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Journal of Neuroengineering and... May 2024Proprioceptive impairments are common after stroke and are associated with worse motor recovery and poor rehabilitation outcomes. Motor learning may also be an important...
BACKGROUND
Proprioceptive impairments are common after stroke and are associated with worse motor recovery and poor rehabilitation outcomes. Motor learning may also be an important factor in motor recovery, and some evidence in healthy adults suggests that reduced proprioceptive function is associated with reductions in motor learning. It is unclear how impairments in proprioception and motor learning relate after stroke. Here we used robotics and a traditional clinical assessment to examine the link between impairments in proprioception after stroke and a type of motor learning known as visuomotor adaptation.
METHODS
We recruited participants with first-time unilateral stroke and controls matched for overall age and sex. Proprioceptive impairments in the more affected arm were assessed using robotic arm position- (APM) and movement-matching (AMM) tasks. We also assessed proprioceptive impairments using a clinical scale (Thumb Localization Test; TLT). Visuomotor adaptation was assessed using a task that systematically rotated hand cursor feedback during reaching movements (VMR). We quantified how much participants adapted to the disturbance and how many trials they took to adapt to the same levels as controls. Spearman's rho was used to examine the relationship between proprioception, assessed using robotics and the TLT, and visuomotor adaptation. Data from healthy adults were used to identify participants with stroke who were impaired in proprioception and visuomotor adaptation. The independence of impairments in proprioception and adaptation were examined using Fisher's exact tests.
RESULTS
Impairments in proprioception (58.3%) and adaptation (52.1%) were common in participants with stroke (n = 48; 2.10% acute, 70.8% subacute, 27.1% chronic stroke). Performance on the APM task, AMM task, and TLT scores correlated weakly with measures of visuomotor adaptation. Fisher's exact tests demonstrated that impairments in proprioception, assessed using robotics and the TLT, were independent from impairments in visuomotor adaptation in our sample.
CONCLUSION
Our results suggest impairments in proprioception may be independent from impairments in visuomotor adaptation after stroke. Further studies are needed to understand factors that influence the relationship between motor learning, proprioception and other rehabilitation outcomes throughout stroke recovery.
Topics: Humans; Male; Female; Proprioception; Middle Aged; Adaptation, Physiological; Stroke; Stroke Rehabilitation; Aged; Psychomotor Performance; Robotics; Adult
PubMed: 38762552
DOI: 10.1186/s12984-024-01360-7 -
Complementary Therapies in Medicine Oct 2023Acupuncture or similar needling therapy has long been used to improve well-being, but its effectiveness in management of chronic ankle instability (CAI) is unclear. To... (Meta-Analysis)
Meta-Analysis Review
Effects of acupuncture or similar needling therapy on pain, proprioception, balance, and self-reported function in individuals with chronic ankle instability: A systematic review and meta-analysis.
OBJECTIVE
Acupuncture or similar needling therapy has long been used to improve well-being, but its effectiveness in management of chronic ankle instability (CAI) is unclear. To investigate the efficacy of acupuncture or similar needling therapy on pain, proprioception, balance, and self-reported function in individuals with CAI.
METHODS
Nine databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, PEDro, CNKI, WanFang, and CQVIP) were systematically searched from inception to April 2023. This study included randomized controlled trials involving acupuncture or similar needling therapy as an intervention for individuals with CAI. Data were extracted independently by two assessors using a standardized form. Literature quality and risk bias were assessed by using the PEDro scale.
RESULTS
Twelve trials (n = 571) were found, of which the final meta-analysis was conducted with eight. Different studies employ varying treatments, including specific needle types, techniques, and therapeutic frameworks. Compared to control without acupuncture or similar needling therapy, acupuncture or similar needling intervention resulted in improved pain (WMD 1.33, 95 % CI 0.14-2.52, I²=90 %, p = 0.03), proprioception (active joint position sense, WMD 1.71, 95 % CI 0.95-2.48, I²=0 %, p < 0.0001), balance (SMD 0.54, 95 % CI 0.03-1.04, I²=46 %, p = 0.04), and self-reported function (Cumberland Ankle Instability Tool (WMD 2.92, 95 % CI 0.94-4.90, I²=78 %, p = 0.004); American Orthopedic Foot and Ankle Society (WMD 9.36, 95 % CI 6.57-12.15, I²=0 %, p < 0.001); Foot and Ankle Ability Measure: activities of daily living (WMD 5.09, 95 % CI 1.74-8.44, I²=0 %, p = 0.003)) for individuals with CAI.
