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Active versus passive touch: factors influencing the transmission of somatosensory signals to primary somatosensory cortex.

Active and passive touch, respectively with and without voluntary movement on the part of the subject, are frequently reported to be equivalent in terms of the resultant perceptual abilities. This review reexamines the notion of perceptual equivalence in the light of growing evidence that the transmission of tactile inputs is diminished, or "gated," during the course of active movement. It is concluded that there is indeed gating of cutaneous inputs during active touch. In most experiments, the paradoxical observation of perceptual equivalence between active and passive touch can partly be explained by the choice of task, namely, tactile discriminations that depend on relative, and not absolute, differences in inputs. The surprising lack of evidence for any superiority of passive touch over active touch can likely be explained by several factors. First, performance with active touch may be enhanced by the motor strategy, e.g., by reducing the speed of movement at critical points, and so reducing the degree of gating, and (or) by optimally orienting the exploring digits so as to bring the most sensitive skin areas into contact with the object in question. Second, central influences, including attention and motor set, may be specifically activated during voluntary movement and contribute to enhancing performance during active touch. Thus, the gating influences associated with active touch may be offset, partly or wholly, by the combined influence of these factors to yield (near) perceptual equivalence for active and passive touch.

Animals↗

Therapeutic touch and the terminally ill: healing power through the hands.

I hope it has become apparent that the use of Therapeutic Touch can be a useful addition to more conventional hospice treatments. Also, it can be a very rewarding and fulfilling experience for the patient. It has been so for me. I feel extremely fortunate to have been given the opportunity of introducing Therapeutic Touch into the Allegheny Hospice, a program of Allegheny General Hospital in Pittsburgh, Pennsylvania. We are still in the early stages of implementation. Currently, we are initiating a research program to accomplish the following with respect to Therapeutic Touch: Demonstrate that Therapeutic Touch does, in fact, yield the same results when performed in a hospice setting as when performed in other settings established by prior research. Establish the degree to which drug levels can be reduced (if any) by the introduction of Therapeutic Touch into the treatment regimen and still maintain an acceptable level of pain control. Demonstrate that the quality of life can be improved for the patients and their families through the use of Therapeutic Touch over the current treatment methods not using Therapeutic Touch. Establish sufficient documentation for respective insurance providers to justify future payment for this treatment. It is envisioned that this program will be accomplished later this year. Our hospice organization is a very dynamic one, dedicated to bringing the best possible care to our patients. In addition to the aforementioned Therapeutic Touch research program, we have just embarked on another research effort to determine the advantages of using a "Low Pressure Air Mattress" to reduce the incidence and severity of skin breakdown. This has the potential to improve the quality of life not only of the patient but also of the care giver. In this day and age when many seem to have severely neglected the sick and elderly, there is a great opportunity for creative, compassionate people to become involved in hospice programs around the country. In so doing, you could render an invaluable service to your fellow, man, and, at the same time, achieve a deep sense of fulfillment. Anyone wishing to become involved in a hospice program or interested in learning Therapeutic Touch may contact me at Allegheny Hospice, a Allegheny Center, 6th floor, Pittsburgh, Pa., 15212.

Education, Nursing, Continuing↗

A computer touch-screen apparatus for training visual discriminations in rats.

We describe an operant conditioning apparatus that uses computerized touch-screen technology and is designed for the versatile and highly controlled testing of rats in a potentially wide variety of behavioral paradigms. Although computer-controlled touch-screen systems have been developed for use with pigeons, monkeys, and humans, analogous technologies and methods have not yet been developed for rats. The development of a touch-screen system for rats could enhance the efficiency of behavioral research with rats, and may offer a unique tool for studying animal learning. In the first test of the utility of the apparatus, 3 Sprague-Dawley rats learned to activate the touch screen only after the touch-screen panel was made slightly movable. These animals then learned to discriminate visual stimuli presented on the computer monitor, but only after the food magazine and pellet dispenser were moved to the rear of the chamber opposite the stimulus display and response window. In a test of the utility of the modified apparatus, 6 Long-Evans rats learned to activate the touch screen and learned one of three different simple discriminations using computer-generated, visually presented stimuli. A basic method for training rats to activate the computer touch screen and for visual discrimination training is described. Results show that rats learned to activate the touch screen and discriminate visual stimuli presented on a computer monitor. Potential applications and advantages of the touch-screen-equipped rat operant conditioning chamber are discussed.

