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PubMed2001

Proprioception from a spinocerebellar perspective.

This review explores how proprioceptive sensory information is organized at spinal cord levels as it relates to a sense of body position and movement. The topic is considered in an historical context and develops a different framework that may be more in tune with current views of sensorimotor processing in other central nervous system structures. The dorsal spinocerebellar tract (DSCT) system is considered in detail as a model system that may be considered as an end point for the processing of proprioceptive sensory information in the spinal cord. An analysis of this system examines sensory processing at the lowest levels of synaptic connectivity with central neurons in the nervous system. The analysis leads to a framework for proprioception that involves a highly flexible network organization based in some way on whole limb kinematics. The functional organization underlying this framework originates with the biomechanical linkages in the limb that establish functional relationships among the limb segments. Afferent information from limb receptors is processed further through a distributed neural network in the spinal cord. The result is a global representation of hindlimb parameters rather than a muscle-by-muscle or joint-by-joint representation.

Animals↗
PubMed2004

Proprioception of the shoulder joint after surgical repair for Instability: a long-term follow-up study.

BACKGROUND: Proprioceptive capabilities play an important role in stability of the shoulder joint. HYPOTHESIS: Decreased proprioceptive capabilities can improve by surgical repair of shoulder instability. STUDY DESIGN: Prospective long-term study. METHODS: The proprioceptive capabilities of 14 patients with recurrent anterior shoulder instability were examined preoperative and with a minimum follow-up of 5 years postoperative using the angle reproduction test. The patients' data were compared to a healthy control group. RESULTS: The joint position sense improved significantly in abduction, flexion, and rotation (P <.05). The preoperative difference from the target joint position was 9.3 degrees (SD, 4.6 degrees ) for the summarized positions in abduction, 9.1 degrees (SD, 4.5 degrees ) in flexion, and 10.1 degrees (SD, 5.1 degrees ) in rotation. Postoperatively, it improved to 5.6 degrees (SD, 2.9 degrees ) in abduction, 5.6 degrees (SD, 2.7 degrees ) in flexion, and 5.0 degrees (SD, 1.8 degrees ) in rotation. The joint position sense of the uninvolved contralateral shoulder improved too. CONCLUSIONS: Five years after surgical repair for shoulder instability, the joint position sense improved significantly, to a level of normal, healthy shoulders.

Adolescent↗
PubMed2004

The effect of a proprioceptive balance board training program for the prevention of ankle sprains: a prospective controlled trial.

BACKGROUND: Ankle sprains are the most common injuries in a variety of sports. HYPOTHESIS: A proprioceptive balance board program is effective for prevention of ankle sprains in volleyball players. STUDY DESIGN: Prospective controlled study. METHODS: There were 116 male and female volleyball teams followed prospectively during the 2001-2002 season. Teams were randomized by 4 geographical regions to an intervention group (66 teams, 641 players) and control group (50 teams, 486 players). Intervention teams followed a prescribed balance board training program; control teams followed their normal training routine. The coaches recorded exposure on a weekly basis for each player. Injuries were registered by the players within 1 week after onset. RESULTS: Significantly fewer ankle sprains in the intervention group were found compared to the control group (risk difference = 0.4/1000 playing hours; 95% confidence interval, 0.1-0.7). A significant reduction in ankle sprain risk was found only for players with a history of ankle sprains. The incidence of overuse knee injuries for players with history of knee injury was increased in the intervention group. History of knee injury may be a contraindication for proprioceptive balance board training. CONCLUSIONS: Use of proprioceptive balance board program is effective for prevention of ankle sprain recurrences.

Adult↗
PubMedDate not supplied

Proprioception in the anterior cruciate deficient knee.