CONCLUSIONS
The available evidence suggests that acupuncture or similar needling therapy may improve pain, proprioception, balance, and self-reported function in individuals with CAI, but more trials are needed to verify these findings. Furthermore, various needles and techniques using in different studies have resulted in methodologic limitations that should be addressed in the future.
Topics: Humans; Self Report; Activities of Daily Living; Ankle; Acupuncture Therapy; Proprioception; Pain; Joint Instability; Randomized Controlled Trials as Topic
PubMed: 37666474
DOI: 10.1016/j.ctim.2023.102983 -
Neuropsychologia Apr 2024In 1992, Goodale and Milner proposed to study the visual system based on function, thus dissociating vision for perception (ventral stream) and vision for action (dorsal... (Review)
Review
In 1992, Goodale and Milner proposed to study the visual system based on function, thus dissociating vision for perception (ventral stream) and vision for action (dorsal stream). This became known as the Perception and Action model (PAM). Following the PAM in the visual system, a somatosensory PAM was proposed including a body representation for perception and a separate for action. This review explores the body model of the hand and how it relates to the PAM. The body model refers to the internal representation of the body that is responsible for position sense. Previous research has shown that the representation of the hand features systematic distortions: an overestimation of hand width and an underestimation of finger length. These distortions have been reported using different paradigms, different body parts, and in various settings. Thus, body model distortions appear to be a characteristic of human body representation. If the body model of the hand is distorted, how can actions like reaching and grasping be accurate? We review evidence that body model distortions may in fact provide a functional benefit to our actions, that cortical maps in the somatosensory and motor cortices reflect these distortions, and that actions rely on a distorted body model. We argue that the body model is a product of both the ventral and dorsal somatosensory streams. Further, we suggest that the body model is an example of the inextricable link between the two streams.
Topics: Humans; Hand; Fingers; Body Image; Hand Strength; Proprioception; Visual Perception; Psychomotor Performance
PubMed: 38490535
DOI: 10.1016/j.neuropsychologia.2024.108853 -
Archives of Physical Medicine and... Mar 2024To investigate shoulder, elbow and wrist proprioception impairment poststroke.
OBJECTIVES
To investigate shoulder, elbow and wrist proprioception impairment poststroke.
DESIGN
Proprioceptive acuity in terms of the threshold detection to passive motion at the shoulder, elbow and wrist joints was evaluated using an exoskeleton robot to the individual joints slowly in either inward or outward direction.
SETTING
A university research laboratory.
PARTICIPANTS
Seventeen stroke survivors and 17 healthy controls (N=34). Inclusion criteria of stroke survivors were (1) a single stroke; (2) stroke duration <1 year; and (3) cognitive ability to follow simple instructions.
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
Threshold detection to passive motion and detection error at the shoulder, elbow and wrist.
RESULTS
There was significant impairment of proprioceptive acuity in stroke survivors as compared to healthy group at all 3 joints and in both the inward (shoulder horizontal adduction, elbow and wrist flexion, P<.01) and outward (P<.01) motion. Furthermore, the distal wrist joint showed more severe impairment in proprioception than the proximal shoulder and elbow joints poststroke (P<.01) in inward motion. Stroke survivors showed significantly larger detection error in identifying the individual joint in motion (P<.01) and the movement direction (P<.01) as compared to the healthy group. There were significant correlations among the proprioception acuity across the shoulder, elbow and wrist joints and 2 movement directions poststroke.
