EFFECTS OF TACTILE AND PROPRIOCEPTIVE FEEDBACK ON MANUAL FUNCTION IN PATIENTS WITH TYPE II DIABETES
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Control of manual function requires optimal integration of sensory and motor systems. Pathology to either of these systems may lead to sub-optimal object manipulation. A growing body of literature has identified changes to sensory function in individuals with Type II Diabetes (T2D); however, the impact of the disease on the motor system has not been thoroughly investigated. The purpose of this study is to evaluate the effects of tactile and proprioceptive feedback on manual function in patients with T2D compared to age- and sex- match control subjects. Both groups of participants will have sensory deficits induced through median nerve block at the wrist (treatment 1) and at the elbow (treatment 2). This method allows for safe and effective temporary removal of tactile sensation distal to the wrist (treatment1) and tactile and proprioceptive sensations distal to the elbow (treatment 2). If sensory deficits due to neuropathy in T2D are the sole contributors to changes in manual function in T2D, then both groups should display equal reduction in manual motor function. If, however, another physiological mechanism is responsible for said motor changes than it can be expected that the T2D group will display greater reductions in manual motor performance than the control group. Overall, tactile sensation measurements suggested differences between the T2D group and the healthy cohort; however, tactile sensation in the T2D group at baseline was found to be equivalent to tactile function of the control group in the anesthesia conditions. Clinical assessment of gross motor movements suggested the sensory system as the primary component responsible for sensorimotor changes, while tasks of fine motor movement indicated another component to be responsible for changes other than those produced by the sensory system. More sensitive kinetic testing also reveals that another system is at play causing sensorimotor changes, this system however is unknown and further research is required to identify this key component.