The evaluation of tactile dysfunction in the hand in type 1 diabetes: a novel method based on haptics

Aims We present an innovative method based on haptics for the evaluation of the sense of touch in the hand, in people affected by type 1 diabetes. Methods Forty individuals affected by diabetes and 20 healthy controls took part in the study; the diabetes group was further divided into two subgroups based on vibration sensitivity in the lower limb. By means of a novel haptic device, tactile sensitivity in the fingertip was measured as the ability of the participants to discriminate slip motion speed. Results Tactile sensitivity was significantly lower in individuals affected by diabetes as compared to controls. Depending on the subgroup, the difference from the controls was equal to 0.11 (95% CI from 0.029 to 0.186) and to 0.267 (95% CI from 0.198 to 0.336). Within the diabetes group, tactile sensitivity correlated with vibration sensitivity in the upper (p = 0.001) and lower limb (p = 0.003). A significant relationship between nerve conduction parameters and tactile sensitivity was found (p = 0.03). Finally, we combined the different predictors (clinical, vibratory and electroneurography data) by using cluster analysis; tactile sensitivity was found to be significantly different between different clusters (p = 0.004). Conclusions Early signs of tactile dysfunction in the hand were found in individuals affected by diabetes, even in absence of diabetic neuropathy. The protocol presented in this study is a promising tool for the assessment of tactile dysfunction in the hand in people affected by type 1 diabetes

Design and test of an autonomous reconfigurable dynamic investigation test-rig on haptics (ARDITA) for pre-screening of the peripheral neuropathy diseases

This work presents a new device ARDITA (Autonomous Reconfigurable Dynamic Investigation Test-rig on hAptics) that is able to indent the fingertip with sinusoidal waves. Its reconfig-urability permits to change these waves in amplitude, spatial and timing frequencies. The device is designed in order to be autonomous and reconfigurable, but also the portability and the size were taken into account, because the clinicians had to move it from an hospital to the other one and because each patient arms has a different size. In this work, the authors applied this feature to investigate the relationship between the tactile sensitivity of index and little finger both in healthy people and people who suffer peripheral neuropathies as the Carpal Tunnel Syndrome (CTS). The last ones were examined also with the Electromyography (EMG). 40 healthy people and 17 ill patients were tested. The results showed that ARDITA determined not only the index and little finger performance were inverted in patients respect to the subject, but also the increment of incorrect responses were perfected correlated with the increment of the degree of the illness