Proprioception was quantified in a group of patients who had documented complete ACL tears. Threshold to detection of passive change in position of the knee was measured using a well-described test. Eleven patients with arthroscopically proven complete ACL tears and findings consistent with moderate to severe anterolateral rotatory instability were tested. Testing was done within the 30 degrees to 40 degrees range of knee flexion. Patients were blindfolded and the injured and uninjured knees were tested in random sequence so that the normal knee could serve as an internal control. Testing was also done in a blind manner, i.e., the examiner did not know which knee had been injured. An age-matched control group underwent identical testing. Potentially significant variables such as age, time from injury, and degree of rehabilitation as measured by thigh circumference and isokinetic testing of the knee were included in a multivariate analysis. Control subjects demonstrated virtually identical threshold values between their two knees, the mean variation being less than 2%. The test group, however, showed a significantly higher mean threshold value for the injured versus the noninjured knee (P less than 0.01), the mean variation being over 25%. Multivariate analysis demonstrated that changes recorded in the proprioception of the injured knee were attributable to the loss of the ACL rather than to other variables. Patients who have complete ACL tears and moderate to severe rotatory instability may also experience a decline in proprioceptive function of their knee.

Adult↗
PubMedDate not supplied

The effect of elastic bandages on human knee proprioception in the uninjured population.

Elastic bandages are often used to treat musculoskeletal disorders, even though there is little scientific evidence currently to support this generalized practice. We tested the hypothesis that elastic bandages improve proprioception of the bandaged joint during their use, and that this benefit was more than temporary. The uninjured human knee was used as a model. Fifty-four volunteers (54 knees), aged 22 to 40 years, were asked to identify a prior set joint angle as their knee was passively extended. Each knee was tested without the elastic bandage, immediately after bandage application, after 1 hour of bandage wear, and finally after removal of the bandage. Results showed that elastic bandages significantly improved knee joint proprioception in the uninjured knee during the entire interval of their use (mean decrease in inaccuracy of 1.0 degree, equivalent to 25% improvement, P < 0.05), and that this benefit was lost when the bandage was removed. The magnitude of the improvement, or the potential beneficial effect of the bandage, was inversely related to the participant's inherent knee proprioceptive ability, which was demonstrated in the test group before the initial application of the bandage.

Adult↗
PubMed2005

Proprioception and palisade endings in extraocular eye muscles.

Palisade endings occur only in extraocular muscles, and their function is unknown. They form a cuff of nerve terminals around the tips of muscle fibers. We describe here the advantages of using antibodies to a synaptosomal-associated protein (SNAP-25) to study properties of palisade endings in man, monkey, and rat. The stain can be combined readily with other immunofluorescence procedures, and results suggest that the synapses of palisade endings do not bind alpha-bungarotoxin (i.e., are not motor), nor do they contain substance P. These double-labeling data support the hypothesis that palisade endings are non-nociceptive sensory receptors, and could serve a proprioceptive function. With SNAP-25 immunolabeling, palisade endings were identified in the rat for the first time. Thus, palisade endings appear to be present in all vertebrate extraocular muscles studied to date. Their apparent universality, which contrasts with the more variable manifestation of extraocular muscle spindles and Golgi tendon organs, would be expected if proprioceptive feedback is necessary to the function of the ocular motor system, and if palisade endings are the critical proprioceptive structure.

Animals↗
PubMed2002

Effects of vibration in inline skating on the Hoffmann reflex, force, and proprioception.

PURPOSE: The objective of this study was to examine the effects of vibrations induced by inline skating on the Hoffmann (H) reflex, maximal voluntary isometric (MVC) force, and ankle proprioception. METHODS: Accelerometers were used to measure the frequencies and amplitudes of the vibrations encountered at the skate and mid-tibia levels. The soleus H reflex was recorded before and after (for 30 min) inline skating for 30 min. Maximal plantarflexor contractions were performed against a strain gauge while EMG was recorded from the soleus and medial gastrocnemius muscles. An ankle position-matching test was carried out to measure proprioception at the ankle. A Modified Borg Scale was used to obtain the appreciation of leg numbness and fatigue during inline skating. RESULTS: The vibrations measured at the skate chassis level had a mean frequency of 141.8 +/- 25.2 Hz and an amplitude of </=5 g. These vibrations were transmitted to the lower limb as measured by a mean frequency of 34.4 +/- 27.7 Hz and an amplitude of </=2 g at the mid-tibia level. The results demonstrate a clear inhibition ( approximately 35%) of the H reflex after skating that persisted for >35 min after skating. A 10% drop in MVC plantarflexor force was observed after inline skating. There was no accompanying change in EMG signal parameters. The ankle proprioception of the subjects decreased after skating, resulting in reproduction errors twice as large as before skating. CONCLUSION: Vibrations encountered during inline skating resulted in modifications of neuromotor functions related to the muscle spindles' primary afferent. These changes may partially be explained by presynaptic inhibition; however, a more plausible mechanism may be a decrease in the Ia afferent transmission induced by the vibration.

