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Goal synchronization of bimanual skills depends on proprioception.

The present experiments in Human subjects were designed to test whether proprioceptive feedback plays a role in optimising bimanual synchronization in a goal-oriented familiar task. Goal-synchronization is a typical feature of bimanual everyday skills. The purpose of the study was to disturb proprioceptive signalling by means of vibrating the leading left limb while subjects performed a bimanual task on a drawer manipulandum. Blindfolded subjects reached for and opened the drawer with the left hand while the right hand was reaching for grasping an object as the drawer was fully opened. Discrete events of the task were used to measure movement onset times of pulling and grasping hands and of goal arrival times. A spatial--temporal goal invariance was still present despite asymmetrical limb assignments and subjects were blindfolded. In contrast, when vibration (80 Hz) was applied to the forearm flexors of the leading pulling limb, we found that the interval between the hands at goal reaching was significantly prolonged. This suggests that synchronization is not predetermined entirely by feedforward commands and that proprioceptive feedback is necessary for updating an internal forward model and perhaps also for lower-level corrections in order to ensure covariant limb movements for optimal goal-synchronization.

Adult↗

Proprioceptive role for palisade endings in extraocular muscles: evidence from the Jendrassik Maneuver.

A proprioceptive hypothesis for the control of eye movements has been recently proposed based on neuroanatomical tracing studies. It has been suggested that the non-twitch motoneurons could be involved in modulating the gain of sensory feedback from the eye muscles analogous to the gamma (gamma) motoneurons which control the gain of proprioceptive feedback in skeletal muscles. We conducted behavioral and psychophysical experiments to test the above hypothesis using the Jendrassik Maneuver (JM) to alter the activity of gamma motoneurons. It was hypothesized that the JM would alter the proprioceptive feedback from the eye muscles which would result in misregistration of eye position and mislocalization of targets. In the first experiment, vergence eye movements and pointing responses were examined. Data showed that the JM affected the localization responses but not the actual eye position. Perceptual judgments were tested in the second experiment, and the results showed that targets were perceived as farther when the afferent feedback was altered by the JM. Overall, the results from the two experiments showed that eye position was perceived as more divergent with the JM, but the actual eye movements were not affected. We tested this further in Experiment 3 by examining the effect of JM on the amplitude and velocity of saccadic eye movements. As expected, there were no significant differences in saccadic parameters between the control and experimental conditions. Overall, the present study provides novel insight into the mechanism which may be involved in the use of sensory feedback from the eye muscles. Data from the first two experiments support the hypothesis that the JM alters the registered eye position, as evidenced by the localization errors. We propose that the altered eye position signal is due to the effect of the JM which changes the gain of the sensory feedback from the eye muscles, possibly via the activity of non-twitch motoneurons.

Adult↗

Characterization of human joint proprioception by means of a threshold hunting paradigm.

A method has been developed to measure the proprioceptive performance of movement detection in human joints, with the threshold hunting paradigm commonly used in other sensory modalities. Methods applied in former studies regarding movement detection were very time consuming (hours), making them not applicable to patients. Using the threshold hunting paradigm, the subject changes the parameter value continuously around the threshold producing a threshold hunting curve, which itself might be valuable for investigation of movement detection performance. The method presented here, is very quick compared to other studies in this field, especially when velocity is hunted and the threshold values are very low. The threshold parameter value is stable since there is a control at any time over the subject's stimulus perception. Furthermore, a Monte Carlo simulation showed that hunting curves can clearly be distinguished from guessing. Also reliability is given. All these points allow to use the method to evaluate the proprioceptive performance of a single individual. Considering the results, the method described may be useful for basic and clinical investigations regarding the proprioceptive performance limits of movement detection aspects.

Adult↗

[Ocular proprioception and developmental dyslexia. Sixty clinical observations].

