scholarly journals Sensorimotor integration of vision and proprioception for obstacle crossing in ambulatory individuals with spinal cord injury

2017 ◽  
Vol 117 (1) ◽  
pp. 36-46 ◽  
Author(s):  
Raza Naseem Malik ◽  
Rachel Cote ◽  
Tania Lam
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Sensorimotor Integration ◽  
Joint Position Sense ◽  
Functional Mobility ◽  
Motor Deficits ◽  
Gaze Behavior ◽  
Obstacle Crossing ◽  
Vision Condition ◽  
Cord Injury

Skilled walking, such as obstacle crossing, is an essential component of functional mobility. Sensorimotor integration of visual and proprioceptive inputs is important for successful obstacle crossing. The objective of this study was to understand how proprioceptive deficits affect obstacle-crossing strategies when controlling for variations in motor deficits in ambulatory individuals with spinal cord injury (SCI). Fifteen ambulatory individuals with SCI and 15 able-bodied controls were asked to step over an obstacle scaled to their motor abilities under full and obstructed vision conditions. An eye tracker was used to determine gaze behaviour and motion capture analysis was used to determine toe kinematics relative to the obstacle. Combined, bilateral hip and knee proprioceptive sense (joint position sense and movement detection sense) was assessed using the Lokomat and customized software controls. Combined, bilateral hip and knee proprioceptive sense in subjects with SCI varied and was significantly different from able-bodied subjects. Subjects with greater proprioceptive deficits stepped higher over the obstacle with their lead and trail limbs in the obstructed vision condition compared with full vision. Subjects with SCI also glanced at the obstacle more frequently and with longer fixation times compared with controls, but this was not related to proprioceptive sense. This study indicates that ambulatory individuals with SCI rely more heavily on vision to cross obstacles and show impairments in key gait parameters required for successful obstacle crossing. Our data suggest that proprioceptive deficits need to be considered in rehabilitation programs aimed at improving functional mobility in ambulatory individuals with SCI.NEW & NOTEWORTHY This work is unique since it examines the contribution of combined, bilateral hip and knee proprioceptive sense on the recovery of skilled walking function, in addition to characterizing gaze behavior during a skilled walking task in people with motor-incomplete spinal cord injury.

scholarly journals Immediate effects of obstacle crossing training in independent ambulatory patients with spinal cord injury

Spinal Cord ◽  
2013 ◽  
Vol 51 (5) ◽  
pp. 379-383 ◽  
Author(s):  
W Pramodhyakul ◽  
P Wattanapan ◽  
W Siritaratiwat ◽  
W Eungpinichpong ◽  
S Amatachaya
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Obstacle Crossing ◽  
Cord Injury ◽  
Ambulatory Patients

scholarly journals Factors Related to Obstacle Crossing in Independent Ambulatory Patients With Spinal Cord Injury

2010 ◽  
Vol 33 (2) ◽  
pp. 144-149 ◽  
Author(s):  
Sugalya Amatachaya ◽  
Thiwaporn Thaweewannakij ◽  
Jutarat Adirek-udomrat ◽  
Wantana Siritaratiwat
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Obstacle Crossing ◽  
Cord Injury ◽  
Ambulatory Patients

scholarly journals 2282 Targeted eccentric motor control to improve locomotion after incomplete spinal cord injury

2018 ◽  
Vol 2 (S1) ◽  
pp. 29-29
Author(s):  
Kevin O’Brien ◽  
D. Michele Basso ◽  
James Schmiedeler
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Muscle Activation ◽  
Muscle Power ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Motor Deficits ◽  
Incomplete Spinal Cord Injury ◽  
Cord Injury ◽  
Weight Acceptance

OBJECTIVES/SPECIFIC AIMS: Incomplete spinal cord injury typically results in life-long disability, often in the form of profound loss of locomotion capability. Individuals who have experienced incomplete spinal cord injury exhibit persistent eccentric motor deficits, which are particularly prevalent in the weight acceptance phase of gait and emphasized in sagittal plane knee motion and frontal plane hip motion. METHODS/STUDY POPULATION: Motion analysis can capture the kinematic and joint-level deficits of these individuals, but it is impossible to directly calculate the contributions of individual muscles to weight acceptance due to the complexity of the musculoskeletal system. Instead, those muscle contributions must be simulated in order to approximate muscle power during locomotion. RESULTS/ANTICIPATED RESULTS: The traditional method for driving these simulations with electromyography readings is unavailable for individuals who have neuromuscular deficits (e.g., spasticity or paralysis), due to the need to generate reliable maximum voluntary isometric contractions for baseline purposes. Instead, this research develops a novel method for using resting electromyography data to drive musculoskeletal simulations using a muscle activation threshold paradigm. DISCUSSION/SIGNIFICANCE OF IMPACT: The simulation results of this method more closely resemble experimental results, but further simulation refinement is needed to fully capture the true muscle activity.

