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Localization of proprioceptive neurons innervating the muscle spindles of pig extraocular muscles studied by horseradish peroxidase labelling.

Each muscle of the extraocular muscles, containing abundant muscle spindles, was exposed to horseradish peroxidase (HRP) on 8 young pigs (2-month-old, 20-30 kg in body weight, both sexes). The results obtained are follows: The HRP-labelled neurons innervating the superior rectus muscle were always found in a crescent ventro-medio-dorsal fashion in the most medial position of the contralateral oculomotor nucleus. The HRP-labelled cells for the medial rectus muscle appeared close to the superior rectus group in the ipsilateral nucleus. The labelled cells for the inferior rectus muscle appeared in the ventrolateral position of the ipsilateral nucleus and those for the inferior oblique muscle in the area between the medial rectus and inferior rectus muscle groups. The labelled cells for the superior oblique muscle were found in the contralateral trochlear nucleus and those for the lateral rectus muscle bilaterally in the abducens nuclei, predominantly on the ipsilateral side and poorly on the contralateral side. The HRP-labelled cells were composed of large (alpha) and small (gamma) multipolar cells and of bipolar, oval or round (proprioceptive) cells, all intermingled together within the nucleus. The bipolar cells have been also identified in the 3 nuclei by means of Nissl staining technique. On this basis, they should be considered as the proprioceptive neurons. In the shrew-moles, the cell bodies of the proprioceptive neurons innervating the snout muscle spindles have been found close to the ipsilateral glossopharyngeal ganglion and those of the somatic sensory neurons in the ipsilateral trigeminal ganglion. In the pigs, no HRP-labelled cells were found in the trigeminal mesencephalic tract nucleus, but the HRP-labelled cells were found in the ipsilateral trigeminal and the superior cervical sympathetic ganglia. From the results, it could be emphasized that the proprioceptive neurons innervating the pig extraocular muscle spindles are located within the nuclei of the IIIrd, IVth and VIth cranial nerves.

Animals↗

Pedal goniometer to assess ankle proprioception.

The evaluation of the patient who falls requires an assessment of proprioception. Proprioception is traditionally tested in the great toes. Ankle proprioception, which is more relevant to falling, has been poorly, if ever, tested. A pedal apparatus was designed to improve the clinical assessment of ankle proprioception.

Accidental Falls↗

[Disorders of proprioception of the arthrotic knee joint].

We measured proprioception of the knee joint by an active and a passive method in 40 subjects under 30 years of age and in 80 subjects older than 50 years with no evidence of knee joint disease. Joint position sense was also determined in an additional 59 patients with osteoarthrosis of the knee. Proprioception was found to decline with increasing age. In the osteoarthritic knee the measured values were significantly higher than in both groups without knee-joint involvement. An elastic bandage had a positive effect. There was a positive correlation between proprioception and clinical parameters. Walking ability and range of motion did not significantly influence the proprioception. Patients receiving physical therapy showed an improved joint position sense.

Adult↗

Central distribution of cervical primary afferents in the rat, with emphasis on proprioceptive projections to vestibular, perihypoglossal, and upper thoracic spinal nuclei.