Acceleration↗
PubMed1999

Detailed analysis of proprioception in normal and ACL-deficient knees.

We assessed proprioception using threshold levels for the perception of knee movement at slow angular velocities (0.1 degrees/s to 0.85 degrees/s) in 20 patients with unilateral tears of the anterior cruciate ligament (ACL) and 15 age-related control subjects. Failure to detect movement was also analysed. The threshold levels of detection did not differ between the damaged and undamaged knees in the patients or between the patients and the control group. Failure to appreciate movement, however, was significantly greater in knees with ACL loss compared with the undamaged knees of patients and the control group. Our findings show a proprioceptive deficit in the absence of the ACL. Measurements of threshold levels of detection of passive movement alone are not suitable for the evaluation of proprioceptive loss in ACL deficiency; assessment of failure to appreciate movement is essential.

Adult↗
PubMed2004

Enhanced accuracy in novel mirror drawing after repetitive transcranial magnetic stimulation-induced proprioceptive deafferentation.

When performing visually guided actions under conditions of perturbed visual feedback, e.g., in a mirror or a video camera, there is a spatial conflict between visual and proprioceptive information. Recent studies have shown that subjects without proprioception avoid this conflict and show a performance benefit. In this study, we tested whether deafferentation induced by repetitive transcranial magnetic stimulation (rTMS) can improve mirror tracing skills in normal subjects. Hand trajectory error during novel mirror drawing was compared across two groups of subjects that received either 1 Hz rTMS over the somatosensory cortex contralateral to the hand or sham stimulation. Mirror tracing was more accurate after rTMS than after sham stimulation. Using a position-matching task, we confirmed that rTMS reduced proprioceptive acuity and that this reduction was largest when the coil was placed at an anterior parietal site. It is thus possible, with rTMS, to enhance motor performance in tasks involving a visuoproprioceptive conflict, presumably by reducing the excitability of somatosensory cortical areas that contribute to the sense of hand position.

Adolescent↗
PubMed2005

Central suppression of regenerated proprioceptive afferents.

Long after a cut peripheral nerve reinnervates muscle and restores force production in adult cats, the muscle does not respond reflexively to stretch. Motivated by the likelihood that stretch areflexia is related to problems with sensing and controlling limb position after peripheral neuropathies, we sought to determine the underlying mechanism. Electrophysiological and morphological measurements were made in anesthetized rats having one of the nerves to the triceps surae muscles either untreated or cut and immediately rejoined surgically many months earlier. First, it was established that reinnervated muscles failed to generate stretch reflexes, extending observations of areflexia to a second species. Next, multiple elements in the sensorimotor circuit of the stretch reflex were examined in both the PNS and CNS. Encoding of muscle stretch by regenerated proprioceptive afferents was remarkably similar to normal, although we observed some expected abnormalities, e.g., increased length threshold. However, the robust stretch-evoked sensory response that arrived concurrently at the CNS in multiple proprioceptive afferents produced synaptic responses that were either smaller than normal or undetectable. Muscle stretch failed to evoke detectable synaptic responses in 13 of 22 motoneurons, although electrical stimulation generated monosynaptic excitatory postsynaptic potentials that were indistinguishable from normal. The ineffectiveness of muscle stretch was not attributable therefore to dysfunction at synapses made between regenerated Ia afferents and motoneurons. Among multiple candidate mechanisms, we suggest that centrally controlled neural circuits may actively suppress the sensory information encoded by regenerated proprioceptive afferents to prevent recovery of the stretch reflex.