PURPOSE: The objective of this study is to assess proprioception anomalies in postural deficiency syndrome in a group of children suffering from reading impairment. MATERIAL AND METHODS: Sixty male patients with an average age of 11 years and 9 months were included in the study. Initially, they were given a standardized neuropsychological examination, which confirmed the diagnosis of reading impairment. Then after filling out a questionnaire seeking a proprioceptive anomaly, the patients were subjected to a clinical ocular and postural examination consisting of nine precisely described steps. RESULTS: All of the patients recruited for the study presented clinical signs confirming a proprioception disorder found as a part of postural deficiency syndrome. CONCLUSION: This study opens a new direction for research concerning the origin and treatment of at least some reading-impaired children.

Adolescent↗

The effect of expertise in gymnastics on proprioceptive sensory integration in human subjects.

The ability of experts in motor skills requiring a fine postural control to keep a stable upright posture while facing the task of reinserting proprioceptive information was investigated. Seven expert gymnasts and seven experts in other non-gymnastics sports were asked to stand as immobile as possible in two conditions of vision and no-vision. Within a trial, ankle proprioceptive input was modified by means of tendon vibration of both antagonistic ankle muscles. Center of foot pressure (COP) displacements were recorded using a force platform. Contrasting with the non-gymnasts, the gymnasts were able to rapidly take advantage of the reinsertion of proprioceptive information to decrease their COP displacements. These results suggest that the efficiency of the integration process leading to the reweighting of sensory information can be significantly improved through a specific training.

Adult↗

Experimental muscle pain produces central modulation of proprioceptive signals arising from jaw muscle spindles.

The aim of the present study was to investigate the effects of intramuscular injection with hypertonic saline, a well-established experimental model for muscle pain, on central processing of proprioceptive input from jaw muscle spindle afferents. Fifty-seven cells were recorded from the medial edge of the subnucleus interpolaris (Vi) and the adjacent parvicellular reticular formation from 11 adult cats. These cells were characterized as central units receiving jaw muscle spindle input based on their responses to electrical stimulation of the masseter nerve, muscle palpation and jaw stretch. Forty-five cells, which were successfully tested with 5% hypertonic saline, were categorized as either dynamic-static (DS) (n=25) or static (S) (n=20) neurons based on their responses to different speeds and amplitudes of jaw movement. Seventy-six percent of the cells tested with an ipsilateral injection of hypertonic saline showed a significant modulation of mean firing rates (MFRs) during opening and/or holding phases. The most remarkable saline-induced change was a significant reduction of MFR during the hold phase in S units (100%, 18/18 modulated). Sixty-nine percent of the DS units (11/16 modulated) also showed significant changes in MFRs limited to the hold phase. However, in the DS neurons, the MFRs increased in seven units and decreased in four units. Finally, five DS neurons showed significant changes of MFRs during both opening and holding phases. Injections of isotonic saline into the ipsilateral masseter muscle had little effect, but hypertonic saline injections made into the contralateral masseter muscle produced similar results to ipsilateral injections with hypertonic saline. These results unequivocally demonstrate that intramuscular injection with an algesic substance, sufficient to produce muscle pain, produces significant changes in the proprioceptive properties of the jaw movement-related neurons. Potential mechanisms involved in saline-induced changes in the proprioceptive signals and functional implications of the changes are discussed.

Animals↗

Novel proprioceptive action in stepping down.

A hypothesis is offered which extends the concept of proprioception to use information necessarily obtained during the first part of a complex motion (stepping down) to facilitate the second part. It is suggested that, when the leading foot of a normal person stepping down arrives at its destination, relevant proprioceptive information is used by the following foot in its descent, to render its movement more efficient. Analogy to another effort-minimizing proprioceptive mechanism and a possible mechanical manifestation of the hypothesis are given.

Biomechanical Phenomena↗

Relationship of knee joint proprioception to pain and disability in individuals with knee osteoarthritis.

