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PubMed2004

Neck proprioception and spatial orientation in cervical dystonia.

Neck muscle vibration is known to influence body orientation and posture during locomotion and stance in normal subjects. To verify the hypothesis that neck proprioceptive input can be misinterpreted in patients with cervical dystonia (CD), lateral continuous vibration was applied to the sternocleidomastoid muscle during both stepping-in-place and quiet stance, with eyes closed. The orienting responses of CD patients were compared with those of normal subjects. Vibration effects on body orientation during stepping and stance were apparently different from normal, since no effects were seen when all patients' data collapsed were analysed. However, while some patients did not respond to vibratory stimuli regardless of the vibrated side, others had a 'good' side, the stimulation of which produced effects on body orientation similar to those observed in normal subjects. Homogeneous groups within the patient population were identified, based on the vibration-induced responses under stepping conditions. The different orienting or postural responses observed in CD patients were correlated with disease-related features such as spontaneous head position, maximum range of voluntary head yaw, presence or absence of a botulinum toxin treatment and disease duration. Our data suggest that, in CD patients, the reference system used in the control of body orientation in space is either refractory to the lateralized proprioceptive neck input or modified such that the input from both sides produces an orientation shift in the same sense. This would depend on the pathogenesis of the disease or on an adaptive process connected to the head abnormal posture. It seems that this refractoriness spreads to both sides of the neck with the advancement of the disease, thereby possibly entraining a progressive shift from a reference system based on the head to a more reliable egocentric reference.

Adult↗
PubMed1981

Contralateral effects of upper extremity proprioceptive neuromuscular facilitation patterns.

Electromyography was used to determine the presence of electrical activity in the nonexercised latissimus dorsi, infraspinatus, and pectoralis major muscles while the contralateral limb underwent the proprioceptive neuromuscular facilitation pattern of flexion, abduction, external rotation with elbow straight and extension, adduction, internal rotation with elbow straight. Activity was present in all of these muscles during both components of the pattern. There was no significant difference in activity for the pectoralis major muscle during the flexor as compared to extensor component. The infraspinatus was more active during the flexor component, while the latissimus dorsi was more active during the extensor component. These results could be used in planning a treatment program for patients who are unable to exercise one of their upper extremities and who could benefit from the contralateral effects of upper extremity proprioceptive neuromuscular facilitation patterns.

Adult↗
PubMed1991

Depression of Hoffmann reflexes following voluntary contraction and implications for proprioceptive neuromuscular facilitation therapy.

Postcontraction depression of Hoffmann-reflex (H-reflex) amplitudes was examined to study the rationale underlying proprioceptive neuromuscular facilitation relaxation techniques. The time course of H-reflex amplitude depression was used to assess postcontraction changes in motoneuron reflex excitability. Sixteen healthy female subjects performed voluntary isometric plantar-flexion contractions (65%-75% of maximal voluntary contraction) in a prone position. H-reflex stimulation began at a postcontraction delay of 0.05, 0.1, 0.5, 1, or 5 seconds and continued every 10 seconds for 1 minute. Reflexes were depressed (mean = 67% decrease) by 0.05 second postcontraction, reached maximal depression (mean = 83.3% decrease) from 0.1 to 1 second postcontraction, recovered to 70% of control amplitudes (mean = 30% decrease) by 5 seconds postcontraction, and reached 90% control amplitudes (mean = 10% decrease) by 10.05 seconds postcontraction. The results indicate that proprioceptive neuromuscular facilitation techniques (eg, hold-relax) purported to produce a phase of relaxation following voluntary contraction do appear to produce a strong, but brief, neuromuscular inhibition that may be clinically useful for applying stretch.

Adult↗
PubMed1994

Impaired proprioceptive acuity at the proximal interphalangeal joint in patients with the hypermobility syndrome.

Twelve patients with the hypermobility syndrome (> or = 4 on the Beighton score) were examined to establish whether they showed any impairment of proprioception. A position matching paradigm was used which required subjects to align a finger silhouette with the kinaesthetically perceived position of their hidden index finger. Position sense at the PIP joint was found to be significantly (P < 0.0001) impaired in hypermobile patients who made larger matching errors at all angles compared to age- and sex-matched controls. The patients also demonstrated biasing in the direction of errors made when the PIP joint was positioned +/- 20 degrees away from the mid-position. These patients perceived the PIP joint to be less displaced towards the extremes of the range of movement than it really was. The mechanism underlying this impairment of proprioception remains speculative and it is not clear whether this disturbance is a cause or an effect of the hypermobility syndrome.

