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Proprioceptive contributions to tactile identification of figures: dependence on figure size.

Studies on the recognition of objects or shapes explored by a hand or finger have concentrated on the relative merits of different methods of exploration--in particular, whether the exploring hand or finger is moved by the subject himself (active), is guided by an assistant (passive), or remains stationary with the shape being moved by an assistant (tactile). These factors, together with another variable--the size of the explored shape--were investigated in twelve normal adults whose task, without the aid of vision, was to explore and identify various shapes with the tip of the extended right index finger. Two series of shapes were used, a large (15 cm) and small (3 cm) series, both of which consisted of twelve shapes each being a variant of the letter 'S'. The shapes were outlined as rows of Braille-like dots on a flat surface. Exploration was also tested in the proprioceptive mode, in which the exploring hand was guided by an assistant around a shape which was simply drawn on the surface so as to give a minimum of tactile information. For neither large nor small shapes could we demonstrate differences between active, passive and proprioceptive exploration. For the small shapes, the active, passive and proprioceptive modes gave no advantage over purely tactile assessment. However, for the larger shapes, active, passive and proprioceptive modes allowed better identification than movement of the shape. Thus, purely cutaneous signals appear sufficient for optimal discrimination of small figures but proprioceptive signals, generated by movement, are needed for optimal discrimination of larger figures.

Humans↗

Human self-motion perception during translatory vestibular and proprioceptive stimulation.

Self-motion perception in space was studied in normal human subjects during passive vestibular stimulation (lateral translation of whole body in space), proprioceptive stimulation (of feet relative to trunk) and combinations thereof with the eyes closed. Stimulation was sinusoidal, +/- 10 cm, over a frequency range of 0.025-0.4 Hz. Vestibular self-motion perception became increasingly underestimated at low frequency, due to a rather high detection threshold. Proprioceptive stimulation at low frequency elicited a small self-motion illusion. During body translation relative to the stationary feet (vestibular-proprioceptive combination) the magnitude of perceived self-motion was constant across frequency and its threshold was low, as if determined by proprioception alone. Nevertheless, the results can be interpreted in terms of a vestibular-proprioceptive interaction, in analogy to previous findings for rotational stimuli.

Evoked Potentials, Somatosensory↗

Repetitive pointing to remembered proprioceptive targets improves 3D hand positioning accuracy.

Repetitive pointing movements to remembered proprioceptive targets were investigated to determine whether dynamic proprioception could be used to modify the initial sensorimotor conditions associated with an active definition of the target position. Twelve blindfolded subjects used proprioception to reproduce a self-selected target position as accurately as possible. Ten repetitions for each limb were completed using overhead and scapular plane pointing tasks. A 3D optical tracking system determined hand trajectory start and endpoint positions for each repetition. These positions quantified three-dimensional pointing errors relative to the target position and the initial and preceding movement repetitions, as well as changes in movement direction and extent. Target position and cumulative start position errors were significantly greater than the corresponding preceding movement (inter-repetition) errors, and increased as the trial progressed. In contrast, hand trajectory start and endpoint inter-repetition errors decreased significantly with repeated task performance, as did movement extent, although it was consistently underestimated for each repetition. Pointing direction remained constant, except for the angle of elevation for scapular plane pointing, which consistently decreased throughout the trial. The results suggest that the initial conditions prescribed by actively defining a proprioceptive target were subsequently modified by dynamic proprioception, such that movement reproduction capability improved with repeated task performance.

Biomechanical Phenomena↗

Mental motor imagery and the body schema: evidence for proprioceptive dominance.

Previous studies have demonstrated that both visual and proprioceptive feedback influence motor control. The relative contributions of these sensory modalities to the on-line computation of body position--that is, the body schema--remain unclear. We report a study designed to explore the roles of vision and proprioception in motor planning. The task required subjects to judge if a pictured stimulus was a right or left hand; stimuli included pictures of a right or left hand in a palm up or palm down position and in six different angular rotations (0 degrees , 60 degrees , 120 degrees , 180 degrees , 240 degrees , 300 degrees ). Each subject was tested with his/her right hand palm down and palm up. There were three conditions: a "control" condition (real hand in view), a "fake hand" condition (fake hand in view, real hand out of view), and a "proprioception" condition (no fake hand, real hand out of view). We found that proprioceptive input (that is, the subject's "felt position") had a significant influence on mental rotation whereas the visually perceived posture of the hand did not. We suggest that, at least under some circumstances, proprioceptive inflow may represent the dominant sensory input to the on-line representation of the body in space.