Proprioception plays an integral role in neuromotor control of the knee joint and deficits in knee joint proprioception are well documented in individuals with knee osteoarthritis (OA). However, the functional relevance of these deficits is not clear. This cross-sectional study evaluated the relationship between knee joint proprioception and pain and disability in a large cohort of individuals with knee OA. Two hundred and twenty participants (145 F, 75 M) with symptomatic knee OA were recruited from the community. Five non-weight bearing active tests with ipsilateral limb matching responses were performed at 20 degrees and 40 degrees flexion to measure knee joint position sense. Pain and disability were assessed by self-reported questionnaires and objective measures of balance and gait. Results showed little association between knee joint position sense variables and measures of pain and disability (r values <0.24, most p>0.05). When comparing participants with the worst and best joint position sense, no significant differences in pain and disability could be found (p>0.05). While our study design does not allow causality to be established, these results suggest that deficits in joint position sense may be due to factors other than pain and that deficits are not large enough to impact upon disability.

Cohort Studies↗

Normal shoulder proprioception and the effect of lidocaine injection.

The purpose of this study was to investigate the effect of age, dominance, joint position, and lidocaine injection on proprioception of the normal shoulder. Position sense and the detection of passive shoulder motion were investigated in 40 young (20 to 30 years) and old (50 to 70 years) subjects. An additional 20 young subjects were tested before and after a glenohumeral (n = 10) or a subacromial (n = 10) lidocaine injection was performed. A significant decline occurred in proprioception between the young and old age groups. No difference was observed between dominant and nondominant sides. Position sense was consistently less accurate in the maximum range of motion tested when compared with the lesser ranges tested for flexion and abduction. No differences were identified in the ability to detect motion in flexion, abduction, and external rotation in the younger group, whereas in the older group a difference was observed in flexion. No learning effect was detected for any test trial. No significant changes occurred in proprioceptive ability after either glenohumeral or subacromial lidocaine injection was performed.

Adult↗

Postural responses to combined vestibular and hip proprioceptive stimulation in man.

Vestibular-proprioceptive interaction in human postural control in the frontal plane was studied by analysing the lateral body sway evoked in a standing subject by a weak, near-threshold galvanic vestibular stimulation combined with a balanced, bilateral vibration of the medial gluteus muscles. The intensities of the stimuli were adjusted so that none of them produced a consistent postural response when delivered alone. The pattern of the lateral body sway evoked by the combined stimulation was compared with postural responses to suprathreshold vestibular stimulation and asymmetric (unilateral) vibration of the hip abductors. During the vestibular stimulation alone the head movement started earlier and was larger than movement of the hip. During unilateral vibration the head movement was delayed with respect to the hip movement and the amplitude of head deviation was less than that of the hip. The pattern of postural response to combined vestibular stimulation and balanced vibration resembled that observed under unbalanced, unilateral vibration in terms of both the latencies and amplitudes of deviation of the body segments from their respective baseline positions. It is suggested that the asymmetric vestibular signal provided by galvanic stimulation of the labyrinth introduces a bias into the reference frame for central interpretation of proprioceptive signals so that a symmetric proprioceptive input gives rise to a lateral body sway when referenced to an asymmetric vestibular input.

Adult↗

The effects of proprioceptive stimulation on cognitive processes in patients after traumatic brain injury.

OBJECTIVE: To investigate the hypothesis that proprioceptive stimulation may be effective in the treatment of brain injury, using neurophysiologic and neuropsychologic measures. DESIGN: Cohort analytic study. SETTING: Patients recovering from traumatic brain injury (TBI) in a neurologic rehabilitation hospital were examined. PARTICIPANTS: Eleven patients with TBI (Glasgow Coma Scale score > 3) and 11 healthy control subjects matched for age and education. INTERVENTIONS: Subjects were examined with the event-related potential (ERP) technique during a computerized choice-reaction-time task, in which they had to discriminate between even and odd digits. There were experimental runs with and without vibratory stimuli applied to the left forearm serving as proprioceptive stimulation. In addition, ERPs were recorded to vibratory stimuli without any additional task. MAIN OUTCOME MEASURES: Outcome measures included latencies and amplitudes of the P300 ERP component and of the late negative component. RESULTS: In the passive vibration condition, both groups showed the same ERP distribution. In the choice-reaction-time task, latencies and amplitudes of the P300 differed between the 2 groups. The patient group showed longer P300 latencies, which were shortened by vibratory stimuli. In contrast, the control subjects were not affected by vibratory stimuli. CONCLUSION: Our findings support the hypothesis that pathologic cognitive processes after TBI can be improved by proprioceptive stimulation. Muscle vibration has positive effects on pathologically slowed cognitive processes but not in healthy subjects.