Adult↗
PubMed1996

Extraocular proprioception is required for spatial localization in man.

We studied the effect of extraocular muscle deafferentation on the performance of manual pointing to foveated visual targets at different craniotopic locations. Five patients who underwent unilateral thermocoagulation of the trigeminal nerve (V) for trigeminal neuralgia were tested before and after surgery. Only the group of patients with postsurgical corneal anaesthesia, attesting to involvement of the ophthalmic branch (which carries the ocular proprioceptive fibres), presented deficits in accuracy of pointing. The position of initial and final pointing was shifted toward the lesioned side predominantly in the ipsilateral hemispace. These data support a model in which balanced ocular proprioceptive inputs are required for accuracy of visually guided movements in egocentric space.

Afferent Pathways↗
PubMed1998

Proprioception acts as the main source of input in human S-I activation experiments: a functional MRI study.

During tactile exploration cells in human somatosensory cortex S-I receive input from skin receptors and from proprioceptive feedback. To study the extent to which these sources contribute to cell activation we used functional magnetic resonance imaging (fMRI) in order to visualize the spatial extent and amplitude of activation in S-I during active finger movement and passive stimulation of finger tips. In all subjects (n = 6) we measured activation elicited by unilateral single finger tapping (active task) and mechanical stimulation of the palm of the index finger (passive task). In the finger tapping condition all subjects showed a strict contralateral activation of somatosensory cortex S-I and motor cortex M-I. In the passive stimulation experiment we found activation of the contralateral somatosensory cortex S-I only. Although subjects were trained to perform the finger movement with the same frequency and pressure in comparison to the passive stimulation, the activation within S-I induced by finger movements was always significantly larger than that induced by passive stimulation. This result implies that activation of somatosensory cortex originates to a large extent from proprioception while tactile input plays a minor role in S-I excitation.

Adult↗
PubMedDate not supplied

Proprioceptive function in knees with and without total knee arthroplasty.

The goal of this study was to evaluate the differences in angle reproduction capability after nonconstrained posterior cruciate ligament retaining total knee arthroplasty after a follow-up time of 63.9 months compared with the healthy contralateral leg and a control group. In 28 total knee arthroplasty patients (mean age, 65.7 yr) and 25 control subjects (mean age, 55.7 yr), 16 measurements were made between 0 degrees and 90 degrees in 30 degree steps. The leg was positioned by the examiner and then relaxed; afterward, the subject was asked to reproduce the original position. Each measurement was made with the patient or control being blindfolded and not blindfolded to assess the influence of visual control. We found significant differences in total knee arthroplasty patients in contrast to healthy subjects. Without visual control, the mean deviation of the total knee arthroplasty group starting with a 0 degree angle was 7.7+/-5.9 degrees and 4.6+/-4.7 degrees for the healthy subjects. With visual control, the mean deviation in the patient group was 11+/-7.5 degrees, and in the control group, it was 7.2+/-5.0 degrees. Total knee arthroplasty patients did not show significant differences between the operated on and the contralateral knee. Also, in the total knee arthroplasty group, significant differences could not be found comparing reproduction with and without visual control and comparing both starting positions. In the control group, significant differences could be found comparing visual and nonvisual control in the 60 degree angle. The comparison between the 30 and 60 degree repositioning from both 0 and 90 degree starting positions showed a significant difference in the 60 degree angle. In summary, reduced proprioceptive capabilities are present after knee arthroplasty in both the operated on and the contralateral leg in our study group. Postoperative complaints can perhaps be explained by a loss of proprioceptive capabilities, especially at the 60 degree angle. The operative technique should involve special care of ligaments and muscles to preserve stability and receptors as well. Rehabilitation should pay more attention to the remaining receptors.

Aged↗
PubMed1982

Proprioception in schizophrenia.

