scholarly journals A robot-aided visuomotor wrist training induces gains in proprioceptive and movement accuracy in the contralateral wrist

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yizhao Wang ◽  
Huiying Zhu ◽  
Naveen Elangovan ◽  
Leonardo Cappello ◽  
Giulio Sandini ◽  
...  
Keyword(s):  
Position Sense ◽  
Just Noticeable Difference ◽  
Neurophysiological Mechanism ◽  
Left Wrist ◽  
Movement Accuracy ◽  
Visuomotor Task ◽  
Spatial Movement ◽  
Proprioceptive Training ◽  
Motor Error ◽  
Proprioceptive Function

AbstractProprioceptive training is a neurorehabilitation approach known to improve proprioceptive acuity and motor performance of a joint/limb system. Here, we examined if such learning transfers to the contralateral joints. Using a robotic exoskeleton, 15 healthy, right-handed adults (18–35 years) trained a visuomotor task that required making increasingly small wrist movements challenging proprioceptive function. Wrist position sense just-noticeable-difference thresholds (JND) and spatial movement accuracy error (MAE) in a wrist-pointing task that was not trained were assessed before and immediately as well as 24 h after training. The main results are: first, training reduced JND thresholds (− 27%) and MAE (− 33%) in the trained right wrist. Sensory and motor gains were observable 24 h after training. Second, in the untrained left wrist, mean JND significantly decreased (− 32%) at posttest. However, at retention the effect was no longer significant. Third, motor error at the untrained wrist declined slowly. Gains were not significant at posttest, but MAE was significantly reduced (− 27%) at retention. This study provides first evidence that proprioceptive-focused visuomotor training can induce proprioceptive and motor gains not only in the trained joint but also in the contralateral, homologous joint. We discuss the possible neurophysiological mechanism behind such sensorimotor transfer and its implications for neurorehabilitation.

scholarly journals Effects of a Robot-aided Somatosensory Training on Proprioception and Motor Function in Stroke Survivors

2020 ◽  
Author(s):  
I-Ling Yeh ◽  
Jessica Holst-Wolf ◽  
Naveen Elangovan ◽  
Anna Vera Cuppone ◽  
Kamakshi Lakshminarayan ◽  
...  
Keyword(s):  
Position Sense ◽  
Chronic Stroke ◽  
Tactile Feedback ◽  
Just Noticeable Difference ◽  
Current Evidence ◽  
Stroke Survivors ◽  
Spatial Error ◽  
Upper Limb Function ◽  
Age Range ◽  
Proprioceptive Function

Abstract Background- Proprioceptive deficits after stroke are associated with poor upper limb function, slower motor recovery, and decreased self-care ability. Improving proprioception should enhance motor control in stroke survivors, but current evidence is inconclusive. Thus, this study examined whether a robot-aided somatosensory-based training requiring increasingly accurate active wrist movements improves proprioceptive acuity and motor performance in chronic stroke. Methods - Twelve adults with chronic stroke completed a 2-day training (age range: 42 – 74 years; median time-after-stroke: 12 months; median Fugl-Meyer UE: 65). Retention was assessed at Day 5. Grasping the handle of a wrist-robotic exoskeleton, participants trained to roll a virtual ball to a target through continuous wrist adduction/abduction movements. During training vision was occluded, but participants received real-time, vibro-tactile feedback on their forearm about ball position and speed. Primary outcome was the just-noticeable-difference (JND) wrist position sense threshold as a measure of proprioceptive acuity. Secondary outcomes were spatial error in an untrained wrist tracing task and somatosensory-evoked potentials (SEP) as a neural correlate of proprioceptive function. Ten neurologically-intact adults were recruited to serve as non-stroke controls for age, gender and hand dominance (age range: 44 to 79 years; 6 women, 4 men).Results – Participants significantly reduced JND thresholds at posttest and retention (F(2, 38) = 4.54, p = 0.017, ηp2 = 0.20) in both groups. A higher pretest JND threshold was associated with a higher threshold reduction at posttest and retention (r = -0.86, -0.90, p ≤ 0.001) among the stroke participants. Error in the untrained tracing task was reduced by 22% at posttest, yielding an effect size of w = 0.13. Stroke participants exhibited significantly reduced P27-N30 peak-to-peak SEP amplitude at pretest (U = 11, p = 0.03) compared to the non-stroke group. SEP measures did not change systematically with training.Conclusion - This study provides proof-of-concept that non-visual, proprioceptive training can induce fast, measurable improvements in proprioceptive function in chronic stroke survivors. There is encouraging but inconclusive evidence that such somatosensory learning transfers to untrained motor tasks.Trial Registration Clinicaltrials.gov; Registration ID: NCT02565407; Date of registration: 01/10/2015; URL: https://clinicaltrials.gov/ct2/show/NCT02565407

scholarly journals A comparison of the proprioception of osteoarthritic knees and post total knee arthroplasty

