# The Effect of Custom Insoles on Muscle Activity in Diabetic Individuals with Neuropathy
## 3 Results  
### Comparison with Healthy Subjects  
In terms of demographic parameters, the PN subjects showed statistically significantly higher weight and BMI (* \(p\) < 0.05 see Table 1). In terms of sEMG activity (Figure 3), statistically significant differences were observed either in the condition with or without CI. Overall, the envelope profiles of PN subjects showed an altered pattern throughout the gait cycle. Specifically, at the level of TA, in NoCI condition, a statistically significant reduction was observed during swing, while a statistically significant increase was detected during both midstance and terminal stance. In the CI condition we observed a reduction of TA activity at loading response and initial swing accompanied by an increase of activity at terminal stance. When we consider the GL in the NoCI condition, a statistically significant increase of activity was observed from the push off phase up to terminal swing. In the CI condition a statistically significant decrease was observed at the end of the midstance, accompanied by an increase during the midswing. In terms of RF in the NoCI condition, a statistically significant decrease was noted at loading response, accompanied by a statistically significant increase from the midstance up to the end of the gait cycle. In CI condition RF showed a statistically significant decrease from loading response up to midstance, followed by a statistically significant increase during the midswing. Finally, the GM in the NoCI condition showed a statistically significant decrease at loading response followed by a statistically significant increase from the midstance up to the end of the gait cycle. In the CI condition a similar trend was observed. Overall, in terms of dynamic plantar pressure (Figure 4), a statistically significant increase was observed on both mean and peak pressure, with and without the CI, for the majority of the stance phase of gait. However, a statistically significant reduction in the CI condition was observed with respect to NoCI. To detail, when considering the normalized peak pressure in the CI condition, a statistically significant reduction can be observed with  
Figure 3: Variables extracted from sEMG signals. From top to bottom, from left to right: mean and standard deviation of the sEMG envelope (Mean value = dashed line, mean \(\pm\) 1 standard deviation = shaded area) of Tibialis Anterior, Gastrocnemius Lateralis, Rectus Femoris, Gluteus Medius. In yellow, the sEMG values of the control subjects (C); in blue, that of the PN subjects without wearing the custom inside (NoCI); and in red, that of the PN subjects while wearing the custom inside (CI). On the y axis, the envelope values normalized on the peak value detected during gait (% peak envelope), on the x axis, the gait cycle percentages. At the bottom of each figure: blue bars indicate the instant of the gait cycle where statistically significant differences were detected between C and NoCI; red bars indicate the instant of the gait cycle where statistically significant differences were detected between C and CI; and green bars indicate the instant of the gait cycle where statistically significant differences were detected between NoCI vs. CI (_p_ < 0.05). respect to C from initial contact up to loading response, and from midstance up to pushoff. It is worth noting that in the NoCI condition, for the normalized values, a statistically significant decrease was detected at initial contact and from terminal stance up to pushoff, while an increase was recorded during midstance, in contrast to the CI assessment. In terms of GRFs, overall, statistically significant lower values were detected in both the CI and NoCI conditions, with the exception of 10% of the stance phase of gait, where an increase was noted (i.e., 40-50%). Overall, the contact surface recorded higher values during the all-stance phase of the gait in the CI condition.