Animals↗

Gender and culture differences in touching behavior.

The authors used gender and culture to examine the theory that touching behavior is an expression of dominance. Participants were 120 men and women from Italy, the Czech Republic, and the United States. The authors examined both hand touches and nonhand touches. For hand touches, there was a significant gender-by-culture interaction in that Czech men as a group touched more than any of the other groups. For nonhand touches, Czech and Italian women and Italian men as groups touched significantly more than any of the other groups. Taken in cultural context, these results seem to support the dominance theory for touches with the hand but not for nonhand touches. The authors discussed implications and future directions.

Adult↗

Massage therapy and therapeutic touch in children: state of the science.

OBJECTIVE: To review and critique the research on the effect of massage therapy and therapeutic touch in children, and to describe clinical implications and make suggestions for future study. DATA SOURCES: Studies were obtained through online computer searches of CINAHL, MEDLINE, PsychInfo, and SocioFile. Key words used were tactile, kinesthetic, massage therapy, touch, therapeutic touch, infants, and children. STUDY SELECTION, DATA EXTRACTION, AND SYNTHESIS: Fourteen massage therapy studies were selected because they met the following 3 criteria: investigated massage therapy in children; were published in refereed nursing, allied health, or infant and child development journals between 1969 and 1999; and were quantitative in nature. Studies were divided according to developmental age for analysis: neonates, preschool, and older children. Five therapeutic touch studies, 3 quantitative and 2 qualitative, were selected because they were the only empirical reports about the effect of therapeutic touch in children to date. In addition to critiques, the therapeutic touch studies were examined for the following 10 characteristics: study purpose/hypotheses, background/literature review, sample selection method, study design/random assignment, independent variable/length of treatment/control and confounders, dependent variables/measurements, outcomes, study limitations, and implications for future research. CONCLUSIONS: More research exists to support the use of massage therapy than therapeutic touch in children. A set of common findings across 2 decades of study suggests that massage therapy may be useful in the care of infants and children. Because massage therapy and therapeutic touch seem to elicit similar parasympathetic effects, therapeutic touch may be useful. There is insufficient evidence, however, to recommend its use in children without qualifications.

Adolescent↗

Patients' attitudes to comforting touch in family practice.

OBJECTIVE: To examine patients' attitudes to comforting touch in family practice. DESIGN: A survey was designed with statements and responses to proposed scenarios. SETTING: Twenty family practices throughout Ontario. PARTICIPANTS: Family practice patients; of 400 surveys distributed, 376 were completed (94% response rate). MAIN OUTCOME MEASURES: Patients responded to scenarios on a five-point Likert scale, ranging from strongly disagree to strongly agree. Results were analyzed using SPSS for DOS. RESULTS: Most patients in this population believed that touch can be comforting (66.3%) and healing (57.9%). Women were more accepting of comforting touch than men in all scenarios. Acceptance of comforting touch declined for both sexes as touch became proximal and more intimate. Men and women were more accepting of comforting touch from female doctors. Acceptance of all comforting touch declined markedly if a physician was unfamiliar to a patient, regardless of the physician's sex. CONCLUSION: Most patients surveyed believed touch is comforting and healing and viewed distal touches (on the hand and shoulder) as comforting.

Adolescent↗

The neural circuit for touch sensitivity in Caenorhabditis elegans.

The neural pathways for touch-induced movement in Caenorhabditis elegans contain six touch receptors, five pairs of interneurons, and 69 motor neurons. The synaptic relationships among these cells have been deduced from reconstructions from serial section electron micrographs, and the roles of the cells were assessed by examining the behavior of animals after selective killing of precursors of the cells by laser microsurgery. This analysis revealed that there are two pathways for touch-mediated movement for anterior touch (through the AVD and AVB interneurons) and a single pathway for posterior touch (via the PVC interneurons). The anterior touch circuitry changes in two ways as the animal matures. First, there is the formation of a neural network of touch cells as the three anterior touch cells become coupled by gap junctions. Second, there is the addition of the AVB pathway to the pre-existing AVD pathway. The touch cells also synapse onto many cells that are probably not involved in the generation of movement. Such synapses suggest that stimulation of these receptors may modify a number of behaviors.

