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Normalized EMG Amplitude During Repeated Sit-to-Stand Transfers in Patients with Diabetic Peripheral Neuropathy
Safi Ullah1, Kamran Iqbal1, Muhammad Rizwan1
1School of Engineering and Engineering Technology, University of Arkansas at Little Rock, Little Rock, AR 72204, USA.
Bioengineering (Basel, Switzerland)
|July 28, 2026
Summary
Neuromuscular activation during sit-to-stand transfers in diabetic peripheral neuropathy (DPN) patients showed no significant differences compared to healthy individuals. Muscle activation patterns during these movements may not be sensitive enough to detect DPN-related changes.
Area of Science:
- Neurology
- Biomechanics
- Exercise Physiology
Background:
- Diabetic peripheral neuropathy (DPN) leads to sensorimotor deficits in the lower extremities, increasing fall risk.
- Understanding neuromuscular control during functional movements like sit-to-stand (STS) transfers is crucial for managing DPN complications.
Purpose of the Study:
- To compare phase-specific lower-limb muscle activation during repeated STS transfers between ambulatory DPN patients and healthy controls.
- To investigate the sensitivity of surface electromyography (sEMG) in detecting neuromuscular alterations in DPN during transitional tasks.
Main Methods:
- Fifteen ambulatory DPN patients and fifteen age/gender-matched healthy controls participated.
- Bilateral sEMG of vastus lateralis, vastus medialis, biceps femoris, gluteus maximus, and gluteus medius was recorded.
- EMG data were normalized to maximum voluntary contractions (MVCs) and analyzed for STS and stand-to-sit phases.
Main Results:
- No statistically significant differences in normalized muscle activation were found between DPN patients and controls during either phase (p > 0.05).
- Effect sizes were small-to-medium, with confidence intervals indicating uncertainty.
- Gluteus maximus activation during STS showed the largest effect size favoring the DPN group (d = 0.54), though not statistically significant.
Conclusions:
- MVC-normalized EMG amplitude alone may lack sensitivity to detect neuromuscular alterations in ambulatory DPN patients during transitional tasks.
- Both groups exhibited higher vastus lateralis and gluteus maximus activation during STS compared to stand-to-sit, indicating greater demand during rising.
- Further research with larger cohorts is needed to confirm potential compensatory strategies, like increased gluteus maximus activation in DPN.