CONCLUSIONS
There were significant proprioceptive sensory impairments across the shoulder, elbow and wrist joints poststroke, especially at the distal wrist joint. Accurate evaluations of multi-joint proprioception deficit may help guide more focused rehabilitation.
Topics: Humans; Elbow Joint; Wrist; Cognition; Proprioception; Stroke
PubMed: 37714505
DOI: 10.1016/j.apmr.2023.08.029 -
Nature Communications Jul 2023Locomotor activities can enhance learning, but the underlying circuit and synaptic mechanisms are largely unknown. Here we show that locomotion facilitates aversive...
Locomotor activities can enhance learning, but the underlying circuit and synaptic mechanisms are largely unknown. Here we show that locomotion facilitates aversive olfactory learning in C. elegans by activating mechanoreceptors in motor neurons, and transmitting the proprioceptive information thus generated to locomotion interneurons through antidromic-rectifying gap junctions. The proprioceptive information serves to regulate experience-dependent activities and functional coupling of interneurons that process olfactory sensory information to produce the learning behavior. Genetic destruction of either the mechanoreceptors in motor neurons, the rectifying gap junctions between the motor neurons and locomotion interneurons, or specific inhibitory synapses among the interneurons impairs the aversive olfactory learning. We have thus uncovered an unexpected role of proprioception in a specific learning behavior as well as the circuit, synaptic, and gene bases for this function.
Topics: Animals; Caenorhabditis elegans; Gap Junctions; Interneurons; Proprioception; Avoidance Learning; Locomotion
PubMed: 37500635
DOI: 10.1038/s41467-023-40286-x -
Clinical Biomechanics (Bristol, Avon) Dec 2023The aim was to examine static/dynamic balance and proprioception of Systemic Sclerosis by comparing healthy and relationship with demographic and disease-related data.
BACKGROUND
The aim was to examine static/dynamic balance and proprioception of Systemic Sclerosis by comparing healthy and relationship with demographic and disease-related data.
METHODS
21 Systemic Sclerosis and 19 healthy were included.Berg Balance Scale (functional balance), Sensamove Sensbalance Maxiboard Software (static, dynamic balance:reaction time and travel time and proprioception), Scleroderma Health Assessment Questionnaire/Health Assessment Questionnaire (health status), Medsger's Disease Severity Scale, Modified Rodnan Skin Score were used in evaluation.
FINDINGS
Comparing the groups, there was significant difference in Berg Balance Scale (p:0.036); Health Assessment Questionnaire/Scleroderma Health Assessment Questionnaire (p:0.001); Static balance-center (p:0.001), front (p:0.001), back (p:0.001), left (p:0.001), right (p:0.021); proprioception-front (p:0.025);Reaction Time-front (p:0.031) and left (p:0.010);Travel Time-front (p:0.041) and left (p:0.014) in favor of healthy group.In Systemic Sclerosis, disease severity had moderate correlation with static balance-back (r:-0.504,p:0.020).Skin thickness had low correlation with Reaction Time-front (r:-0.449,p:0.041).Age had low correlation with Travel time-front (r:0.458,p:0.037) and proprioception-left (r:0.450,p:0.041); moderate with Travel time-back (r:0.515;p:0.017) and proprioception-front (r:0.539,p:0.012).
INTERPRETATION
Compared to healthy, Systemic Sclerosis had worse health status, functional balance, static/dynamic balance and proprioception.This situation is related to disease severity, skin thickness and age. Evaluations made with objective methods may have the potential to determine the extent of the problem.Clinicians can guide the treatment of patients with SSc by evaluating their static/dynamic balance and proprioception.With early treatment, additional problems that may occur due to worsening of balance and proprioception can be prevented.Proprioception and dynamic balance evaluation can be performed for older patients, static balance when disease activity is high, and dynamic balance when skin thickness score is high.