The projections of primary afferents from rostral cervical segments to the brainstem and the spinal cord of the rat were investigated by using anterograde and transganglionic transport techniques. Projections from whole spinal ganglia were compared with those from single nerves carrying only exteroceptive or proprioceptive fibers. Injections of horseradish peroxidase (HRP) or wheat germ agglutinin-horseradish peroxidase conjugate (WGA-HRP) were performed into dorsal root ganglia C2, C3, and C4. Free HRP was applied to the cut dorsal rami C2 and C3, greater occipital nerve, sternomastoid nerve, and to the C1/2 anastomosis, which contains afferents from suboccipital muscles and the atlanto-occipital joint. WGA-HRP injections into ganglia C7 and L5 were performed for comparative purposes. Injections of WGA-HRP or free HRP into rostral cervical dorsal root ganglia and HRP application to C2 and C3 dorsal rami produced labeling in dorsal and ventral horns at the level of entrance, the central cervical nucleus, and in external and main cuneate nuclei. From axons ascending to pontine and descending to upper thoracic spinal levels, medial collaterals were distributed to medial and descending vestibular, perihypoglossal and solitary nuclei, and the intermediate zone and Clarke's nucleus dorsalis in the spinal cord. Lateral collaterals projected mainly to the trigeminal subnucleus interpolaris and to lateral spinal laminae IV and V. Results from HRP application to single peripheral nerves indicated that medial collaterals were almost exclusively proprioceptive, whereas lateral collaterals were largely exteroceptive with a contribution from suboccipital proprioceptive fibers. WGA-HRP injections into dorsal root ganglia C7 and L5 failed to produce significant labeling within vestibular and periphypoglossal nuclei, although they demonstrated classical projection sites within the brainstem and spinal cord. The consistent collateralisation pattern of rostral cervical afferents along their whole rostrocaudal course enables them to contact a variety of precerebellar, vestibulospinal, and preoculomotor neurons. These connections reflect the well-known significance of proprioceptive neck afferents for the control of posture, head position, and eye movements.

Afferent Pathways↗

Effects of Pointing Rate and Availability of Visual Feedback on Visual and Proprioceptive Components of Prism Adaptation.

While looking through laterally displacing prisms, subjects pointed 60 times straight ahead of their nose at a rate of one complete movement every 2 or 3 s, with visual feedback available early in the pointing movement or delayed until the end of the movement. Sagittal pointing was paced such that movement speed covaried with pointing rate. Aftereffect measures (obtained after every 10 pointing trials) showed that when the limb became visible early in a pointing movement, proprioceptive adaptation was greater than visual, but when visual feedback was delayed until the end of the movement, the reverse was true. This effect occurred only with the 3-s pointing rate, however. With the 2-s pointing rate, adaptation was predominately proprioceptive in nature, regardless of feedback availability. Independent of the availability of visual feedback, visual adaptation developed more quickly with 3-s pointing, whereas proprioceptive adaptation developed more rapidly with 2-s pointing. These results are discussed in terms of a model of perceptual-motor organization in which the direction of coordinative (guidance) linkage between eye-head (visual) and hand-head (proprioceptive) systems (and consequently the locus of discordance registration and adaptive recalibration) is determined jointly by pointing rate and feedback availability. An additional effect of pointing rate is to determine the rate of discordant inputs. Maximal adaptive recalibration occurs when the input (pointing) rate matches the time constant of the adaptive encoder in the guided system.

Journal Article↗

A novel device for the measurement of proprioception in the hand.

BACKGROUND: Together with visual information, awareness of limb position and movement is essential for limb coordination. A proprioceptive deficit has been demonstrated in a number of rheumatological disorders. There is a lack of a portable device for measuring hand proprioception in the field. METHODS: A compact portable device for measuring joint position sense in the metacarpophalangeal joint of the index finger of either hand was constructed. This device was manually operated and required the subject to match the position of the hidden finger with a surface-mounted silhouette. Reliability studies were performed over three consecutive days in 12 normal volunteers. RESULTS: Intrasubject variability [95% confidence interval (CI)] was 0.86 degrees (0.04-1.76) between days 1 and 2, and 1.23 degrees (1.04-3.50) between days 2 and 3. The intraclass correlation coefficient (95% CI) between all 3 days was 0.92 (0.85-0.96). Average proprioceptive error (95% CI) in the sample population was 5.72 degrees (1.23-10.2) over the 3 days. This value was 5.94 degrees , 5.79 degrees and 5.42 degrees on days 1, 2 and 3, respectively. No difference was found between sexes but dominant hands gave smaller errors (mean dominant error 5.11 degrees , mean non-dominant error 6.35 degrees ; t = -3.4, P = 0.002). CONCLUSIONS: This report describes a new portable device for measuring proprioception in the hand. Reproducibility was shown to be good on an individual and group basis. These results are promising and warrant larger age- and sex-related studies. The ease and portability of the device make it ideal for use in epidemiological studies of rheumatological disorders involving the hands, including joint hypermobility.

Adult↗

Influence of sensory and proprioceptive impairment on the development of phantom limb syndrome during regional anesthesia.