B. Ritzler (J. Abnorm. Psychol., 86: 501-504, 1977) failed to replicate previous weight-lifting studies showing a proprioceptive deficit in schizophrenics. However, Ritzler did not use the same standard weights that the previous studies employed. Could this difference in procedure have caused his failure to replicate? Two experiments were completed to provide additional information about this question and related issues. In Experiment I, chronic hospitalized schizophrenics and normals were tested with light and heavy weights. Rosenbaum's original modified method of limits and the method of constant stimuli were utilized. Both methods provided comparable results, which, like Ritzler's data, failed to show a differential impairment in the discrimination of the light weights for paranoid schizophrenics. In Experiment II, outpatient paranoid schizophrenics, outpatient nonparanoid schizophrenics, outpatient psychiatric patients, and aged normals were evaluated utilizing the same psychophysical procedure and standard weights employed in the original studies. No differential impairment was found for the light weights for any group. These results provide strong support for Ritzler's position that a proprioceptive deficit is not unique to schizophrenia.

Adult↗
PubMed1996

Proprioceptive mechanisms in the cruciate ligaments: an electromyographic study on reflex activity in the thigh muscles.

The hypothesis of a proprioceptive mechanism arising from mechanoreceptors in the cruciate ligaments and with efferences to the thigh muscles is investigated in an animal model. Electromyographic (EMG) studies of the quadriceps and hamstrings muscles were performed in six sheep anesthetized by intravenous injection of chloralose on applying static and dynamic shear forces to isolated fascicle bundles in the anterior (ACL) and posterior (PCL) cruciate ligaments at 200 to 500 N and 50 to 200 N/sec, respectively. With the help of an external fixator, the knee joint position was varied at 25 to 150 degrees. The relative preload of the anteromedial and posterolateral fascicles in the ACL and the anterior and posterior fascicles in the PCL induced by variation of the joint angle was measured with the help of strain gages. By static and dynamic loading of the anteromedial group of the ACL, EMG activity in the hamstrings increases significantly to 159 +/- 22 and 257 +/- 46 microV seconds, respectively (p < 0.001), with a simultaneous suppression of the quadriceps activity. Static and dynamic loading of the posterolateral ACL group results in a significant excitation of the quadriceps with mean potentials of 142 +/- 29 and 173 +/- 23 microV seconds, respectively (p < 0.001). Mechanical shear applied both to the anterior and posterior fascicles of the PCL induces a significant activation of the ipsilateral quadriceps muscles with a simultaneous inhibition of the hamstrings (p < 0.001). The quality of mechanical loading, i.e., static or dynamic shear, determines the degree of muscular recruitment significantly (p < 0.01). The joint angle contributes to a modulation in the quantitative EMG excitation. Linear regression analysis of the integrated EMG potential values and the amount of passive preload induced by the respective joint position results in a close correlation (r = + 0.78 to + 0.86). The results lead to the conclusion that a proprioceptive mechanism exists that arises from the cruciate ligaments and influences the tone in the thigh muscles. The degree of muscle excitation on mechanical ligament loading is modulated by the amount of preload in the ACL and PCL and the quality of load applied.

Animals↗
PubMed2001

A multi-station proprioceptive exercise program in patients with ankle instability.

PURPOSE: The aim of the present study was to investigate the effects of a 6-wk multi-station proprioceptive exercise program that is easy to integrate in normal training programs. METHODS: Patients with chronic ankle instability were used, and results of three testing procedures before and afterward were compared: joint position sense, postural sway, and muscle reaction times to sudden inversion events on a tilting platform. A total of 30 subjects with 48 unstable feet were evaluated (exercise group: N = 31; control group: N = 17). RESULTS: In the exercise group, the results showed a significant improvement in joint position sense and postural sway as well as significant changes in muscle reaction times. CONCLUSION: Based on the present results, a multi-station proprioceptive exercise program can be recommended for prevention and rehabilitation of recurrent ankle inversion injuries.

Adult↗
PubMedDate not supplied

Proprioceptive function in children with adolescent idiopathic scoliosis.

Recent studies in Japan and in Sweden have suggested that a disturbance of postural equilibrium exists in idiopathic scoliosis. Proprioceptive function is one of the factors involved, and therefore a study of proprioception in patients with adolescent idiopathic scoliosis (AIS) was carried out. No difference was noted in joint position sense and in fine motor control between 24 scoliotics and matched controls taken from a group of 70 normal children of the same age group. Blindfold weight discrimination, a test of muscle spindle and tendon stretch receptor function, also showed no abnormality in scoliotic children. The Charpentier test, thought to be a test of control of muscle spindle function, showed a tendency to an infantile response in patients with adolescent idiopathic scoliosis, while the control subjects showed a normal size-weight response.l This suggests that the muscle spindle system may be at fault in AIS and supports the suggestion that postural equilibrium reactions may be abnormal in this disease.