Analysis of Variance↗

Position coding in a video-controlled pointing task with a rotated visual display: evidence for individual differences in visuo-proprioceptive interaction.

In video-controlled tasks, visuomotor performance is generally initially poor with rotated visual display, but improves through trial-by-trial learning. We hypothesise that the inaccurate processing of the visual hand-to-target vector mainly results from the persistent influence of non-visual information relating to arm posture. To test this hypothesis, arm-related proprioceptive and visual information were independently manipulated in a video-controlled pointing task. Analysis of movement vectors revealed that the target was located according to the visual hand but its proprioceptive orientation (Allelocentric(1) system of reference, N = 10), or according to the proprioceptive hand location and orientation (Egocentric system of reference, N = 8). The prevalence of one system of reference correlated with the accuracy of proprioceptive signals informing about arm posture. One obstacle in mastering video-controlled task results thus from the persistent influence of proprioceptive information in the spatial coding of visual goals for action, which however differs across individuals.

Adolescent↗

Proprioception in somatoform disorders.

20 patients with somatoform disorders as defined by DSM-IV and 20 healthy controls were examined for their proprioception. Several psychophysiological theories of somatoform disorders suggest biased proprioceptive abilities. The primary question is, whether we may find an inaccurate myogen perception in somatization as suggested by the approach of Bischoff or a more precise proprioception as may be derived from concepts of a higher awareness of body reactions. Furthermore it is expected, that somatoform patients perceive their muscle tension more intensely than do healthy subjects. Proprioceptive abilities were tested using a visual EMG biofeedback task. Resulting objective data and subjective ratings were analyzed within a psychophysiological regression approach which allows one to estimate the reliability, precision and intensity of proprioception. Results revealed that somatoform subjects demonstrated a more precise but not a more intense perception of muscle tension than did healthy controls.

Adult↗

Afferent mechanism of cortical myoclonus studied by proprioception-related SEPs.

Proprioception-related somatosensory evoked potentials (SEPs) to passive flexion movement of the middle finger at proximal interphalangeal joint were recorded in 7 patients with myoclonus of cortical origin who demonstrated enlarged electrical SEPs (giant SEPs). In 3 out of the 7 patients, the proprioception-related SEPs were also enlarged. The remaining 4 patients showed giant electrical SEPs without enhancement of proprioception-related SEPs. Long loop electromyographic response was recorded during the resting condition in all of the 3 patients with enlarged proprioception-related SEPs. We have previously reported that proprioception-related SEPs are mainly generated by muscle afferent inputs, though electrical SEPs are thought to reflect mostly cutaneous inputs with some contribution from muscle afferents. Therefore, it is concluded that hyperexcitability of the sensorimotor cortex in cortical myoclonus is modality-specific. Cortical excitability is exaggerated to both cutaneous and deep receptor inputs in some patients, but only to cutaneous input in others.

Adult↗

Effect of the posterior cruciate ligament in knee-joint proprioception in total knee arthroplasty.

The primary purpose of the study was to examine the role of the posterior cruciate ligament (PCL) in knee-joint proprioception after total knee arthroplasty (TKA). Knee-joint proprioception was measured in 10 patients with nonsacrificed PCL TKAs and 10 with sacrificed PCL TKAs. Knee-joint proprioception was evaluated through reproduction of static knee angles using a Penny and Giles electrogoniometer. The primary variable was absolute angular error (AAE). AAE was defined as the absolute value of the difference between the test angle and the patient's perceived version of the test angle. Proprioception deficit was compared to the WOMAC questionnaire which evaluates pain, stiffness, and physical function of the lower extremity. No significant difference was found between the nonsacrificed PCL TKA (4.33 degrees +/- 1.52 degrees) and sacrificed PCL TKA (4.38 degrees +/- 1.39 degrees) AAE values (P > .4). Furthermore, no significant differences were observed in the WOMAC questionnaire scores for all three parameters between the two types of knee prosthesis (P > .35). The current findings suggest that the preservation of the PCL in TKA may not improve knee-joint proprioception and subsequently may not improve TKA functional performance.

Aged↗

Peripheral NT3 signaling is required for ETS protein expression and central patterning of proprioceptive sensory afferents.