BACKGROUND: The relation between impairment of sensorimotor function and occurrence of phantom limb syndrome (PLS) during regional anesthesia has not been described. This study assessed the temporal relation between PLS and the progression of sensorimotor impairment during placement of a brachial plexus nerve block. METHODS: Fifty-two patients had their arm randomly placed either alongside their body (group A) or in 90 degrees abduction (group B) immediately after brachial plexus nerve block placement. Responses to pin prick, cold, heat, touch, proprioception, and voluntary movement were assessed every 5 min for 60 min. Meanwhile, patients described their perceptions of the size, shape, and position of their anesthetized limb. RESULTS: Phantom limb syndrome occurred 19 +/- 9 min after nerve block placement. Proprioception was impaired and abolished after 22 +/- 9 and 43 +/- 17 min, respectively (P < 0.05 vs. PLS onset). When PLS occurred, responses to pin prick, cold, heat, and proprioception were abolished in 96, 94, 87, and 4% of patients, respectively. Patients were more likely to feel their anesthetized limb in adduction and in abduction in groups A and B (P < 0.05 vs. group A), respectively. After PLS had become motionless, two stereotyped positions were identified: arm adduction, elbow flexion, hand over the abdomen (68% of group A patients) and arm abduction, elbow flexion, hand held close to the homolateral ear (48% of group B patients). CONCLUSIONS: This study provides a better understanding of the determinants of PLS by showing that the final position of PLS is related both to the abolition of proprioception and the initial position of the anesthetized limb.

Adult↗

Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects.

OBJECTIVES: To investigate whether subjects with knee osteoarthritis (OA) have reduced static postural control, knee proprioceptive acuity, and maximal voluntary contraction (MVC) of the quadriceps compared with normal controls, and to determine possible independent predictors of static postural sway. METHODS: 77 subjects with symptomatic and radiographic knee OA (58 women, 19 men; mean age 63.4 years, range 36-82) and 63 controls with asymptomatic and clinically normal knees (45 women, 18 men; mean age 63 years, range 46-85) underwent assessment of static postural sway. 108 subjects (59 patients, 49 controls) also underwent assessment of knee proprioceptive activity and MVC (including calculation of quadriceps activation). In patients with knee OA knee pain, stiffness, and functional disability were assessed using the WOMAC Index. The height (m) and weight (kg) of all subjects was assessed. RESULTS: Compared with controls, patients with knee OA were heavier (mean difference 15.3 kg, p<0.001), had increased postural lateral sway (controls: median 2.3, interquartile (IQ) range 1.8-2.9; patients: median 4.7, IQ range 1.9-4.7, p<0.001), reduced proprioceptive acuity (controls: mean 7.9, 95% CI 6.9 to 8.9; patients: mean 12.0, 95% CI 10.5 to 13.6, p<0.001), weaker quadriceps strength (controls: mean 22.5, 95% CI 19.9 to 24.6; patients: mean 14.7, 95% CI 12.5 to 16.9, p<0.001), and less percentage activation of quadriceps (controls: mean 87.4, 95% CI 80.7 to 94.2; patients: mean 66.0, 95% CI 58.8 to 73.2, p<0.001). The significant predictors of postural sway were knee pain and the ratio of MVC/body weight. CONCLUSIONS: Compared with age and sex matched controls, subjects with symptomatic knee OA have quadriceps weakness, reduced knee proprioception, and increased postural sway. Pain and muscle strength may particularly influence postural sway. The interaction between physiological, structural, and functional abnormalities in knee OA deserves further study.

Adult↗

Effect of tai chi exercise on proprioception of ankle and knee joints in old people.

