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Lauren M. Harte, James J. Czyrny, Sonja Pavlesen, and Michael R. Ferrick

Key Points ▸ Common peroneal neuropathy can result from repetitive contusion injuries in cheerleaders. ▸ Symptoms will improve with cessation of cheerleading activities. ▸ A protective knee brace with adequate padding may prevent neuropathy recurrence. ▸ Awareness of this association will help with

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Hananeh Younesian, Nader Farahpour, Mehrdokht Mazde, Martin Simoneau, and Katia Turcot

Diabetes mellitus (DM) type 2 is the most common metabolic disease around the world. 1 In 2017, about 424.9 million people were affected by diabetes, which is expected to rise to 628.6 million by the year 2045. 2 Diabetes peripheral neuropathy (DPN) is a common complication among DM patients 3

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Theo Mulder, Rob den Otter, and Baziel van Engelen

The flexibility of the human motor system is remarkable. Even when parts of the system are damaged, the output often remains optimal or near-optimal. The neuromotor system is designed to keep the output optimal by shifting between input sources. This capability is termed the principle of continuous adaptation. This article describes an experiment in which patients suffering from a hereditary motor and sensory neuropathy, type la (Charcot Marie Tooth disease, type la), had to perform fine motor movements. We examined whether they were able to regulate these movements in spite of the fact that the somatosensory input and motor output was substantially impaired as a result of the chronic, slowly progressing neuropathy. It was predicted that these patients were able to perform fine movements as long as the movements were well known and over-learned. Furthermore, it was predicted that these patients would compensate for the loss of somatosensory information by becoming more dependent on vision. A second prediction was that the quality of the motor performance would break down when these patients had to perform a novel motor pattern. The performance of the patients (n = 10) was contrasted with the performance of 20 healthy subjects. The results indicated that the patients, indeed, were able to perform the over-learned movements and that their performance deteriorated significantly when they had to perform a novel motor pattern. No indication, however, could be found for visual compensation.

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Samuele Contemori and Andrea Biscarini

neuropathy of the suprascapular nerve. This neuropathy leads to paralysis and atrophy of the infraspinatus muscle. 14 – 20 Indeed, overhead activity athletes with suprascapular nerve palsy exhibit an evident reduction of the soft tissue bulk in the infraspinatus fossa of the HS compared with the healthy

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Pooja Bhati and M. Ejaz Hussain

defined. Research has indicated that the risk of coronary heart disease (CHD) increases up to 3 to 5 times in individuals with diabetes than nondiabetics. 5 , 6 Cardiac autonomic neuropathy (CAN) strongly and independently predicts all-cause and cause-specific mortality, but is still considered to be the

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Roger J. Paxton, Caitlin Feldman-Kothe, Megan K. Trabert, Leah N. Hitchcock, Raoul F. Reiser II, and Brian L. Tracy

Introduction:

The purpose was to determine the effect of peripheral neuropathy (PN) on motor output variability for ankle muscles of older adults, and the relation between ankle motor variability and postural stability in PN patients.

Methods:

Older adults with (O-PN) and without PN (O), and young adults (Y) underwent assessment of standing postural stability and ankle muscle force steadiness.

Results:

O-PN displayed impaired ankle muscle force control and postural stability compared with O and Y groups. For O-PN, the amplitude of plantarflexor force fluctuations was moderately correlated with postural stability under no-vision conditions (r = .54, p = .01).

Discussion:

The correlation of variations in ankle force with postural stability in PN suggests a contribution of ankle muscle dyscontrol to the postural instability that impacts physical function for older adults with PN.

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D.S. Blaise Williams III, Denis Brunt, and Robert J. Tanenberg

The majority of plantar ulcers in the diabetic population occur in the forefoot. Peripheral neuropathy has been related to the occurrence of ulcers. Long-term diabetes results in the joints becoming passively stiffer. This static stiffness may translate to dynamic joint stiffness in the lower extremities during gait. Therefore, the purpose of this investigation was to demonstrate differences in ankle and knee joint stiffness between diabetic individuals with and without peripheral neuropathy during gait. Diabetic subjects with and without peripheral neuropathy were compared. Subjects were monitored during normal walking with three-dimensional motion analysis and a force plate. Neuropathic subjects had higher ankle stiffness (0.236 N·m/ deg) during 65 to 80% of stance when compared with non-neuropathic subjects (−0.113 N·m/deg). Neuropathic subjects showed a different pattern in ankle stiffness compared with non-neuropathic subjects. Neuropathic subjects demonstrated a consistent level of ankle stiffness, whereas non-neuropathic subjects showed varying levels of stiffness. Neuropathic subjects demonstrated lower knee stiffness (0.015 N·m/deg) compared with non-neuropathic subjects (0.075 N·m/deg) during 50 to 65% of stance. The differences in patterns of ankle and knee joint stiffness between groups appear to be related to changes in timing of peak ankle dorsiflexion during stance, with the neuropathic group reaching peak dorsiflexion later than the non-neuropathic subjects. This may partially relate to the changes in plantar pressures beneath the metatarsal heads present in individuals with neuropathy.

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Column-editor : Robert D. Kersey

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Rick W. Wilson

Suprascapular nerve palsy has been frequently reported in athletes, particularly baseball pitchers, volleyball players, and weight lifters, but it is easily overlooked during the evaluation of shoulder pain. Entrapment of the suprascapular nerve is usually suspected only after atrophy is noted. The presence of painless weakness of the external rotator muscles should alert the clinician to the presence of nerve damage, which can be confirmed by electromyography. This case study demonstrates the usefulness of isokinetic testing and magnetic resonance imaging in identifying cystic lesions causing neuropathy among athletes who have failed conservative treatment for shoulder pain.

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Beatriz H. Thames and Stacey L. Gorniak

diabetes either with or without diagnosis of diabetic peripheral neuropathy per collaborating physician, diagnosed via clinical examination and electrodiagnostics. Healthy individuals recruited to participate in this study did not have a diagnosis of type II diabetes, type I diabetes, or prediabetes. Study