To study the role of NT3 in directing axonal projections of proprioceptive dorsal root ganglion (DRG) neurons, NT3(-/-) mice were crossed with mice carrying a targeted deletion of the proapoptotic gene Bax. In Bax(-/-)/NT3(-/-) mice, NT3-dependent neurons survived and expressed the proprioceptive neuronal marker parvalbumin. Initial extension and collateralization of proprioceptive axons into the spinal cord occurred normally, but proprioceptive axons extended only as far as the intermediate spinal cord. This projection defect is similar to the defect in mice lacking the ETS transcription factor ER81. Few if any DRG neurons from Bax(-/-)/NT3(-/-) mice expressed ER81 protein. Expression of a NT3 transgene in muscle restored DRG ER81 expression in NT3(-/-) mice. Finally, addition of NT3 to DRG explant cultures resulted in induction of ER81 protein. Our data indicate that NT3 mediates the formation of proprioceptive afferent-motor neuron connections via regulation of ER81.

Afferent Pathways↗

Extraocular muscle proprioceptors and proprioception.

Uncertainty of the roles of proprioception and efference copy in visual spatial perception persists. Proprioception has won back some support recently mainly on the evidence gained from physiological experiments in man, and rather than being mutually exclusive, the two mechanisms have been presented as collaborating. Another view supported by human and animal experiments states that current visual spatial perception may be served by efference copy whereas proprioception is responsible for temporal adaptations of the system. Certain characteristics of visuomotor cells of the monkey cortex can be explained assuming an efference copy input. Anatomical data from different sources are not easily reconciled. Disagreement about the nerve pathway of muscle afferents weakens arguments based on the results of open loop experiments involving nerve lesions in monkeys. The assumed presence of Golgi tendon organs in human extraocular muscles is no longer tenable and instead, palisade endings similar to those of cats and monkeys and other, irregular nerve endings are described. But man differs in having a limited and patchy distribution of neurotendonous endings and moreover, they may develop only after infancy. The allocation of a sensory function to palisade endings in myotendinous cylinders appears secure, at least in cats. Detailed examination of muscle spindles in man reveals anomalies of structure sufficient to question their capacity to provide useful proprioceptive information. One of the anomalies is the atrophy of intrafusal muscle fibres, present in both infant and adult muscles, and it is proposed that the redundant sensory endings, which do not appear to degenerate, search for new targets and may account for the random presence of tendon nerve endings. These observations place the role of proprioception in human extraocular muscles in jeopardy; they are unsupportive of the recent physiological studies and favour efference copy.

Afferent Pathways↗

Physical training increases isometric muscular strength and proprioceptive performance in haemophilic subjects.

Sufficient muscular strength and proprioception lessen the risk of joint damage, however, both are impaired in haemophilic subjects. The aim of the study was to investigate proprioceptive performance and isometric muscular strength before and after a specialized training in haemophilic subjects (H) compared with two groups of control subjects (C). Nine subjects with severe haemophilia A, and eight 'active' C (AC) without haemophilia took part in a physical training programme over a 6-month period. Eleven 'passive' C (PC) were requested to avoid any additional training during this period. Proprioceptive performance and isometric strength were determined before and after the training programme. The maximal isometric muscular strength in the legs, bilaterally measured by knee extensor (and leg press) was increased (P < 0.05) by 34% (29%) after training in the H and by 20% (28%) in the AC groups while remaining unchanged in the PC group. The performance in one-leg-stand tests after training was increased (P < 0.05) in the H and AC groups. An improvement of angle reproduction of 20 degrees and 40 degrees (P < 0.05) in the H compared with the PC groups was seen in the tests. Quantitative sensory testing by the tuning fork showed an increase (P < 0.05) in performance of both H and AC groups. The results of the present study confirm that specific sports therapy focused on proprioceptive function and accompanied by gentle strength training with low resistance and 20-25 repetitions is able to increase proprioceptive performance and muscular strength with a minimal stress to the joints. It is strongly recommended that specialized sports therapy be included as an integral component of the complete treatment regimen of haemophilic subjects.

Adolescent↗

[Prospective proprioceptive and coordinative training for injury reduction in elite female soccer].