Animals↗

[On compulsive hand-washing--psychopathology of "touching"].

Compulsive hand-washing has been well known to the psychiatrists, since Legrand du Saulle described this disorder by the name of "délire du toucher" (1866), which refers to mysophobia or contact-phobia. But its clinical significance seems to have been not fully examined, except from the psychoanalytical point of view, that has observed the repression of sexuality in its pathology. This report presents four cases of compulsive hand-washing, and explores why they exclusively wash their hands. In order to elucidate the reason for their hand-washing and its significance, this report aims to study the relation of following three elements; "Sexuality", "hand" and "touching". As the idioms using "hand" often represent the various modes of sexual life in Japanese language as well as in English, so the "touching by hand" is reasonably considered to evoke the sexual impulsions, which the hand-washers fear and wish to avoid. On the other hand, "touching" is, necessarily in nature, to be touched by the touched object. For example, one who touches the lover's hand is inevitably to be touched by hers. That is; one is forced to be an object of one's object, which becomes to be a subject. In this sense, the act of "touching" means to lose one's "being subject" and to melt oneself into the situation where the structural distinction of subject and object can disappear. So one's act of "touching" or vivid contact with the other can cause anxiety by means of losing one's ego, which may be also a critical point to introduce to create something new. A compulsive hand-washer fears and avoids this critical moment that can make him lose his "being subject", so he "washes his hands of (cuts off relation with)" the situation that can undermine his ego. This avoidance of having contact can be compared to "the lose of vivid contact with the reality (la perte du contact avec la réalité (Minkowski)" observed in schizophrenia. In their ways of life, many hand-washers are not less autistic than the schizophrenics.om

Adult↗

Predictive value of intraoperative touch preparation analysis of sentinel lymph nodes for axillary metastasis in breast cancer.

BACKGROUND: Accurate intraoperative diagnosis of axillary malignancy facilitates completion axillary lymph node dissection (ALND) at the time of initial surgery. The capability to address both the primary tumor and axillary disease in a single procedure offers several advantages. This study was designed to define the predictive value of intraoperative touch preparation analysis of sentinel lymph nodes for axillary metastasis in breast cancer and to evaluate the ability of the technique to facilitate accurate synchronous ALND. METHODS: A consecutive cohort of patients with breast cancer at an Army medical center underwent intraoperative touch preparation analysis of sentinel lymph nodes concordant with initial excision. Those found to have sentinel nodes positive by touch preparation analysis underwent ALND at the initial procedure. Patients with negative sentinel nodes by touch preparation analysis, but positive by final pathology, underwent subsequent ALND. Results of the touch preparation analysis were compared with the final pathology. RESULTS: Over a 16-month period, 71 consecutive patients with breast cancer underwent initial excision and touch preparation analysis of 162 sentinel lymph nodes. Final pathology confirmed axillary metastasis in 32% (23 of 71) of patients. Of these, intraoperative touch preparation analysis identified 48% (11 of 23). There were no false positives or unnecessary axillary dissections based upon touch preparation results. Per sentinel node, the positive predictive value was 100%, the sensitivity was 47%, and the specificity was 100%. On a per patient basis, the positive predictive value was 100%, and the sensitivity and specificity were 48% and 100%, respectively. CONCLUSIONS: Intraoperative touch preparation analysis is an effective adjunct to sentinel lymph node biopsy. In our series, it facilitated a definitive cancer operation at the time of initial surgery in nearly 50% of patients, and ensured that no patient underwent an unnecessary axillary dissection.

Adult↗

Genes regulating touch cell development in Caenorhabditis elegans.

To identify genes regulating the development of the six touch receptor neurons, we screened the F(2) progeny of mutated animals expressing an integrated mec-2::gfp transgene that is expressed mainly in these touch cells. From 2638 mutated haploid genomes, we obtained 11 mutations representing 11 genes that affected the production, migration, or outgrowth of the touch cells. Eight of these mutations were in known genes, and 2 defined new genes (mig-21 and vab-15). The mig-21 mutation is the first known to affect the asymmetry of the migrations of Q neuroblasts, the cells that give rise to two of the six touch cells. vab-15 is a msh-like homeobox gene that appears to be needed for the proper production of touch cell precursors, since vab-15 animals lacked the four more posterior touch cells. The remaining touch cells (the ALM cells) were present but mispositioned. A similar touch cell phenotype is produced by mutations in lin-32. A more severe phenotype; i.e., animals often lacked ALM cells, was seen in lin-32 vab-15 double mutants, suggesting that these genes acted redundantly in ALM differentiation. In addition to the touch cell abnormalities, vab-15 animals variably exhibit embryonic or larval lethality, cell degenerations, malformation of the posterior body, uncoordinated movement, and defective egg laying.