scholarly journals Trunk sensory and motor cortex is preferentially integrated with hindlimb sensory information that supports trunk stabilization

2020 ◽  
Author(s):  
Bharadwaj Nandakumar ◽  
Gary H. Blumenthal ◽  
Francois Philippe Pauzin ◽  
Karen A. Moxon
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Cortex ◽  
Postural Control ◽  
Functional Recovery ◽  
Sensorimotor Integration ◽  
Cortical Reorganization ◽  
Sensory Cortex ◽  
Proprioceptive Information ◽  
Cord Injury

AbstractSensorimotor integration in the trunk system has been poorly studied despite its importance for examining functional recovery after neurological injury or disease. Here, we mapped the relationship between thoracic dorsal root ganglia and trunk sensory cortex (S1) to create a detailed map of the extent and internal organization of trunk primary sensory cortex, and trunk primary motor cortex (M1) and showed that both cortices are somatotopically complex structures that are larger than previously described. Surprisingly, projections from trunk S1 to trunk M1 were not anatomically organized. We found relatively weak sensorimotor integration between trunk M1 and S1 and between trunk M1 and forelimb S1 compared to extensive integration between trunk M1 and hindlimb S1 and M1. This strong trunk/hindlimb connection was identified for high intensity stimuli that activated proprioceptive pathways. To assess the implication of this integration, the responses in sensorimotor cortex were examined during a postural control task and supported sensorimotor integration between hindlimb sensory and lower trunk motor cortex. Together, these data suggest that trunk M1 is guided predominately by hindlimb proprioceptive information that reached the cortex directly via the thalamus. This unique sensorimotor integration suggests an essential role for the trunk system in postural control, and its consideration could be important for understanding studies regarding recovery of function after spinal cord injury.SignificanceThis work identifies extensive sensorimotor integration between trunk and hindlimb cortices, demonstrating that sensorimotor integration is an operational mode of the trunk cortex in intact animals. The functional role of this integration was demonstrated for postural control when the animal was subjected to lateral tilts. Furthermore, these results provide insight into cortical reorganization after spinal cord injury making clear that sensorimotor integration after SCI is an attempt to restore sensorimotor integration that existed in the intact system. These results could be used to tailor rehabilitative strategies to optimize sensorimotor integration for functional recovery.

scholarly journals The sensorimotor effects of a lower limb proprioception training intervention in individuals with a spinal cord injury

2019 ◽  
Vol 122 (6) ◽  
pp. 2364-2371 ◽  
Author(s):  
Taha Qaiser ◽  
Gevorg Eginyan ◽  
Franco Chan ◽  
Tania Lam
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Limb ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
End Point ◽  
Cord Injury ◽  
Training Protocol ◽  
Precision Stepping

Proprioception is critical for movement control. After a spinal cord injury (SCI), individuals not only experience paralysis but may also experience proprioceptive deficits, further confounding motor recovery. The objective of this study was to test the effects of a robotic-based proprioception training protocol on lower limb proprioceptive sense in people with incomplete SCI. A secondary objective was to assess whether the effects of training transferred to a precision stepping task in people with motor-incomplete SCI. Participants with chronic incomplete SCI and able-bodied controls underwent a 2-day proprioceptive training protocol using the Lokomat robotic exoskeleton. The training involved positioning the test leg to various positions and participants were asked to report whether they felt their heel position (end-point position) was higher or lower compared with a reference position. Feedback was provided after each trial to help participants learn strategies that could help them discern different positions of their foot. Changes in end-point position as well as knee joint position sense were assessed pre- and posttraining. We also assessed the effects of proprioception training on the performance of a precision stepping task in people with motor-incomplete SCI. Following training, there were significant improvements in end-point and knee joint position sense in both groups. The magnitude of improvement was related to pretraining (baseline) proprioceptive sense, indicating that those who initially had better lower limb position sense showed greater changes. Participants also showed improvements in performance of a precision stepping task. NEW & NOTEWORTHY We show that it is possible to alter proprioceptive sense in people with incomplete SCI using a passive proprioception training protocol combined with feedback. Improvements in proprioceptive sense transferred from end-point to joint position sense and also to an untrained precision stepping task.

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