Adolescent↗
PubMed2002

The neuroanatomical basis of oculomotor disorders: the dual motor control of extraocular muscles and its possible role in proprioception.

Current investigations show that two separate sets of motoneurons control the extraocular eye muscles, and that is there is a dual final common pathway. We propose that one set of motoneurons are the major source of tension generating eye movements, whereas the other may participate in a proprioceptive system concerned more with the exact alignment and stabilization of the eyes. In this article we discuss the structures that may participate in the proprioceptive circuits; and consider several recent publications in the light of this sensory feedback hypothesis, emphasizing the relevance to eye movement disorders.

Animals↗
PubMed2004

Effect of neuromuscular training on proprioception, balance, muscle strength, and lower limb function in female team handball players.

OBJECTIVE: Introduction of a neuromuscular training program will increase muscle strength, balance, and proprioception in elite female handball players. DESIGN: Prospective intervention study. PARTICIPANTS: Thirty-five female team handball players from 2 teams in the elite division participated. Their mean age was 23 (+/-2.5) years, and their mean weight was 69.2 (+/-7.3) kg. They had played handball for 14.9 (+/-3.2) years, 4.7 (+/-2.8) years at the top level. The total number of training hours per week was 10 to 11. INTERVENTION: Based on earlier studies and knowledge about common risk situations in team handball, an anterior cruciate ligament (ACL) injury prevention program with 3 different sets of exercises was developed, each set with a 5-step progression from simple to more challenging exercises. The teams were instructed to use the program a minimum of 3 times a week during a training period of 5 to 7 weeks, and then once a week during the season. The duration of each training session was approximately 15 minutes. MAIN OUTCOME MEASURES: Balance (KAT 2000), proprioception (threshold to detection of passive motion), muscle strength (Cybex 6000), and 3 functional knee tests. The players were tested pretraining (test 1) and 8 weeks (test 2) and 12 months (test 3) after the training started. RESULTS: There was a significant improvement in dynamic balance between test 1 and test 2, with a balance index (BI) of 924 (+/-225) and 778 (+/-174), respectively (P = 0.01). The effect on dynamic balance was maintained 1 year after training (BI, 730 +/- 156). For static balance, no statistically significant changes were found. For the other variables measured, there were no statistical differences during the study period. CONCLUSION: The ACL injury prevention training program improved dynamic balance in an elite team handball players.

Adult↗
PubMed2005

Proprioception and rotation range sensitization associated with subclinical neck pain.

STUDY DESIGN: Cross-sectional study. OBJECTIVE: To investigate neck proprioception, range of motion, muscle endurance, and self report of pain and disability in patients with subclinical neck pain. SUMMARY OF BACKGROUND DATA: Untreated (i.e., subclinical) neck pain represents a category intermediate between "no pain" and "treated (i.e., clinical) pain." Therefore, the features that characterize it may be targeted for early management to prevent progression. METHODS: Eighty-one healthy Korean university student volunteers, aged between 18 and 30 years (mean age, 23.2 years), were measured for proprioceptive sensitivity to differences in the extent of midrange neck retraction and rotation movements using a device that was not attached to the head; neck range of motion (twice) using the cervical range of motion device; and neck muscle endurance using a modified Biering-Sorensen test. Finally, patients were asked about any recurrent neck pain and completed Korean translations of four commonly used neck pain and disability questionnaires. RESULTS: Patients were categorized into three frequency of neck pain groups: never/infrequent, monthly, or weekly. There were significant differences between these groups on the four self-report questionnaires. Neck muscle endurance was significantly lower for the groups reporting monthly and weekly pain compared with the never/infrequent group. At the second range of motion test, increased range was obtained for patients with infrequent or no neck pain, but left rotation range of motion was less on the second test (sensitization) for patients reporting monthly and weekly pain. Movement extent discrimination was best for the group with the greatest pain frequency. CONCLUSIONS: A history of subclinical neck pain is associated with lower neck muscle endurance capacity and with less rotation range of motion on second testing but when frequent (occurring weekly or more often) is associated with greater sensitivity in judging neck movement extent. Improving strength and rotation range should therefore be investigated as targets of treatment for subclinical neck pain.