PURPOSE: Does a prospective proprioceptive-coordinative additional training intervention in elite female soccer changes frequency and pattern of injuries? MATERIALS AND METHODS: 24 female soccer players of the German first division team of FC Bayern München were thoroughly supervised during the season 2003/04 regarding injuries resulting in an absence from at least one scheduled training session or game. During the winter break an additional proprioceptive-coordinative training program was initiated, which was performed on a regular basis during the second half of the season. Furthermore, we evaluated jump&reach, throwing power, coordinative skills, and flexibility. RESULTS: All evaluated fitness results increased significantly during the season after the training intervention, such as jump&reach 44 +/- 4 cm vs. 38 +/- 10 cm (p < 0.05), coordinative power left and right leg, respectively (71 +/- 44 s vs. 45 +/- 37 s, 80 +/- 41 s vs. 50 +/- 32 s, both p < 0.05), flexibility left and right hip (89 +/- 8 degrees vs. 78 +/- 13 degrees and 88 +/- 9 degrees vs. 79 +/- 10 degrees, p < 0.05). Comparing the 1st to the 2nd half of the season, 25 vs. 26 injuries after foulplay and 69 vs. 52 without contact occur (p < 0.05). Muscle injuries resulting in game or training absence were significantly reduced by 400% (12 vs. 3, p < 0.05). In the 1st half of the season, 2 anterior cruciate ruptures (ACL) occur vs. none in the 2nd half after the training intervention. CONCLUSION: An additional proprioceptive-coordinative training intervention increases coordinative abilities, jump power, throwing power, and flexibility during a half season. After initiation of the proprioceptive-coordinative training the incidence of muscle injuries resulting in an absence of at least one game or practice session was reduced significantly by 400 %. Regarding the reduced incidence of ACL injuries after proprioceptive-coordinative training in female elite soccer players, further studies have to be performed to elucidate the value of this training intervention.

Adult↗

Upper limb exteroceptive somatosensory and proprioceptive sensory afferent modulation of hemispatial neglect.

In many paradigms of stimulation techniques aimed at reducing hemispatial neglect, somatosensory and proprioceptive stimulation are often interchanged, although the anatomical and functional pathways transmitting these signals are clearly different. Therefore, we have investigated the effects of one somatosensory stimulation technique, the cyclic pressure application (CPA), and have compared them with the effects of left transcutaneous electrical stimulation (TENS) on the expression of left hemispatial neglect in 13 stroke patients, as assessed by two visuospatial exploration tasks: the Star Cancellation task and Schenkenberg's Line Bisection task. In a first experiment, four treatment conditions were given: TENS, CPA, TENS + CPA, as well as a placebo condition. For each patient, the intensity of the TENS was determined, based on his/her conscious somatosensory threshold for the electrical impulses. In order to determine whether unconscious proprioceptive afferent information instead of exteroceptive somatosensory stimulation is a sufficient condition to improve hemispatial neglect, we carried out a second experiment, only with patients suffering from complete somatosensory loss. The effects of the different treatments were investigated, using the same sequence as for Experiment 1, but, this time, the applied intensity of TENS was manipulated over two conditions : (1) one in which the intensity of TENS stimulation was below the motor (proprioceptive) threshold and (2) one in which the intensity was determined following the degree of proprioceptive stimulation demonstrated by the point at which a visible muscle contraction during the stimulation could be elicited. The results demonstrated that proprioceptive-based TENS stimulation is a sufficient condition to reduce hemispatial neglect, even when a severe somatosensory loss was present.

Aged↗

Correlation analysis of proprioceptive acuity in ipsilateral position-matching and velocity-discrimination.

In order to plan and control movements the central nervous system (CNS) needs to continuously keep track of the state of the musculoskeletal system. Therefore the CNS constantly uses sensory input from mechanoreceptors in muscles, joints and skin to update information about body configuration on different levels of the CNS. On the conscious level, such representations constitute proprioception. Different tests for assessment of proprioceptive acuity have been described. However, it is unclear if the proprioceptive acuity measurements in these tests correlate within subjects. By using both uni- and multivariate analysis we compared proprioceptive acuity in different variants of ipsilateral active and passive limb position-matching and ipsilateral passive limb movement velocity-discrimination in a group of healthy subjects. The analysis of the position-matching data revealed a higher acuity of matching for active movements in comparison to passive ones. The acuity of matching was negatively correlated to movement extent. There was a lack of correlation between proprioceptive acuity measurements in position-matching and velocity-discrimination.