Afferent Pathways↗
PubMedDate not supplied

The effects of static friction and backlash on extended physiological proprioception control of a powered prosthesis.

In general, externally powered prostheses do not provide proprioceptive feedback and thus require the user to rely on cognitively expensive visual feedback to effectively control the prosthesis. Applying the concept of extended physiological proprioception (EPP) to externally powered prostheses provides direct feedback to the user's proprioceptive system regarding the position, velocity, and forces applied to the prosthesis. However, electric elbows with EPP controllers developed at the Northwestern University Prosthetics Research Laboratory have exhibited unexplained "jerky" behavior in both clinical fittings and bench-top operation. In addition, the development of limit cycles, a specific type of constant-amplitude oscillation, had been observed in bench-top use of these elbows. Backlash and static friction within the EPP system were found to be primarily responsible for the development of limit cycles. Reducing static friction and backlash improved the system's performance. These results suggest that to most effectively implement EPP, prosthesis manufacturers should design prosthetic components that minimize static friction and backlash.

Arm↗
PubMedDate not supplied

[Influence of proprioceptive training in the improvement of neuromuscular performance after ACL reconstruction].

ACL injury leads to a decrease in proprioceptive abilities, which can be improved with ACL surgery and postoperative rehabilitation. The goal of our study was to investigate whether the impact of coordinative training can be differentiated from the influence of surgery on proprioceptive improvement, and whether there is a correlation between improvement in coordinative abilities and other objective parameters of functional recovery. This follow-up study included 45 patients who had undergone ACL reconstruction and who were randomised into a conservative (TH-C) and an intensive (TH-I) rehabilitation group. In the TH-I group, coordinative training began earlier due to unrestricted weight-bearing. The groups were first compared preoperatively, then postoperatively, after 6 weeks, 4, 6, 9, and 12 months via the single leg stance test, the one leg hop test, the Lysholm knee score, and the Tegner score. A faster recovery of coordinative skills was registered in the TH-I group. Already after 6 weeks, highly statistically significant progress in one leg stance abilities was noticed, while in the TH-C group the same was not noticed until 4 months after surgery (p < 0.01). Such a result speaks for the distinct influence of proprioceptive training on coordinative abilities. Also, a highly statistically significant correlation was noticed between the single leg stance, one leg hop, Lysholm, and Tegner tests (p < 0.01), which points out the importance of a good rehabilitation programme, since neuromuscular performance cannot be separated from other parameters of functional recovery.

Adult↗
PubMed1989

Performance of the vertical position in synchronized swimming as a function of skill, proprioceptive and visual feedback.

This experiment assessed the efficacy of proprioceptive and visual information for the performance of "vertical position" by synchronized swimmers. Three skill groups of 5 senior, 5 intermediate, and 5 novice synchronized swimmers performed 40 vertical positions under four conditions. The conditions were: self-initiated with and without vision, and following experimenter perturbation, with and without vision. The dependent measure was degrees of error from true vertical. Analysis indicated that either proprioception or proprioception and vision may be used in performing vertical positions. A significant main effect was found among skill groups.

Adolescent↗
PubMed1993

Proprioceptive responses under rising and falling BACs: a test of the Mellanby effect.

This study examined proprioceptive responses under equivalent rising and falling blood alcohol concentrations (BAC), using a repeated-measures design. Seven volunteer subjects, 21 to 35 years of age, participated in the study. After alcohol consumption, BAC readings were obtained every 5 minutes, and the proprioceptive responses were measured at the following BAC levels (in %): 0 (baseline), rising 0.05, 0.075, 0.1, falling 0.075, and 0.05. The analysis focused on the comparisons of these measures at the equivalent rising and falling 0.05% and at the 0.075% BACs. Results showed that the proprioceptive response was less accurate during the rising than the falling BACs.

Adolescent↗
PubMed2001

Effect of fatigue on knee proprioception: implications for dynamic stabilization.