2017 ◽  
Vol 3 (4) ◽  
pp. 781
Author(s):  
Cherith Reddy Chillakuru ◽  
N. Jambu ◽  
Akshay Deepak
Keyword(s):  
Knee Replacement ◽  
Position Sense ◽  
Joint Position Sense ◽  
Subjective Feeling ◽  
Joint Position ◽  
Passive Motion ◽  
Osteoarthritic Knee ◽  
The Status ◽  
Total Knee ◽  
Proprioceptive Function

<p class="abstract"><strong>Background:</strong> Proprioception of the knee joint is an important factor for establishing balance, and smooth walking. The effect of arthroplasty on proprioception can be a determinant of post-operative function and subjective feeling of the arthroplasty. We wished to check the status of osteoarthritic knees and how their proprioceptive function is, in comparison to knees post total knee replacement.</p><p class="abstract"><strong>Methods:</strong> We compared 80 unilateral knee replacement patients with their osteoarthritic counterpart in the opposite knee. There was 50% Cruciate Retaining (n =40), Posterior Stabilized 50% (n =40). We assessed the proprioception using threshold to detection of passive motion and conscious awareness of passive joint position.<strong></strong></p><p class="abstract"><strong>Results:</strong> 73.8% (n =59) of patients experienced a better joint position sense, 21% (n =17) had decreased joint position sense and 5% (n =4) had the same, when compared to the contralateral osteoarthritic knee. The mean of threshold to detection of passive motion was 2.16+0.68 for the replaced knees versus 2.72±0.61 for the contralateral osteoarthritic knee.</p><p class="abstract"><strong>Conclusions:</strong> The proprioception of the knees that were replaced with arthroplasties had a better proprioceptive function then the osteoarthritic knees. This further solidifies the reasons to replace the dysfunctional osteoarthritic knee. </p>

scholarly journals Response to Tendon Vibration Questions the Underlying Rationale of Proprioceptive Training

2017 ◽  
Vol 52 (2) ◽  
pp. 97-107 ◽  
Author(s):  
Anat Vilnai Lubetzky ◽  
Sarah Westcott McCoy ◽  
Robert Price ◽  
Deborah Kartin
Keyword(s):  
Achilles Tendon ◽  
Center Of Pressure ◽  
Multiscale Entropy ◽  
Support Surface ◽  
Ankle Sprains ◽  
Control Mechanisms ◽  
Tendon Vibration ◽  
Healthy Group ◽  
Proprioceptive Training ◽  
Proprioceptive Function

Context: Proprioceptive training on compliant surfaces is used to rehabilitate and prevent ankle sprains. The ability to improve proprioceptive function via such training has been questioned. Achilles tendon vibration is used in motor-control research as a form of proprioceptive stimulus. Using measures of postural steadiness with nonlinear measures to elucidate control mechanisms, tendon vibration can be applied to investigate the underlying rationale of proprioceptive training. Objective: To test whether the effect of vibration on young adults' postural control depended on the support surface. Design: Descriptive laboratory study. Setting: Research laboratory. Patients or Other Participants: Thirty healthy adults and 10 adults with chronic ankle instability (CAI; age range = 18−40 years). Intervention(s): With eyes open, participants stood in bilateral stance on a rigid plate (floor), memory foam, and a Both Sides Up (BOSU) ball covering a force platform. We applied bilateral Achilles tendon vibration for the middle 20 seconds in a series of 60-second trials and analyzed participants' responses from previbration to vibration (pre-vib) and from vibration to postvibration (vib-post). Main Outcome Measure(s): We calculated anterior-posterior excursion of the center of pressure and complexity index derived from the area under multiscale entropy curves. Results: The excursion response to vibration differed by surface, as indicated by a significant interaction of P &lt; .001 for the healthy group at both time points and for the CAI group vib-post. Although both groups demonstrated increased excursion from pre-vib and from vib-post, a decrease was observed on the BOSU. The complexity response to vibration differed by surface for the healthy group (pre-vib, P &lt; .001). The pattern for the CAI group was similar but not significant. Complexity changes vib-post were the same on all surfaces for both groups. Conclusions: Participants reacted less to ankle vibration when standing on the BOSU as compared with the floor, suggesting that proprioceptive training may not be occurring. Different balance-training paradigms to target proprioception, including tendon vibration, should be explored.