Adult↗

Effects of localization and intensity of experimental muscle pain on ankle joint proprioception.

Accurate proprioceptive input is a prerequisite for balance control and coordination of movement. The present study investigated whether experimental muscle pain induced in healthy human subjects disturbed movement sense (detection of movement) or position sense (recognition of a reference position). Muscle pain was produced by infusion of 6% hypertonic saline simultaneously in m. tibialis anterior (TA) and m. soleus (experiment 1), by infusion of 6% hypertonic saline in TA (experiment 2) and by infusion of 9% hypertonic saline in TA (experiment 3). Control measurements were done with infusions of 0.9% isotonic saline. All infusions of 6% and 9% saline produced pain intensities significantly higher than the corresponding control infusions. Only infusion of 6% saline in two muscles (visual analogue scale=4-5) produced an elevation in movement detection thresholds which was significantly higher, compared with before infusion. No other significant changes in movement and position sense were found during the painful or control infusions. Pain of relatively high intensity in two antagonist muscles is necessary to disturb the movement detection threshold. The ability to recognize a reference position is not disturbed by experimentally induced muscle pain. Whether the disturbed movement sense is caused by sensitivity changes in muscle spindle afferents or altered processing of proprioceptive input cannot be answered. The present findings indicate that human ankle proprioception is rather robust to muscle pain.

Adult↗

[Effects of a proprioceptive training program on sensorimotor capacities of the lower extremity in patients with anterior cruciate ligament instability].

Sensomotory function after ACL-reconstruction was tested prior and after a proprioceptive rehabilitation program with the Kinesthetic Ability Trainer (KAT 2000) which documented the static balance index (SBI). A control group consisting of healthy subjects was also tested two times with a time interval of six weeks. The results showed an adaptation effect to the testing device in the control group with an 17.12% increase of the SBI. There were no differences between the dominant and non dominant extremity. The active sensomotory function in the healthy knee of the operated patients showed no difference to the control group. Proprioceptive capabilities of the acl-reconstructed knee joints was significant reduced 6.42 weeks after surgery. A special proprioceptive rehabilitation program for six weeks significantly reduced this deficit. In the patient group sensomotory function of both knee joints could be increased to a level higher than in the control group. In the operated extremity the static balance index increased 27.75% and in the non injured extremity the SBI increased 16.88%.

Adult↗

[Changes in proprioceptive capacities of the shoulder joint in ventral shoulder instability. A comparative study before and after arthroscopic labrum refixation].

Measurements of movement sense determined by threshold levels for the perception of motion of the shoulder were performed in 10 patients with unilateral posttraumatic shoulder instabilities, in 30 patients who underwent arthroscopic labrum repair for recurrent anterior shoulder instability, and in 15 age-related controls. In patients with anterior shoulder instabilities threshold levels for the perception of motion were higher. In addition, movement sense measurements revealed a marked, but time dependent improve of proprioceptive abilities in patients who underwent arthroscopic labrum repair. While in the shoulders of patients with an postoperative period shorter than 18 months elevated threshold levels for the perception of motion still could be observed, after a postoperative period of 18 moths or more movement sense was not different from normal, uninjured shoulders. In conclusion, our study gives evidence for a proprioceptive deficit with anterior shoulder instability which improves significantly after arthroscopic labrum repair. The restitution of proprioceptive abilities, however, seems to be a time dependent process.

Adult↗

[Proprioceptive reaction in the healthy and chronically unstable ankle joint].