Alleles↗

The Caenorhabditis elegans spalt-like gene sem-4 restricts touch cell fate by repressing the selector Hox gene egl-5 and the effector gene mec-3.

Members of the spalt (sal) gene family encode zinc-finger proteins that are putative tumor suppressors and regulate anteroposterior (AP) patterning, cellular identity, and, possibly, cell cycle progression. The mechanism through which sal genes carry out these functions is unclear. The Caenorhabditis elegans sal gene sem-4 controls the fate of several different cell types, including neurons, muscle and hypodermis. Mutation of sem-4 transforms particular tail neurons into touch-neuron-like cells. In wild-type C. elegans, six touch receptor neurons mediate the response of the worm to gentle touch. All six touch neurons normally express the LIM homeobox gene mec-3. A subset, the two PLM cells, also express the Hox gene egl-5, an Abdominal-B homolog, which we find is required for correct mec-3 expression in these cells. The abnormal touch-neuron-like-cells in sem-4 animals express mec-3; we show that a subset also express egl-5. We report: (1) that ectopic expression of sem-4 in normal touch cells represses mec-3 expression and reduces touch cell function; (2) that egl-5 expression is required for both the fate of normal PLM touch neurons in wild-type animals and the fate of a subset of abnormal touch neurons in sem-4 animals, and (3) that SEM-4 specifically binds a shared motif in the mec-3 and egl-5 promoters that mediates repression of these genes in cells in the tail. We conclude that sem-4 represses egl-5 and mec-3 through direct interaction with regulatory sequences in the promoters of these genes, that sem-4 indirectly modulates mec-3 expression through its repression of egl-5 and that this negative regulation is required for proper determination of neuronal fates. We suggest that the mechanism and targets of regulation by sem-4 are conserved throughout the sal gene family: other sal genes might regulate patterning and cellular identity through direct repression of Hox selector genes and effector genes.

Animals↗

Intra-operative touch preparation cytology; does it have a role in re-excision lumpectomy?

OBJECTIVE: Breast carcinoma is the most frequently diagnosed malignancy in women of North America. The combination of breast conservation surgery and radiotherapy has become a standard of treatment for the majority of breast cancers. It is critical to obtain clear margins to minimize local recurrence. However, avoiding multiple re-excisions for margin clearance helps optimize cosmetic results in patients undergoing breast conservation surgery. Intra-operative touch preparation cytology (IOTPC) may decrease the need for multiple re-excisions and thereby improve cosmesis. The literature suggests that IOTPC can be useful in evaluation of margins. Klimberg et al. evaluated the touch preparation technique prospectively in 428 patients undergoing breast biopsy for undiagnosed breast masses. Margin evaluation was correct in 100% of the lesions and was used to re-excise the margins when touch prep results were positive. They reported a diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 100% for the touch prep technique. To the best of our knowledge, there has been no published data on the role of IOTPC for evaluation of margins in re-excision cases. This report describes our experience with IOTPC for margin assessment for re-excision partial mastectomy at Beth Israel Medical Center (BIMC). The purpose of this study is to determine whether IOTPC is reliable for evaluating margins in patients undergoing re-excision for involved or close margins. METHODS: A prospective study of 30 patients, who have undergone re-excision partial mastectomy for involved or close margins after breast conservation surgery with the use of IOTPC for margin assessment at BIMC was performed. The re-excision lumpectomy specimens were oriented by the surgeon intra-operatively and were submitted fresh to pathology for cytologic assessment. The touch prep method consisted of touching the corresponding margin onto the glass slide. The principle of this technique is that if cancer cells are present they will stick to the slide, while fat cells will not. A slide was prepared for each re-excision specimen. Air-dried samples were stained immediately using the Diff-Quik method and examined under the microscope by a cytopathologist. RESULTS: Thirty patients underwent re-excision lumpectomy for involved or close margins with touch preparation cytology for assessment of 68 margins. Twenty-six patients had invasive ductal carcinoma and/or ductal carcinoma in situ, three patients had invasive lobular carcinoma and the remaining one patient had a combination of invasive lobular and ductal carcinoma. There was a correlation between touch prep cytology and final pathology in 56/68 margins, which accounts for 82.4% of the cases. CONCLUSION: Intra-operative touch preparation cytology for assessment of margins in patients undergoing re-excision lumpectomy for involved or close margins has a sensitivity of 75%, specificity of 82.8%, positive predictive value of 21.4%, and negative predictive value of 98.2%. This high negative predictive value and a single false negative margin are quite significant. Therefore, based on our experience, IOTPC can be a useful tool for intra-operative assessment of margins for patients undergoing re-excision partial mastectomy.