OBJECTIVES: To assess if tai chi, a traditional Chinese form of exercise, could improve proprioception in old people and if the effects of tai chi on proprioception are more evident than other exercise forms in the elderly. METHODS: By detecting the threshold of passive movement, ankle and knee joint kinaesthesis was measured in 21 elderly long term tai chi practitioners (TC group), 20 elderly long term swimmers/runners (S/R group), and 27 elderly sedentary controls (control group). RESULTS: Ankle joint kinaesthesis differed significantly among the three groups (p = 0.001). Subjects in the TC group could detect a significantly smaller amount of motion than those in the S/R group (p = 0.022) and control group (p = 0.001). No significant difference was found between the S/R group and the control group (p = 0.701). The threshold for detection of passive motion was significantly different in knee extension and flexion. For knee flexion, the TC group showed a significantly lower mean threshold for detection of passive motion than the control group (p = 0.026). There were no significant differences between the S/R group and control group (p = 0.312), or between the TC group and S/R group (p = 0.533). For knee extension, no significant difference was noted among the three groups (p = 0.597). CONCLUSIONS: The elderly people who regularly practiced tai chi not only showed better proprioception at the ankle and knee joints than sedentary controls, but also better ankle kinaesthesis than swimmers/runners. The large benefits of tai chi exercise on proprioception may result in the maintenance of balance control in older people.

Aged↗

Proprioception and Muscle Strength in Subjects With a History of Ankle Sprains and Chronic Instability.

OBJECTIVE: To examine if patients with chronic ankle instability or a history of ankle sprains without chronic instability have worse proprioception or less invertor and evertor muscle strength. DESIGN AND SETTING: We assessed proprioception and muscle strength on the Biodex isokinetic dynamometer in the laboratory of the Department of Sports Medicine, University Hospital Ghent. SUBJECTS: Subjects included 87 physical education students (44 men, 43 women, age = 18.33 +/- 1.25 years, mass = 66.09 +/- 8.11 kg, height = 174.11 +/- 8.57 cm) at the University of Ghent in Belgium. Their ankles were divided into 4 groups: a symptom-free control group, subjects with chronic ankle instability, subjects who had sustained an ankle sprain in the last 2 years without instability, and subjects who sustained an ankle sprain 3 to 5 years earlier without instability. MEASUREMENTS: Active and passive joint-position sense was assessed at the ankle, and isokinetic peak torque was determined for concentric and eccentric eversion and inversion movements at the ankle. RESULTS: Statistical analysis indicated significantly less accurate active position sense for the instability group compared with the control group at a position close to maximal inversion. The instability group also showed a significantly lower relative eversion muscle strength (% body weight). No significant differences were observed between the control group and the groups with past sprains without instability. CONCLUSIONS: We suggest that the possible cause of chronic ankle instability is a combination of diminished proprioception and evertor muscle weakness. Therefore, we emphasize proprioception and strength training in the rehabilitation program for ankle instability.

Journal Article↗

Cooling does not affect knee proprioception.

The effect of cooling on proprioception of the knee has not been studied extensively. In this study, we investigated the movement reproduction (timing and accuracy) aspect of proprioception. Subjects were tested under two conditions: a 20-minute application of ice and control. Proprioceptive accuracy and timing were measured by passively moving the knee, then comparing the subject's active reproduction of the passive movement. Subjects were blindfolded, then tested in three sectors of the knee's range of motion: 90 degrees to 60 degrees , 60 degrees to 30 degrees , and 30 degrees to full extension. Ice application had no apparent effect on the subject's ability to perform accurate movement reproductions in the sectors tested. However, accuracy of the subject's final angle reproduction varied between the sectors as did the total time of the movement. One possible explanation for the difference between sectors is that different receptors are active at different points in the knee's range of motion. We conclude that cooling the knee joint for 20 minutes does not have an adverse effect on proprioception.

Journal Article↗

Effects of a 6-week strength and proprioception training program on measures of dynamic balance: a single-case design.

