ref1321","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1249\/01.mss.0000240328.31276.fc","article-title":"Effects of hiking downhill using trekking poles while carrying external loads","volume":"39","author":"Bohne","year":"2007","journal-title":"Med Sci Sports Exerc"},{"key":"ref1371","doi-asserted-by":"crossref","first-page":"360","DOI":"10.7547\/1000360","article-title":"Off-loading the diabetic foot for ulcer prevention and healing","volume":"100","author":"Cavanagh","year":"2010","journal-title":"JAPMA"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.1097\/00005768-200212000-00020","article-title":"Correlates of adults' participation in physical activity: review and update","volume":"34","author":"Trost","year":"2002","journal-title":"Med Sci Sports Exerc"},{"key":"ref741","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00592-009-0126-3","article-title":"Exercise for the management of type 2 diabetes: a review of the evidence","volume":"47","author":"Zanuso","year":"2010","journal-title":"Acta Diabetol"},{"key":"ref1061","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/JES.0b013e31825f7483","article-title":"Select exercise modalities may reverse movement dysfunction because of peripheral neuropathy","volume":"40","author":"Li","year":"2012","journal-title":"Exerc Sport Sci Rev"},{"key":"ref911","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/PHM.0b013e31802ee1d1","article-title":"Falls and gait characteristics among older persons with peripheral neuropathy","volume":"86","author":"Demott","year":"2007","journal-title":"Am J Physical Med Rehabil"},{"key":"ref1201","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.2337\/diacare.27.7.1783","article-title":"Focal entrapment neuropathies in diabetes","volume":"27","author":"Vinik","year":"2004","journal-title":"Diabetes Care"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/j.clinbiomech.2011.03.009","article-title":"Forefoot plantar pressure reduction of off-the-shelf rocker bottom provisional footwear","volume":"26","author":"Kavros","year":"2011","journal-title":"Clin Biomech"},{"key":"ref961","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1053\/apmr.2001.19742","article-title":"A focused exercise regimen improves clinical measures of balance in patients with peripheral neuropathy","volume":"82","author":"Richardson","year":"2001","journal-title":"Arch Phys Med Rehabil"},{"key":"ref981","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/S1360-8592(03)00061-5","article-title":"Core stability and the unstable platform device","volume":"8","author":"Haynes","year":"2004","journal-title":"J Bodywork Movement Ther"},{"key":"ref1381","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/j.clinbiomech.2011.03.009","article-title":"Forefoot plantar pressure reduction of off-the-shelf rocker bottom provisional footwear","volume":"26","author":"Kavros","year":"2011","journal-title":"Clin Biomech"},{"key":"ref1121","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.3109\/09638288.2014.972591","article-title":"\u201cFour legs instead of two:\u201d perspectives on a Nordic walking-based walking programme among people with arthritis","volume":"37","author":"O'Donovan","year":"2015","journal-title":"Disabil Rehabil"},{"key":"ref1161","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1007\/s00415-008-0872-0","article-title":"Early diabetic neuropathy: thermal thresholds and intraepidermal nerve fibre density in patients with normal nerve conduction studies","volume":"255","author":"L\u00f8seth","year":"2008","journal-title":"J Neurol"},{"key":"ref81","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1017\/S1463423612000412","article-title":"Diet and physical activity in the self-management of type 2 diabetes: barriers and facilitators identified by patients and health professionals","volume":"14","author":"Booth","year":"2013","journal-title":"Prim Health Care Res Dev"},{"key":"ref591","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1580\/1080-6032(1996)007[0258:LTTE]2.3.CO;2","article-title":"Hiking sticks in mountaineering","volume":"7","author":"Roeggla","year":"1996","journal-title":"Wilderness Environ Med"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1016\/j.socscimed.2009.02.028","article-title":"The effects of exercise interventions on quality of life in clinical and healthy populations; a meta-analysis","volume":"68","author":"Gillison","year":"2009","journal-title":"Soc Sci Med"},{"key":"ref171","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/j.metabol.2011.01.006","article-title":"The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus","volume":"60","author":"Jorge","year":"2011","journal-title":"Metabolism"},{"key":"ref811","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1136\/pgmj.2003.010553","article-title":"Barriers to physical activity in patients with diabetes","volume":"80","author":"Thomas","year":"2004","journal-title":"Postgrad