Chronic lateral instability of the ankle, a condition with frequent ankle sprain episodes, difficulties to walk and run on uneven ground and often pain, occurs in 20-30% after acute ankle sprains. The treatment of CLI as well as of acute ankle sprains have more and more in addition to operative reconstructions been focused on proprioceptive training which is in concordance with the results of recent research results. The present study shows that the reaction time after sudden angular displacement of the ankle on a trapdoor is increased by approximately 15 ms in patients with chronic lateral instability compared to control persons. We conclude that delayed proprioceptive response to sudden angular displacement of the ankle can be one of the causes to chronic lateral instability of the ankle and that proprioceptive training should be included in the treatment of acute and chronic ankle disabilities.

Adult↗

[Proprioceptive capacities of the healthy knee joint: modification by an elastic bandage].

In 30 healthy volunteers with clinical inconspicuous knee joints, the proprioception of the knee joint was evaluated. The proprioceptive capability of the subjects was tested by an angle reproduction test. Additionally all knee joints were measured with and without an elastic knee bandage. The study showed no difference, neither between the left and the right knee joint, nor between men and women. However, at the mid-range of knee joint motion a significant deterioration of the proprioception could be documented. Applying an elastic knee bandage resulted in a significant improvement of the results.

Adult↗

[Proprioceptive functions of the shoulder girdle in healthy subjects].

UNLABELLED: In 30 healthy volunteers (12 female, 18 male; age: 22-36 years) we evaluated the proprioceptive function of the glenohumeral joint. The volunteers were asked to place the arm in different positions with and without visual control. The test was performed for the dominant as well as for the non dominant extremity. The following joint positions were measured: 50 degrees, 100 degrees, 150 degrees abduction, 50 degrees, 100 degrees, 150 degrees flexion, +45 degrees, 0 degree, -45 degrees rotation in 90 degrees of abduction. The documentation of the joint position was performed with a motion analysing system with passive reflecting markers. The results showed significant differences between the measurements with and without visual control. Without visual control we found the worst results for flexion and extension below shoulder level. We documented significant differences of the results with and without visual control for this range of motion. However, for external rotation above the shoulder level we could not demonstrate significant differences. In neutral rotation as well as internal rotation we found again significant differences. Therefore, proprioception seems to be worse below the shoulder level (50 degrees abduction, flexion). Better results in comparison with the entire group had two volunteers with general good coordinative capabilities. We could not demonstrate differences between the dominant and non dominant extremity nor between male and female. CLINICAL RELEVANCE: Our results demonstrated low variance of the proprioceptive function of the glenohumeral joint in healthy volunteers. This may serve as a base for further evaluations in different patient populations.

Adult↗

[Proprioceptive abilities of patients with post-traumatic instability of the glenohumeral joint].

PURPOSE: The purpose of this study was to evaluate joint position sense (JPS) in patients with posttraumatic glenohumeral instability. MATERIALS AND METHODS: In 28 patients with posttraumatic instability and in a matched control group of 30 subjects proprioception capability was evaluated. For documentation of proprioception an angle reproduction test (ART) was performed with which joint positions sense (JPS) was measured for abduction, flexion, and rotation in three angles each. RESULTS: In both groups there was a significant better JPS with visual control than without. In contrast to the control group the patients were not able to increase angle reproduction capability without visual control when comparing positions below shoulder level with positions at or above shoulder level. When comparing the patients to the controls there were differences in most of the ARTs with worse results in the patient group. These differences were significant in 150 degrees flexion with and without visual control, in 150 degrees abduction without and in 100 degrees abduction with visual control. For rotation there were trends for almost all joint positions, however, the differences were significant only in the -45 position. When comparing the noninjured contralateral shoulder of the patients with the control group, there still were differences. Again these were not in all joint positions significant, but significant worse JPS could be demonstrated in 150 degrees abduction without visual control, 50 degrees flexion without visual control, -45 degrees rotation without and 0 degrees rotation with visual control. CONCLUSIONS: A proprioceptive deficit can be documented in patients with posttraumatic glenohumeral instability. This may be one reason for permanent instability. The contralateral joint also shows reduction in joint position sense. For consecutive treatment as well as for rehabilitation both shoulder joint should be addressed.

Adult↗