OBJECTIVE: To examine the effects of a 6-week strength and proprioception training program on clinical measures of balance, and to introduce characteristics of a single-case research design that may be beneficial to the athletic training profession as both a research and a clinical tool. DESIGN AND SETTING: A multiple baseline design across subjects was used to assess the effects of the intervention. The training program was performed three times a week and consisted of manual muscle strengthening and proprioception training for the plantar flexor, dorsiflexor, inversion, and eversion muscle groups. SUBJECTS: Three subjects (age = 17.6 +/- 1.24 yr, wt = 78.6 +/- 1.07 kg, ht = 186.2 +/- 4.3 cm) who had previously sustained first-degree lateral ankle sprains. MEASUREMENTS: Dynamic balance was tested three times a week using a single-plane balance board (SPBB). Each subject was tested for two double-leg conditions (forward/backward, right/left) and one single-leg condition (forward/backward) for each extremity. The dependent variable was the number of times that the balance board made contact with the floor. Visual inspection was used to evaluate whether the treatment resulted in a change of performance. RESULTS: Although the intervention did not produce obvious improvements in balance for all evaluation criteria for all testing conditions, it is apparent that the strength and proprioception training program positively influenced all three subjects' ability to balance dynamically on an SPBB. A change in mean scores from baseline to intervention phase was evident for all testing conditions. However, a change in slope and level was not as apparent for all testing conditions, especially the single-leg conditions. CONCLUSION: The results revealed that the strength and proprioception training program produced improvements in the ability to balance as assessed dynamically on an SPBB.

Journal Article↗

The Sensorimotor System, Part II: The Role of Proprioception in Motor Control and Functional Joint Stability.

OBJECTIVE: To discuss the role of proprioception in motor control and in activation of the dynamic restraints for functional joint stability. DATA SOURCES: Information was drawn from an extensive MEDLINE search of the scientific literature conducted in the areas of proprioception, motor control, neuromuscular control, and mechanisms of functional joint stability for the years 1970-1999. DATA SYNTHESIS: Proprioception is conveyed to all levels of the central nervous system. It serves fundamental roles for optimal motor control and sensorimotor control over the dynamic restraints. CONCLUSIONS/APPLICATIONS: Although controversy remains over the precise contributions of specific mechanoreceptors, proprioception as a whole is an essential component to controlling activation of the dynamic restraints and motor control. Enhanced muscle stiffness, of which muscle spindles are a crucial element, is argued to be an important characteristic for dynamic joint stability. Articular mechanoreceptors are attributed instrumental influence over gamma motor neuron activation, and therefore, serve to indirectly influence muscle stiffness. In addition, articular mechanoreceptors appear to influence higher motor center control over the dynamic restraints. Further research conducted in these areas will continue to assist in providing a scientific basis to the selection and development of clinical procedures.

Journal Article↗

Does total hip arthroplasty mean sensorial and proprioceptive lesion? A clinical study.

Total hip arthroplasty means sacrificing the joint capsule and the mechanoreceptors contained therein. Recent neurophysiological experiences seem to redefine the sensorial and proprioceptive role of the joint capsule in favor of the activity of the muscular mechanoreceptors, particularly in the area of the coxofemoral joint. The authors have examined the sensorial lesion caused by total hip arthroplasty in a group of 20 patients. Clinical testing was conducted prior to surgery, 7 and 40 days later. The tests were aimed at exploring the perceptive and proprioceptive activity of the hip, and showed marked decrease in all of the receptorial activity one week after surgery. After 40 days perceptive function was completely recovered, as the scores for tests conducted were the same as those obtained prior to surgery: proprioceptive activity was instead considerably improved, with significant changes in most parts of the tests. The authors conclude by observing that total hip arthroplasty does not cause permanent lesion of the perception of joint movement; furthermore, renewed coxofemoral mechanics allow for a better proprioceptive response with strengthening of static and dynamic antigravitational reactions.

Age Factors↗

Effect of age and osteoarthritis on knee proprioception.

OBJECTIVE: To test the hypotheses that 1) knee position sense declines with age; 2) patients with osteoarthritis (OA) have worse knee position sense than elderly controls; and 3) knee position sense is correlated with functional status. METHODS: The threshold for detection of knee joint displacement was measured in 30 patients with bilateral knee OA (Kellgren/Lawrence grade > or =2 in both knees), 29 elderly controls (who met clinical and radiographic criteria for exclusion of OA), and 25 young controls. Range of motion, laxity, radiographic severity, and functional status were also assessed. RESULTS: A moderate correlation was found between joint displacement detection threshold and age (r = 0.598 and r = 0.501 for the right knee and the left knee, respectively). The threshold was substantially and significantly different between the OA patients and the elderly controls. Proprioceptive impairment was associated with worse disease-specific functional status. CONCLUSION: Proprioception declines with age, and is further impaired in elderly patients with knee OA. Poor proprioception may contribute to functional impairment in knee OA.