Topics: Humans; Scleroderma, Systemic; Proprioception; Skin; Physical Therapy Modalities
PubMed: 37844542
DOI: 10.1016/j.clinbiomech.2023.106122 -
International Journal of Oral Science Sep 2023Dental primary afferent (DPA) neurons and proprioceptive mesencephalic trigeminal nucleus (MTN) neurons, located in the trigeminal ganglion and the brainstem,...
Dental primary afferent (DPA) neurons and proprioceptive mesencephalic trigeminal nucleus (MTN) neurons, located in the trigeminal ganglion and the brainstem, respectively, are essential for controlling masticatory functions. Despite extensive transcriptomic studies on various somatosensory neurons, there is still a lack of knowledge about the molecular identities of these populations due to technical challenges in their circuit-validated isolation. Here, we employed high-depth single-cell RNA sequencing (scRNA-seq) in combination with retrograde tracing in mice to identify intrinsic transcriptional features of DPA and MTN neurons. Our transcriptome analysis revealed five major types of DPA neurons with cell type-specific gene enrichment, some of which exhibit unique mechano-nociceptive properties capable of transmitting nociception in response to innocuous mechanical stimuli in the teeth. Furthermore, we discovered cellular heterogeneity within MTN neurons that potentially contribute to their responsiveness to mechanical stretch in the masseter muscle spindles. Additionally, DPA and MTN neurons represented sensory compartments with distinct molecular profiles characterized by various ion channels, receptors, neuropeptides, and mechanoreceptors. Together, our study provides new biological insights regarding the highly specialized mechanosensory functions of DPA and MTN neurons in pain and proprioception.
Topics: Animals; Mice; Neurons; Proprioception; Gene Expression Profiling; Pain; Sequence Analysis, RNA
PubMed: 37749100
DOI: 10.1038/s41368-023-00246-z -
ACS Nano Jul 2023The coexistence and interaction of excitatory and inhibitory neurotransmitters at biological synapses enable bilingual communication, serving as a physiological...
The coexistence and interaction of excitatory and inhibitory neurotransmitters at biological synapses enable bilingual communication, serving as a physiological foundation for organism adaptation, internal stability, and regulation of behavior and emotions in mammals. Neuromorphic electronics are expected to emulate the bilingual functions of the biological nervous system for artificial neurorobotics and neurorehabilitation. Here, we have proposed a bilingual bidirectional artificial neuristor array, which utilizes ion migration and electrostatic coupling properties between intrinsically stretchable and self-healing poly(urea-urethane) elastomer and carbon nanotube electrodes, realized by van der Waals integration. The neuristor exhibits depression or potentiation behaviors in response to the same stimulus in different operational phases and achieves a four-quadrant information-processing capability. These properties make it possible to simulate complex neuromorphic processes, which involve bilingual bidirectional responses, such as withdrawal or addiction responses, and array-based automated refresh. Furthermore, the neuristor array is a self-healing neuromorphic electronic device that can function effectively even under 50% mechanical strain and can recover operation voluntarily within 2 h after experiencing mechanical injury. Additionally, the bilingual bidirectional stretchable self-healing neuristor can emulate coordinated neural signal transmission from the motor cortex to muscles and integrate proprioception through strain modulation, similar to the biological muscle spindle. The properties, structure, operation mechanisms, and neurologically integrated functions of the proposed neuristor signify an advancement in neuromorphic electronics for next-generation neurorehabilitation and neurorobotics.
Topics: Animals; Electronics; Synapses; Synaptic Transmission; Elastomers; Proprioception; Mammals
PubMed: 37382222
DOI: 10.1021/acsnano.3c03212 -
Clinical Biomechanics (Bristol, Avon) Oct 2023Limited research has focused on older prosthesis users despite the expected compounded effects of age and amputation on sensorimotor function, balance, and falls. This... (Observational Study)
Observational Study
BACKGROUND
Limited research has focused on older prosthesis users despite the expected compounded effects of age and amputation on sensorimotor function, balance, and falls. This study compared sensorimotor factors and standing balance between older individuals with and without transtibial amputation, hypothesizing that prosthesis users would demonstrate worse sensorimotor function. Secondarily we assessed the relationship between standing balance and somatosensation in prosthesis users.