The high incidence of injuries that occur later during a session of sports or recreational activities suggests that fatigue may contribute to altered neuromuscular control of the lower limb and an individual's subsequent altered ability to dynamically stabilize the knee joint. One possible mechanism is a fatigue-mediated alteration in proprioception. This paper reviews experimental evidence of fatigue-induced changes in knee joint position sense and movement sense, or kinesthesia. We will discuss the possible physiological mechanisms behind these changes, including the role of joint and muscle receptors in proprioception and neuromuscular control of the knee, and the role of fatigue in changes in afferent output from muscle and joint receptors. We will then explore the implications that alteration in proprioception may have for dynamic stabilization of the knee joint.

Afferent Pathways↗
PubMedDate not supplied

Plasticity of compensatory eye movements in rotatory tests. II. The effect of voluntary, visual, imaginary, auditory and proprioceptive mechanisms.

Two groups of 10 healthy volunteers each with a mean age of 28 years (17-39) were tested in low-frequency rotatory experiments (sinusoidal harmonic acceleration, SHA), at frequencies of 0.01-0.32 Hz. The purpose was to ascertain whether voluntary enhancement and reduction of gain and phase occurred with voluntary performances. The different tests were alertness in darkness, stationary and moving targets, imaginary stationary and moving targets in darkness, proprioceptive moving targets and acoustic stationary and moving targets. Alertness tests in darkness demonstrated a gain increase (0.5-0.7) at 0.01-0.32 Hz, and a decreasing phase lead (40-2 degrees) with increasing frequency. The alertness tests served as a reference for the other tests. In tests with stationary targets, the gain reached unity and the phase was almost 0 degrees. In imaginary stationary target tests, gain and phase were significantly increased compared with alertness. Stationary acoustic targets in darkness significantly enhanced the gain. An increased phase lead was also found. In visual suppression tests (moving target), the gain was near 0. In imaginary moving target tests, the gain decreased significantly. In darkness the gain was significantly more depressed with a proprioceptive moving target than during imaginary moving target. Testing with proprioceptive + acoustic moving target in darkness, displayed an additional gain depression and negative phase at 0.08 Hz. The conclusion is that the influence of non-vestibular mechanisms substantially affects low frequency sinusoidal rotatory testing.

Acoustic Stimulation↗
PubMed2000

Spectral analysis of adult dancers' sways: sex and interaction vision-proprioception.

In subjects of both sexes with or without dance training, dependence on vision and proprioception for postural control was studied by destabilizing these cues on a free seesaw. Fast Fourier transform processing allowed spectral frequency analysis of the platform sways recorded by an accelerometer. Two frequency bands of the total spectral energy were used: the lower (0 - 2 Hz) and the higher (2 - 20 Hz) frequency bands. Dancers were significantly less dependent on vision but use more proprioception than untrained subjects. Professional dance training appears to shift sensorimotor dominance from vision to proprioception, and this evolution seems more marked for males than females. Female and male dancers had similar dynamic performances, but for males, the better neuromuscular coordination may be associated with biomechanical factors.

Adult↗
PubMed1998

Function after anterior cruciate ligament injuries. Influence of visual control and proprioception.

Information about limb positions and movements consists of input from visual, vestibular, cutaneous, muscular, tendinous and joint receptors, but the relative contribution from each type and location of receptors is not known. The aim of this study was: a) to measure the contribution from visual control on extremity function, as measured with a one-leg hop test in healthy persons, in patients with an asymptomatic ACL injury, after non-operative treatment and in patients with a stable knee after an ACL reconstruction, b) to investigate if there was any relation between proprioception from the extremity, as measured with the threshold for detecting passive motion of the knee, and the one-leg hop test with a gradual decrease in visual control. There was a decrease in hop-length when the subjects were deprived of visual control that was significant when the dominant eye or both eyes were blinded, both in the 2 patient groups and the reference population. The magnitude of the length reduction did not differ between the groups or between injured and healthy limbs. In all 4 threshold tests performed as a measure of peripheral proprioception, a stronger relation to hop-length was recorded for the blinded hop than with full visual control in the patients with nonoperated ACL injuries. The coefficients of correlation between hop-length and the proprioceptive recordings in the injured limb were of the same magnitude as on the healthy side.

Adult↗