PROPRIOCEPTIVE TRAINING AS AN ADJUNCT IN OSTEOARTHRITIS OF KNEE

2013 ◽  
Vol 16 (01) ◽  
pp. 1350002 ◽  
Author(s):  
Suraj Kumar ◽  
Ashish Kumar ◽  
Ratnesh Kumar
Keyword(s):  
Pain Intensity ◽  
Functional Disability ◽  
Womac Score ◽  
Position Sense ◽  
Joint Position Sense ◽  
Knee Oa ◽  
Post Test ◽  
Proprioceptive Training ◽  
Conventional Physiotherapy ◽  
Single Blind

Osteoarthritis (OA) is steadily becoming the most common cause of disability with advancing age. So, this study was aimed to prevent and rehabilitate the patient with such disability. Proprioception along with other deficits have been established with threat to the concerned joint. Hence, objective of the study was set to show the efficacy of proprioceptive training with conventional physiotherapy versus conventional physiotherapy. A Pre test- Post test single blind experimental study was designed with 44 patients having knee OA and randomly divided in two groups. Outcome measures were pain intensity on NRS, functional disability on Reduced WOMAC and joint position sense (JPS) error on Electronic Goniometer. Results between group comparisons showed significant improvement in pain intensity (p < 0.05), WOMAC score (p < 0.05) and JPS error (p < 0.05). However both the groups improved significantly but there was more significant improvement in group with proprioception intervention. Hence, it can be concluded that proprioceptive training should be included along with conventional physiotherapy in knee OA rehabilitation.

scholarly journals Assessing Proprioceptive Function: Evaluating Joint Position Matching Methods Against Psychophysical Thresholds

2014 ◽  
Vol 94 (4) ◽  
pp. 553-561 ◽  
Author(s):  
Naveen Elangovan ◽  
Amanda Herrmann ◽  
Jürgen Konczak
Keyword(s):  
Position Sense ◽  
Matching Task ◽  
Joint Position ◽  
Active Motion ◽  
Matching Methods ◽  
Position Errors ◽  
Orthopedic Injury ◽  
Threshold Testing ◽  
Opposite Limb ◽  
Proprioceptive Function

Background The importance of assessing proprioceptive function for rehabilitation after neurological or orthopedic injury has long been recognized. Yet, neither the validity nor the accuracy of the available tests is firmly established. Testing typically involves repeated matching of a given joint position with the same or opposite limb where the difference between the 2 positions indicates proprioceptive acuity. Objectives The aim of this study was to compare position sense acuity between ipsilateral and contralateral matching methods against a psychophysical threshold method to establish the accuracy and relationships between these models. Design A repeated-measures design was used. Method Assessment of forearm position sense for a 10-degree reference position in 27 young adults who were healthy. Results Psychophysical thresholds were revealed to be the most precise and least variable acuity measure. The mean (±SD) threshold (1.05°±0.47°) was significantly lower than mean position errors obtained by both joint position matching tasks (ipsilateral: 1.51°±0.64°; contralateral: 1.84°±0.73°)—a 44% to 75% difference in measurement accuracy. Individual participant position errors correlated poorly with respective thresholds, indicating a lack of concurrent validity. Position errors for both matching methods correlated only mildly with each other. Limitations The data represent performance of a healthy, young adult cohort. Differences between methods will likely be more pronounced in aging and clinical populations. Conclusions Threshold testing and joint position matching methods examine different physiological aspects of proprioceptive function. Because threshold testing is based on passive motion, it most closely reflects afferent sensory feedback processing (ie, proprioception). Matching methods require active motion and are consequently influenced by additional sensorimotor processes. Factors such as working memory and transmission between brain hemispheres also influence joint matching task outcomes.

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