METHODS
Thirteen persons with unilateral transtibial amputation (71.7 years) and 10 able-bodied controls (71.7 years) participated in this cross-sectional observational study. Passive joint range-of-motion, muscle strength, proprioception (joint position sense), tactile sensitivity, and standing balance (center-of-pressure sway) were compared between groups. A multiple linear regression analysis assessed the relationship between proprioception and balance (without vision) in prosthesis users.
FINDINGS
Our hypotheses were generally not supported, with the only differences being reduced joint range-of-motion and strength in prosthesis users (with large effect sizes), but comparable sensation and balance. Notably, prosthesis users demonstrated better proprioception than controls as reflected through better joint position sense when the limb was non-weight bearing. Worse amputated limb proprioception was associated with better standing balance in prosthesis users.
INTERPRETATION
Older prosthesis users have impaired passive joint motion and muscle strength compared to controls that could challenge their ability to position and control the amputated limb to avoid falls during daily activities. However, their better amputated limb proprioception might help counteract those limitations by leveraging sensory feedback from the suspended limb. The relationship between amputated limb proprioception and standing balance suggests a nuanced relationship that warrants further study.
Topics: Humans; Aged; Cross-Sectional Studies; Postural Balance; Amputees; Proprioception; Amputation, Surgical; Artificial Limbs
PubMed: 37757679
DOI: 10.1016/j.clinbiomech.2023.106104 -
The American Journal of Sports Medicine Apr 2024Primary repair of the anterior cruciate ligament (ACL) has some potential advantages over the reconstruction technique, which include but are not limited to better knee...
BACKGROUND
Primary repair of the anterior cruciate ligament (ACL) has some potential advantages over the reconstruction technique, which include but are not limited to better knee sensation due to preservation of the natural ACL tissue in patients compared with tendon graft. Proprioception is impaired after ACL injuries and the sense of the joint position is lost.
PURPOSE/HYPOTHESIS
The purpose of this study was to compare arthroscopic ACL primary repair and ACL reconstruction techniques clinically and functionally and analyze the differences in proprioception. It was hypothesized that primary repair would restore knee joint proprioception more successfully because the original tissue of the ACL is preserved.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
A total of 63 patients (34 underwent reconstruction and 29 underwent primary repair between 2017 and 2020) and 33 healthy controls, as well as the healthy knees of the operated groups, were evaluated between 24 and 48 months (mean, 29 months) postoperatively. Patients with proximal femoral avulsion tears and stump quality suitable for repair underwent primary repair, and those with tears outside these criteria underwent reconstruction using hamstring tendon autograft. Proprioception was evaluated using the active joint position sensation method during weightbearing, with a digital inclinometer used to measure differences between the target and achieved flexion angles of 15°, 30°, and 60°.
RESULTS
At 15° of knee flexion, the deviation angles for the healthy knee of the reconstruction and primary repair groups were significantly smaller than those of the control group ( < .001), but there was no statistically significant difference between the groups in terms of deviation angle at 30° and 60° of flexion. The deviation angle of the operated knees was statistically significantly larger in the reconstruction group than in the primary repair group at all angles. The deviation angles at 15°, 30°, and 60° were 2.83°, 2.66°, and 2.66° in the reconstruction group and 1.00°, 1.00°, and 1.33° in the primary repair group, respectively ( < .001). There was no statistically significant difference between the reconstruction and primary repair groups in terms of clinical scores.
CONCLUSION
Primary ACL repair can preserve proprioception in a well-selected patient group. In short-term follow-up, primary repair of the ACL in patients with proximal femoral avulsion tears and stump quality suitable for repair appears to be proprioceptively protective. Future studies are needed to clarify the long-term consequences of primary repair on proprioception in a larger population.
Topics: Humans; Anterior Cruciate Ligament; Cohort Studies; Knee Joint; Anterior Cruciate Ligament Injuries; Proprioception
PubMed: 38557260
DOI: 10.1177/03635465241228839