Med J"},{"key":"ref1111","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.1097\/00005768-200212000-00020","article-title":"Correlates of adults' participation in physical activity: review and update","volume":"34","author":"Trost","year":"2002","journal-title":"Med Sci Sports Exerc"},{"key":"ref1411","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1249\/00005768-199504000-00021","article-title":"Energy expenditure during submaximal walking with Exerstriders","volume":"27","author":"Rodgers","year":"1995","journal-title":"Med Sci Sports Exerc"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/S1360-8592(03)00061-5","article-title":"Core stability and the unstable platform device","volume":"8","author":"Haynes","year":"2004","journal-title":"J Bodywork Movement Ther"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00592-009-0126-3","article-title":"Exercise for the management of type 2 diabetes: a review of the evidence","volume":"47","author":"Zanuso","year":"2010","journal-title":"Acta Diabetol"},{"key":"ref501","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1580\/08-WEME-OR-196R2.1","article-title":"The impact of footwear and packweight on injury illness among long-distance hikers","volume":"20","author":"Anderson","year":"2009","journal-title":"Wilderness Environ Med"},{"key":"ref621","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.pmrj.2013.09.002","article-title":"The effect of walking with poles on the distribution of plantar pressures in normal subjects","volume":"6","author":"Hudson","year":"2014","journal-title":"PM R"},{"key":"ref641","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S1067-2516(99)80066-0","article-title":"The effect of regular callus removal on foot pressures","volume":"38","author":"Pitei","year":"1999","journal-title":"J Foot Ankle Surg"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jcjd.2013.03.370","article-title":"Predicting exercise adherence for patients with obesity and diabetes referred to a cardiac rehabilitation and secondary prevention program","volume":"37","author":"Forhan","year":"2013","journal-title":"Can J Diabetes"},{"key":"ref511","doi-asserted-by":"crossref","first-page":"380","DOI":"10.7547\/1030380","article-title":"Low long-term risk of foot ulcer recurrence after nerve decompression in a diabetes neuropathy cohort","volume":"103","author":"Nickerson","year":"2013","journal-title":"JAPMA"},{"key":"ref491","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1580\/1080-6032(2003)14[161:BP]2.0.CO;2","article-title":"Backpacking-induced paresthesias","volume":"14","author":"Boulware","year":"2003","journal-title":"Wilderness Environ Med"},{"key":"ref651","doi-asserted-by":"crossref","first-page":"360","DOI":"10.7547\/1000360","article-title":"Off-loading the diabetic foot for ulcer prevention and healing","volume":"100","author":"Cavanagh","year":"2010","journal-title":"JAPMA"},{"key":"ref611","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1097\/00005768-200012000-00020","article-title":"Muscular and metabolic costs of uphill backpacking: are hiking poles beneficial?","volume":"32","author":"Knight","year":"2000","journal-title":"Med Sci Sports Exerc"},{"key":"ref1431","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1055\/s-2000-3775","article-title":"Load carriage energy expenditure with and without hiking poles during inclined walking","volume":"21","author":"Jacobson","year":"2000","journal-title":"Int J Sports Med"},{"key":"ref901","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1097\/00005768-200011000-00016","article-title":"Surface effects on ground reaction forces and lower extremity kinematics in running","volume":"32","author":"Dixon","year":"2000","journal-title":"Med Sci Sports Exerc"},{"key":"ref1021","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1177\/107110079001100303","article-title":"Shoes for the insensitive foot: the effect of a \u201crocker bottom\u201d shoe modification on plantar pressure distribution","volume":"11","author":"Schaff","year":"1990","journal-title":"Foot Ankle"},{"key":"ref241","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1053\/apmr.2001.19742","article-title":"A focused exercise regimen improves clinical measures of balance in patients with peripheral neuropathy","volume":"82","author":"Richardson","year":"2001","journal-title":"Arch Phys Med Rehabil"},{"key":"ref551","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1080\/14763140508522865","article-title":"Effect of walking speed on lower extremity joint loading in graded ramp walking","volume":"4","author":"Schawmeder","year":"2005","journal-title":"Sports Biomech"},{"key":"ref1071","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1249\/01.MSS.0000074459.41029.75","article-title":"Daily weight-bearing activity does not increase the risk of diabetic foot