CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-15). The draft was written by AI, the existence of all 3 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.7.
Verdict No. 2668 · Search date 2026-08-15 · Methodology v0.7

Textured sensory-stimulating insoles,
does it really help with Improved balance in diabetic peripheral neuropathy?

30-Second Summary
C
Evidence Grade C · 50 · Safety caution
Only one of four conditions was nominally significant, so balance improvement cannot be judged in one direction and fall prevention was not tested
No ulcer developed over four weeks, but foot pain occurred in 27% and minor skin irritation in 18% of textured-insole users. People with sensory loss should inspect their feet daily and stop use if injury, redness, or pain appears.
What the
research shows
The grade is C with 50 points. Fifty-three adults were randomized, but only 41 entered the primary center-of-pressure sway analysis. At four weeks, foam with eyes open was nominally significant: sway velocity fell 5% with textured insoles and rose 5% with smooth insoles, P=.04. Firm surface with eyes open, firm surface with eyes closed, and foam with eyes closed were each null, all P≥.15. With no multiplicity adjustment or prespecified endpoint hierarchy, one nominal result among four conditions cannot support a directional judgment. This was a laboratory measure, not an actual fall outcome.
What the
ads claim
The marketed claim remains ‘improved balance.’ But one nominally significant result among four conditions cannot support a directional judgment, and actual fall prevention was not established. Verdict 2670 is D with 28 points for static magnetic insoles and heel pain, a different mechanism and indication.
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Useful facts when choosing a product

  • The intervention used a textured surface; control used a similarly shaped and thick smooth insole.
  • The primary balance analysis included 41 of 53 randomized participants, and only one of four stance conditions reached P=.04.
  • Verdict 2670 is D with 28 points for static magnetic insoles in heel pain, a different mechanism and indication.
Gap Measurement · Verdict 2668 · C 50
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

The results paper by Hatton AL, Chatfield MD, Gane EM, Maharaj JN, Cattagni T, Burns J, Paton J, Rome K, and Kerr G randomized 53 participants, 27 smooth and 26 textured. Forty-seven completed four weeks, while the primary balance analysis used 21 and 20, with 19 in one condition. Center-of-pressure total sway velocity was null on firm-eyes-open (P≥.15), null on firm-eyes-closed (P≥.15), nominally significant on foam-eyes-open (P=.04), and null on foam-eyes-closed (P≥.15). There was no multiplicity adjustment or prespecified endpoint hierarchy. Figure 3 reported intervals graphically. Diabetes Australia Research Program grant Y17G-HATA funded the work, and a company supplied materials without study involvement. The 2019 protocol and 2025 results share ACTRN12617000543381 and are one trial, not replication.

02

Why this is classified as C (50)

Only foam-eyes-open was nominally significant while the other three conditions were null, with no multiplicity adjustment or prespecified hierarchy. EX reflects the lack of a directional result and CX the unavailable numerical precision, giving C with 50 points.

Counterpoint. People with neuropathy may not feel early skin injury and should inspect their feet daily.

Rejudgment record. Cross-check applied — Cross-checked the results paper, protocol, ACTRN record, and repository manuscript for the primary endpoint, stance-specific results, randomized and analyzed counts, unadjusted multiplicity, masking, nonprofit funding, and same-trial status

Scoring profile behind this grade
EndpointSSurrogate marker - laboratory or imaging measures
ReplicationR1Single confirmatory trial
IndependenceI2Decisive evidence is publicly or non-profit funded
Effect sizeEXThe clinical size of the effect could not be judged
PrecisionCXNo pooled confidence interval could be confirmed

The scoring table and the verdict agree (C).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Improved laboratory balance measureCOnly foam-eyes-open was nominally significant; the other three conditions were null, preventing a directional judgment.
Prevention of actual falls?The trial was not sized or followed long enough to test fewer falls.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Hatton AL, Chatfield MD, Gane EM, Maharaj JN, Cattagni T, Burns J, Paton J, Rome K, Kerr G. 2025Assessor-masked parallel-group randomized trial20Diabetes Australia Research Program Y17G-HATA; company supplied materials onlyCenter-of-pressure total sway velocity at four weeksFirm-eyes-open null (P≥.15), firm-eyes-closed null (P≥.15), foam-eyes-open nominally significant at -5% versus +5% (P=.04), foam-eyes-closed null (P≥.15); multiplicity unadjustedOne nominal result among four prevents a directional judgment (EX); numerical CI unavailable (CX)
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Receipt — 3 References

All 3 cited sources were verified for existence at the original page (as of 2026-08-15).

Hatton AL, Chatfield MD, Gane EM, Maharaj JN, Cattagni T, Burns J, Paton J, Rome K, Kerr G. The effects of wearing textured versus smooth shoe insoles for 4-weeks in people with diabetic peripheral neuropathy: a randomised controlled trial. Disabil Rehabil. 2025;47:751-761. PMID: 38819206. DOI: 10.1080/09638288.2024.2360658. ACTRN12617000543381.
checked
Hatton AL, Gane EM, Maharaj JN, Burns J, Paton J, Kerr G, Rome K. Textured shoe insoles to improve balance performance in adults with diabetic peripheral neuropathy: study protocol for a randomised controlled trial. BMJ Open. 2019;9:e026240. PMID: 31320345. DOI: 10.1136/bmjopen-2018-026240. ACTRN12617000543381.
checked
Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Lawrence Erlbaum Associates; 1988.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-15 · Corrections: none

Cite this verdict

Textured sensory-stimulating insoles x balance in diabetic peripheral neuropathy Evidence Grade C card
[Chamgap] Textured sensory-stimulating insoles x balance in diabetic peripheral neuropathy — Evidence Grade C·50. 3 cited sources checked. Source: https://chamgap.com/en/verdicts/blood-sugar/textured-sensory-insoles-diabetic-neuropathy-balance/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.