Adult↗

Proprioception in individuals with ACL-deficient knee and good muscular and functional performance.

The objective of this study was to verify whether proprioception is affected in individuals with ACL-deficient knees and good functional and muscular performances. Eleven subjects with ACL injury and 11 controls participated in the study. Functional performance was assessed using the Cincinnati Knee Rating System (CKRS), hop index, and figure-eight ratio. An isokinetic test was done to evaluate muscular performance. Proprioception was evaluated through position, sense and threshold tests. Analyses of variance were used for data analysis. The injured subjects scored significantly lower in the CKRS (p = 0.001). No statistically significant differences were found in the hop index, in the figure-eight ratio, or in peak torque. There were no statistically significant differences in proprioception bettween groups and between legs. These results indicated that the individuals evaluated in this study with ACL injury and good functional and muscular performance did not have proprioceptive deficits, suggesting that the ligament mechanoreceptors, in some cases, might not contribute relevantly to proprioception.

Adolescent↗

Right temporoparietal cortex activation during visuo-proprioceptive conflict.

The conflict between vision and proprioception has been proposed to explain why healthy subjects perform worse than proprioceptively deafferented patients in conditions with optical displacement, e.g. novel mirror drawing. It is not known which brain processes depend upon the successful integration of visual and proprioceptive information and are therefore impaired when these modalities disagree. With fMRI in healthy subjects we compared brain activity across two conditions with similar visual and proprioceptive stimulation and similar task demands that differed by the congruence of movement showed by the two modalities. Subjects felt the passive movement of the right index finger on a rectangular field and watched a cursor moving on a computer screen. Cursor and finger locations either mapped onto each other (congruent condition) or did not (incongruent condition). Monitoring incongruent compared with congruent movement activated the premotor area bilaterally and the right temporoparietal junction. These brain areas have previously been associated with shifts in the attended location in the visual space. These findings suggest an interaction between vision and proprioception in orienting to spatial locations.

Adult↗

The effect of the hypermobility syndrome on knee joint proprioception.

Proprioceptive sensory feedback is utilized by the central nervous system for conscious appreciation of the position and movement of the body and limbs. In patients with the hypermobility syndrome (HMS), it has been suggested that there is alteration of proprioceptive acuity. Proprioceptive performance of the knee joint was investigated in 10 female subjects who suffered from HMS using a threshold detection paradigm (accurate determination of the onset and direction of knee joint displacement at constant angular velocity). Compared to age- and sex-matched controls, HMS subjects showed significantly higher detection levels at starting knee flexion angles of 30 degrees P < 0.001) and 5 degrees (P < 0.001). Control subjects showed no significant difference in threshold acuity between the sexes (at 5 degrees P = 0.63, at 30 degrees P = 0.48). The increased acuity in proprioception observed towards full extension in the control population (P < 0.001) was absent in the HMS subjects (P = 0.596). Findings reported here suggest that HMS subjects have poorer proprioceptive feedback than controls. Reduced sensory feedback may lead to biomechanically unsound limb positions being adopted. Such a mechanism may allow acceleration of degenerative joint conditions, and may account for the increased prevalence of such conditions seen with HMS subjects.

Adult↗

Proprioceptive function, clinical results, and quality of life after unicondylar sledge prostheses.

OBJECTIVE: Evaluation of proprioceptive performance and quality of life after implantation of unicondylar sledge knee prostheses in comparison with normal control subjects. DESIGN: A total of 17 patients were examined after implantation of unicondylar sledge prostheses. Clinical examination was performed, quality of life was assessed, and proprioceptive performance was examined. A total of 11 healthy subjects of comparable age served as a control group. RESULTS: Clinical results of both groups differed significantly in all categories. Quality-of-life assessment differed only in the following items: physical functioning, role limitation caused by physical problems, and bodily pain. Other than angle reproduction at 15 degrees, no significant differences in proprioceptive testing, neither sway measurement nor angle reproduction, were found. Statistical analysis revealed no correlation between clinical scores and proprioceptive results. CONCLUSIONS: In comparison with normal control subjects of comparable age, the implantation of unicondylar sledge prostheses does not result in proprioceptive deficits. Except for physical functioning, role limitations caused by physical problems and bodily pain, most aspects of quality of life do not differ between patients and control subjects, although the patients' clinical results were significantly lower than the controls.

Aged↗