Biopsy↗

Massage and touch for dementia.

BACKGROUND: Massage and touch have been suggested as a non-pharmacological alternative or supplement to other treatments offered in order to reduce or manage a range of conditions associated with dementia such as anxiety, agitated behaviour and depression. It has also been suggested that massage and touch may counteract cognitive decline. OBJECTIVES: To assess the effects of a range of massage and touch therapies on conditions associated with dementia, such as anxiety, agitated behaviour and depression, identify any adverse effects, and provide recommendations about future trials. SEARCH STRATEGY: We identified trials from a search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 12 July 2005 using the terms massage, reflexology, touch and shiatsu. This Register contains records from all major healthcare databases and many ongoing trials databases and is updated regularly. In addition, general and specific literature databases were searched and patient and therapist organizations contacted. SELECTION CRITERIA: Randomized controlled trials (RCTs) in which a massage or touch intervention was given to persons suffering from dementia of any type, compared with other treatments or no treatment, and in which effect parameters included measures of behavioural problems, caregiver burden, emotional distress or cognitive abilities, were eligible for inclusion. Furthermore, we employed a set of minimal methodological quality criteria as a selection filter. DATA COLLECTION AND ANALYSIS: We identified 34 references in the initial searches. Of these, seven were actual or possible RCTs, but only two were found to meet the requirements of the set of minimal methodological criteria. MAIN RESULTS: The very limited amount of reliable evidence available is in favour of massage and touch interventions for problems associated with dementia. However, this evidence addresses only two specific applications: hand massage for the immediate or short-term reduction of agitated behaviour, and the addition of touch to verbal encouragement to eat for the normalization of nutritional intake. The existing evidence does not support general conclusions about the effect or possible side effects of such interventions. No severe side effects were identified. AUTHORS' CONCLUSIONS: Massage and touch may serve as alternatives or complements to other therapies for the management of behavioural, emotional and perhaps other conditions associated with dementia. More research is needed, however, to provide definitive evidence about the benefits of these interventions.

Anxiety↗

Factors influencing the perception of touch by elderly nursing home residents and their health caregivers.

The purpose of this study was to examine which factors influence the perceptions of touch by elderly nursing home residents and their health caregivers. A random sample of residents (n = 100) and a convenience sample of health caregivers (n = 100) were selected from two nursing homes. The five variables of interest were as follows: staff status; type of touch; area of the body touched; resident's locus of control; and resident's functional level. Vignettes were developed from combinations of variables which described a touch interaction between a resident and caregiver. To determine the main effects of the five variables of interest, fractional factorial analyses of variance were performed. Resident's locus of control appeared to be the most influential factor affecting residents' and caregivers' perceptions of touch. Touch was experienced as positive when it was appropriate to the situation, did not impose greater intimacy than desired, and did not impart a condescending message. Negative touch situations often involved some procedure used in a manner considered "intimate" or when discrepant with the needs of the individual. A conceptual model of interpersonal touch is described and recommendations for further study are discussed.

Adult↗

Face touching in monkeys, apes and man evolutionary origins and cerebral asymmetry.

The evolution of face touching, i.e. the use of the hand to touch the individual's own face, was studied in monkeys, apes and man with the object of examining which hand is used and which part of the face is touched. Monkeys show little if any face touching. Gorillas, orang- utans and chimpanzees show face-touching comparable to man. Left-hand face touching was superior to right-hand touching for both apes and humans. One feature which distinguished humans from other apes was the frequency of chin touching, which is generally high for man. It has been suggested that emotions are expressed more intensely on the left side of the face and it was thought that the left hand is used by the right hemisphere as a special pointer to heighten the effect of this.