ulcers","volume":"35","author":"LeMaster","year":"2003","journal-title":"Med Sci Sports Exerc"},{"key":"ref1141","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/00129334-200201000-00011","article-title":"Diabetic foot ulcers and infections: current concepts","volume":"15","author":"Calhoun","year":"2002","journal-title":"Adv Skin Wound Care"},{"key":"ref781","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jcjd.2013.03.370","article-title":"Predicting exercise adherence for patients with obesity and diabetes referred to a cardiac rehabilitation and secondary prevention program","volume":"37","author":"Forhan","year":"2013","journal-title":"Can J Diabetes"},{"key":"ref371","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.jdiacomp.2005.07.005","article-title":"Exercise training can modify the natural history of diabetic peripheral neuropathy","volume":"20","author":"Balducci","year":"2006","journal-title":"J Diabetes Complications"},{"key":"ref681","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1080\/02701367.1997.10607992","article-title":"The physiological responses to walking with and without Power Poles on treadmill exercise","volume":"68","author":"Porcari","year":"1997","journal-title":"Res Q Exerc Sport"},{"key":"ref1091","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.jdiacomp.2005.07.005","article-title":"Exercise training can modify the natural history of diabetic peripheral neuropathy","volume":"20","author":"Balducci","year":"2006","journal-title":"J Diabetes Complications"},{"key":"ref1271","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1080\/14763140508522865","article-title":"Effect of walking speed on lower extremity joint loading in graded ramp walking","volume":"4","author":"Schawmeder","year":"2005","journal-title":"Sports Biomech"},{"key":"ref321","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.2337\/dc13-2470","article-title":"Risk factors for plantar foot ulcer recurrence in neuropathic diabetic patients","volume":"37","author":"Waaijman","year":"2014","journal-title":"Diabetes Care"},{"key":"ref791","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1186\/1471-2458-14-431","article-title":"Non-adherence to self-care practices & medication and health related quality of life among patients with type 2 diabetes: a cross-sectional study","volume":"14","author":"Saleh","year":"2014","journal-title":"BMC Public Health"},{"key":"ref1341","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.pmrj.2013.09.002","article-title":"The effect of walking with poles on the distribution of plantar pressures in normal subjects","volume":"6","author":"Hudson","year":"2014","journal-title":"PM R"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/S0268-0033(03)00118-9","article-title":"Comparison of physical activity and cumulative plantar tissue stress among subjects with and without diabetes mellitus and a history of recurrent plantar ulcers","volume":"18","author":"Maluf","year":"2003","journal-title":"Clin Biomech"},{"key":"ref451","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.2337\/diacare.21.10.1714","article-title":"Role of neuropathy and high foot pressures in diabetic foot ulceration","volume":"21","author":"Frykberg","year":"1998","journal-title":"Diabetes Care"},{"key":"ref281","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1519\/JSC.0b013e31818eb0c5","article-title":"Does core strength training influence running kinetics, lower-extremity stability, and 5000-M performance in runners?","volume":"23","author":"Sato","year":"2009","journal-title":"J Strength Cond Res"},{"key":"ref771","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4103\/0019-557X.128165","article-title":"Non-adherence to life-style modification and its factors among type 2 diabetic patients","volume":"58","author":"Mumu","year":"2014","journal-title":"Indian J Public Health"},{"key":"ref801","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1017\/S1463423612000412","article-title":"Diet and physical activity in the self-management of type 2 diabetes: barriers and facilitators identified by patients and health professionals","volume":"14","author":"Booth","year":"2013","journal-title":"Prim Health Care Res Dev"}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/japma\/article-pdf\/107\/5\/382\/1407083\/15-219.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/japma\/article-pdf\/107\/5\/382\/1407083\/15-219.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:17:15Z","timestamp":1783505835000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/107\/5\/382"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,1]]},"references-count":132,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,9,1]]}},"URL":"https:\/\/doi.org\/10.7547\/15-219","relation":{},"ISSN":["8750-7315","1930-8264"],"issn-type":[{"value":"8750-7315","type":"print"},{"value":"1930-8264","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,1]]}}}