Adult↗

Effect of reconstruction of the anterior cruciate ligament on proprioception of the knee and the heel strike transient.

Abnormal proprioception of the knee joint has been documented after rupture of the anterior cruciate ligament (ACL) and may result in the loss of muscular reflexes. Excessive loading from the lack of muscular control may predispose the joint to osteoarthrosis. To investigate this problem, 10 patients were studied at an average of 31.6 months after ACL reconstruction. Three tests of joint proprioception and measurements of the vertical component of heel strike force during normal gait were used. A normal control group also was studied. For two of the proprioception tests (reproduction of passive motion and relative reproduction), there were no statistical differences among the uninjured (control) limbs, the normal contralateral limb of patients with a reconstructed ACL, and the extremity with a reconstructed ACL. In the third test (threshold of detection of motion), which previously has been shown to be adversely affected by ACL injury, the measurements for both extremities of patients with a reconstructed ACL were more accurate than those for the control group. The reconstructed extremity performed less accurately than the contralateral extremity (p < 0.05). The heel strike transient (vertical component of ground reaction force at heel strike) for uninjured and ACL-reconstructed limbs was not significantly different. In fact, the extremity with the reconstructed ACL had a lower transient than the uninjured extremity. Heel strike transients in patients with a reconstructed ACL were higher than those in the controls, but the differences were significant only when corrected for velocity of gait.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The cerebellar dorsal granular ridge in an elasmobranch has proprioceptive and electroreceptive representations and projects homotopically to the medullary electrosensory nucleus.

1. Response properties of neurons in the dorsal granular ridge (DGR) of the little skate, Raja erinacea, were studied in decerebrate, curarized fish. Sensory responses included proprioceptive (426 of 952; 45%) and electroreceptive units (526 of 952; 55%). Electroreceptive units responded to weak electric fields with a higher threshold than lower-order units and had large ipsilateral receptive fields, whose exact boundaries were often unclear but contained smaller, identifiable best areas. Proprioceptive units responded to displacement of the ipsilateral fin and were either position- or movement-sensitive. 2. Both proprioceptive and electroreceptive units showed a progression of receptive fields from anterior to posterior body in the rostral to caudal direction along the length of DGR. Sensory maps in DGR projected homotopically to the electrosensory somatotopy in the dorsal nucleus. Peak evoked potentials and units responding to local DGR stimulation occurred only in areas of the dorsal nucleus with receptive fields located within the composite receptive field at the DGR stimulation site. 3. Single shocks to DGR produced a short spike train followed by a prolonged suppression period in the medullary dorsal nucleus. These results have implications for the role of the parallel fiber system in medullary electrosensory processing.

Animals↗

Somatosensory evoked potentials following proprioceptive stimulation of finger in man.

Brisk passive flexion of the proximal interphalangeal joint of the middle finger, produced by using a newly devised instrument, elicited evoked potentials on the scalp. The present study carefully excluded the possible contribution of sensory modalities other than proprioception. The initial part of cortical response was a positive deflexion at the contralateral central area (P1 at 34.6 ms after the stimulus). This was followed by a midfrontal negative wave (N1 at 44.8 ms) and a clear positivity at the contralateral centroparietal area (P2 at 48.0 ms). The evoked responses persisted in spite of the abolition of cutaneous and joint afferents of the finger caused by ischemic anesthesia, but they were lost by ischemic anesthesia of the forearm. Thus, the cortical evoked responses obtained in this study most probably reflect muscle afferent inputs. The scalp distribution of P1 suggested that its cortical generator source was different from that of the N20-P20 components of evoked potentials to electrical median nerve stimulation. Brodmann areas 2 and 3a of human brain, which are known to receive deep receptor inputs, are the most plausible generator sites for the early components of the proprioception-related evoked responses. The amplitude of P2 was related to the velocity but not to the magnitude of movement. In conclusion, the present study established a method for recording the evoked responses to the brisk passive movement of the finger joint, which mainly reflect the dynamic aspects of proprioception mediated through muscle afferent.

Adult↗