Animals↗

Use of differential display for the identification of touch-induced genes from an ethylene-insensitive Arabidopsis mutant and partial characterization of these genes.

Touch has been shown to affect plant growth and development and ethylene has been shown to have similar effects. However, the mechanisms responsible for touch-induced responses remain unclear. Differential display PCR was used to identify touch-regulated genes from 3-week-light-grown ethylene-insensitive etr1-3 Arabidopsis (Columbia ecotype) mutant plants. The differential display PCR screening process yielded 32 cDNA fragments. Subsequent screening of the 32 fragments using northern analysis yielded three touch-inducible clones (A8A, G5A and G7F). These three cDNA were then used to screen a cDNA library. A 1.2kb fragment for OPR3 was obtained from A8A screenings. This cDNA fragment encodes 12-oxophytodienoate-10, 11-reductase (OPR), an enzyme in the jasmonic acid biosynthetic pathway. OPR3 was found to be induced by touch, wounding, methyl jasmonate (MeJA), NaCl and CaCl(2) while ethylene and darkness had no effect. A 2kb cDNA encoding a calcium-dependent protein kinase (CDPK32) was obtained with G5A screenings. CDPK32 was shown to be induced by touch, wounding, NaCl and darkness while ethylene and MeJA had little or no effect. A 1.4kb cDNA encoding a novel protein was recovered from the cDNA library screenings with a G7F fragment. This cDNA had some sequence similarity to GDA1 and was designated GDL for GDA1-like cDNA. GDL was activated by touch, wounding, MeJA, NaCl and CaCl(2) while there was no induction with ethylene and darkness. Using differential display PCR we have successfully been able to identify three clones that are inducible by touch and not by ethylene.

Amino Acid Sequence↗

Localization of touch versus heat pain in the human hand: a dissociative effect of temporal parameters on discriminative capacity and decision strategy.

We studied the influence of temporal parameters on localization of monofilament-evoked touch versus thulium laser-induced and C fiber-mediated pain in human subjects. Stimuli were applied at interstimulus intervals (ISIs) varying from 1 to 9 s to determine discrimination between successive stimulus sites in the palmar skin. Localization threshold was about two times higher for heat pain than touch. The localization threshold for pain, but not touch, decreased with prolongation of the ISI from 1 to 7-9 s, and it remained higher for pain even at the ISI of 9 s. The response time was longer for pain than touch, and it increased with an increase in the ISI, independent of the modality. Discriminative capacity, as assessed by the receiver operating characteristics curve, was markedly better for touch than pain. The discriminative capacity decreased with an increase of the ISI, but only for touch. The results indicate that localization is more accurate for touch than pain. Temporal summation of C fiber-evoked pain contributes to the reduced accuracy of pain localization if the ISI is < or = 3 s. Additionally, temporal factors dissociatively influence the response strategy in the tactile versus pain localization task with the prolongation of the ISI from 1 to 9 s. Due to this strategy change, localization threshold for touch remains constant at prolonged ISIs, in spite of a decrease in discriminative capacity. In a cutaneous localization task, the subject's accuracy and response strategy vary with the modality and temporal parameters of sequential test stimulation.

Adult↗

Passive, active and intra-active (self) touch.

A series of experiments are described in which magnitude estimates of the perceived size of steel balls were made when the balls were actively rolled between the fingertip and several other body sites (thumb, thenar eminence, forearm). This movement, called scripting, involves actively moving an object by a touching surface over another surface of the body which is passively being touched. We define this active/passive activity as "intra-active touch" and the results show that the perceptual size of the balls is dependent upon the body part passively being activated. An additional series of experiments decoupled the actively generated and passively received tactile information by having subjects either perform the scripting on another individual's body site or by having the other individual roll the balls on the subject's various sites. The latter experiments showed that the passive body can contribute to the overall impression of the size of the balls, but only when the intra-active touching involved the glabrous skin of the hands. Intra-active touch between the active finger and the passively touched hairy skin of the forearm showed no effect of the touched surface on the perceived size of the balls. The results suggest that the mechanisms of intra-active touch are different when glabrous skin activates glabrous skin than when glabrous skin activates hairy skin.

Fingers↗