Adolescent↗
PubMed2006

Reliability of a functional clinical test battery evaluating postural control, proprioception and trunk muscle activity.

OBJECTIVE: The purpose of this study was to examine the repeatability and reproducibility of the different tests of a clinical test battery evaluating the components of functional spinal stability: postural control (sway velocity data), proprioception (repositioning error), and muscle activation (electromyographic data). DESIGN: A total of 28 healthy volunteers participated in this study: 14 in the repeatability study and 14 in the reproducibility study. Each subject was tested three times, with an interval of 1 wk between the test sessions. The intraclass correlation coefficients and the standard error of the measurements as a percentage of the grand mean were calculated. RESULTS: The intraclass correlation coefficients for both the repeatability and the reproducibility evaluation showed good to excellent reliability for all variables (intraclass correlation coefficient, 0.60-0.98). The standard error of the measurements as a percentage of the grand mean ranged from 0.004 to 19.94. CONCLUSIONS: The functional clinical test battery investigated in this study proved to be a reliable tool in the assessment of healthy subjects. The evaluation of postural control, proprioception, and muscle activity (coordination, stabilization, maximal voluntary isometric contraction, endurance, and flexion-relaxation) showed good to excellent repeatability and reproducibility. Further analysis of the reliability of these variables in a clinical setting, particularly in patients with low back pain, seems appropriate.

Abdominal Muscles↗
PubMed2006

Updating of an internal model without proprioception: a deafferentation study.

This study sought to determine whether intact proprioception is required to adapt to a novel kinematic environment. We compared adaptation with a rotated visual feedback between a deafferented patient and healthy participants. They performed reaching movements towards visible targets while vision of the cursor was rotated by 30 degrees with respect to hand position. The patient adapted at the same rate and to the same extent as the controls when exposed to the rotated visual feedback. She also presented large aftereffects following removal of the perturbation. This suggests that proprioception is not an absolute requirement to update a kinematic internal model. Adaptation was likely mediated by a comparison between the sensory consequences of a movement as predicted by a forward model and the visual feedback from that movement.

Adaptation, Physiological↗
PubMed2003

Postural control adaptation during galvanic vestibular and vibratory proprioceptive stimulation.

The objective for this study was to investigate whether the adaptation of postural control was similar during galvanic vestibular stimulation and during vibratory proprioceptive stimulation of the calf muscles. Healthy subjects were tested during erect stance with eyes open or closed. An analysis method designed to consider the adaptive adjustments was used to evaluate the motion dynamics and the evoked changes of posture and stimulation response. Galvanic vestibular stimulation induced primarily lateral body movements and vibratory proprioceptive stimulation induced anteroposterior movements. The lateral body sway generated by the galvanic stimulation was proportionally smaller and contained more high-frequency movements (> 0.1 Hz) than the anteroposterior body sway induced by the vibratory stimulation. The adaptive adjustments of the body sway to the stimulation had similar time course and magnitude during galvanic and vibratory stimulation. The perturbations induced by stimulation were gradually reduced within the same time range (15-20 s) and both kinds of stimulation induced a body leaning whose direction was dependent on stimulus. The similarities in the adjustment patterns suggest that postural control operates in the same way independent of the receptor systems affected by the disturbance and irrespective of whether the motion responses were induced in a lateral or anteroposterior direction.

Adaptation, Physiological↗
PubMedDate not supplied

Visual-proprioceptive intermodal perception using point light displays.

Three experiments explored 5- and 7-month-old infants' intermodal coordination of proprioceptive information produced by leg movements, and visual movement information specifying these same motions. The visual information took the form of point light information for leg and feet movements, with visual displays presented in upright, ego-centered on-joint (Experiment 1, N = 48); upright, ego-centered off-joint (Experiment 2, N = 48); and inverted, observer-centered off-joint (Experiment 3, N = 48) orientations. Measures of preferential looking indicated intermodal perception in infants of both ages while seeing on-joint, ego-centered orientations, and for 7-month-olds (and possibly 5-month-olds) while seeing off-joint, ego-centered displays; neither age group demonstrated intermodal perception for off-joint, observer-centered displays. These results suggest that coordination of visual and proprioceptive inputs is constrained by infants' information processing of the displays, and have implications for infants' growing understanding of their self-movement and the development of knowledge of the self.

Concept Formation↗