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Journal of the Royal Society, Interface Jun 2018During human walking, the centre of mass (CoM) is outside the base of support for most of the time, which poses a challenge to stabilizing the gait pattern.... (Review)
Review
During human walking, the centre of mass (CoM) is outside the base of support for most of the time, which poses a challenge to stabilizing the gait pattern. Nevertheless, most of us are able to walk without substantial problems. In this review, we aim to provide an integrative overview of how humans cope with an underactuated gait pattern. A central idea that emerges from the literature is that foot placement is crucial in maintaining a stable gait pattern. In this review, we explore this idea; we first describe mechanical models and concepts that have been used to predict how foot placement can be used to control gait stability. These concepts, such as for instance the extrapolated CoM concept, the foot placement estimator concept and the capture point concept, provide explicit predictions on where to place the foot relative to the body at each step, such that gait is stabilized. Next, we describe empirical findings on foot placement during human gait in unperturbed and perturbed conditions. We conclude that humans show behaviour that is largely in accordance with the aforementioned concepts, with foot placement being actively coordinated to body CoM kinematics during the preceding step. In this section, we also address the requirements for such control in terms of the sensory information and the motor strategies that can implement such control, as well as the parts of the central nervous system that may be involved. We show that visual, vestibular and proprioceptive information contribute to estimation of the state of the CoM. Foot placement is adjusted to variations in CoM state mainly by modulation of hip abductor muscle activity during the swing phase of gait, and this process appears to be under spinal and supraspinal, including cortical, control. We conclude with a description of how control of foot placement can be impaired in humans, using ageing as a primary example and with some reference to pathology, and we address alternative strategies available to stabilize gait, which include modulation of ankle moments in the stance leg and changes in body angular momentum, such as rapid trunk tilts. Finally, for future research, we believe that especially the integration of consideration of environmental constraints on foot placement with balance control deserves attention.
Topics: Biomechanical Phenomena; Foot; Humans; Male; Models, Biological; Muscle, Skeletal; Postural Balance; Proprioception; Walking
PubMed: 29875279
DOI: 10.1098/rsif.2017.0816 -
Complementary Therapies in Medicine May 2022Ankle proprioception and balance impairments are usual consequences of chronic ankle instability (CAI). The impairments affect functional and sport activities and can... (Randomized Controlled Trial)
Randomized Controlled Trial
Comparative effect of walking meditation and rubber-band exercise on ankle proprioception and balance performance among persons with chronic ankle instability: A randomized controlled trial.
BACKGROUND
Ankle proprioception and balance impairments are usual consequences of chronic ankle instability (CAI). The impairments affect functional and sport activities and can lead to recurrent ankle sprain. Mind-body practice is claimed to improve ankle proprioception and balance.
OBJECTIVE
To investigate the effects of walking meditation, a mind-body practice, and compare it with the rubber-band exercise on ankle proprioception and balance among individuals with CAI.
STUDY DESIGN
A randomized controlled trial.
METHODS
Thirty-two participants with CAI aged 20.3 ± 1.8 years were randomized into three groups; 1) walking meditation (WM, n = 10), 2) Rubber-band exercise (RE, n = 11) and 3) control (n = 11). WM and RE were enrolled on a 4-week training regimen (30 min/day, 3 days/week). Before and after the training, ankle proprioception was evaluated by angular error of the ankle reposition test (AEA) at three positions, randomly, i.e., plantarflexion-5°, plantarflexion-10° and dorsiflexion-5°. Balance performance was assessed by the star excursion balance test (SEBT).
RESULTS
As adjusted by pre-training baseline, no significant difference in AEA and SEBT was found among three groups. However, after training, only the WM group revealed a significant decrease in AEA at plantarflexion-5° (p = 0.007) and plantarflexion-10° (p = 0.04) compared to the baseline. For SEBT, the WM and RE groups showed significant improvements compared to the baseline in 4 directions each (p < 0.05), while the control group improved only 2 directions (p < 0.05).
CONCLUSIONS
WM and RE groups significantly improved SEBT after 4-week training when compared to before training. Additionally, WM group also improved ankle proprioception. Therefore, WM demonstrates feasibility as a promising intervention that could be applied for balance and ankle proprioceptive rehabilitations in persons with CAI.
Topics: Adolescent; Adult; Ankle; Chronic Disease; Humans; Meditation; Postural Balance; Proprioception; Rubber; Walking; Young Adult
PubMed: 35093512
DOI: 10.1016/j.ctim.2022.102807 -
Journal of Athletic Training Apr 2019To describe the effects of proprioceptive training on pain, stiffness, function, and functional test outcomes among patients with knee osteoarthritis (OA). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To describe the effects of proprioceptive training on pain, stiffness, function, and functional test outcomes among patients with knee osteoarthritis (OA).
DATA SOURCES
All studies completed from 1946 to 2017 were obtained from 4 databases (PubMed, MEDLINE, CINAHL, and SPORTDiscus).
STUDY SELECTION
Three reviewers independently identified appropriate studies and extracted data.
DATA EXTRACTION
Methodologic quality and level of evidence were assessed using the Physiotherapy Evidence Database scale and Oxford Centre for Evidence-Based Medicine guidelines. The standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for pain, stiffness, function, and functional test outcomes.
DATA SYNTHESIS
Seven randomized controlled trials involving 558 patients with knee OA met the inclusion criteria. The selected studies had Physiotherapy Evidence Database scores of 6 to 8. All randomized controlled trials had an Oxford Centre for Evidence-Based Medicine level of evidence of 2. Meta-analysis of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (SMD = -0.56; 95% CI = -1.06, -0.07; = .026), function subscale (SMD = -0.40; 95% CI = -0.59, -0.21; < .001), and non-WOMAC walking speed test (SMD = -1.07; 95% CI = -2.12, -0.01; = .048) revealed that proprioceptive training had significant treatment effects. Proprioceptive training was not associated with reductions in WOMAC stiffness subscale scores and did not improve non-WOMAC get-up-and-go scores.
CONCLUSIONS
Proprioceptive training effectively promoted pain relief and completion of functional daily activity among patients with knee OA and should be included in rehabilitation programs. Stiffness and other mobility measures were unchanged after proprioceptive training. Modified proprioceptive training programs are needed to target stiffness and improve additional physical function domains.
Topics: Exercise Therapy; Humans; Knee Joint; Osteoarthritis, Knee; Proprioception; Randomized Controlled Trials as Topic; Range of Motion, Articular
PubMed: 30995119
DOI: 10.4085/1062-6050-329-17 -
BMC Neurology Jul 2020There is growing evidence for proprioceptive dysfunction in patients with Parkinson's disease (PD). The Lee Silvermann Voice Treatment-BIG therapy (LSVT-BIG), a special...
BACKGROUND
There is growing evidence for proprioceptive dysfunction in patients with Parkinson's disease (PD). The Lee Silvermann Voice Treatment-BIG therapy (LSVT-BIG), a special training program aiming at an increase of movement amplitudes in persons with PD (PwPD), has shown to be effective on motor symptoms. LSVT-BIG is conceptionally based on improving bradykinesia, in particular the decrement of repetitive movements, by proprioceptive recalibration.
OBJECTIVE
To assess proprioceptive impairment in PwPD as compared to matched controls and to probe potential recalibration effects of the LSVT-BIG therapy on proprioception.
METHODS
Proprioceptive performance and fine motor skills were assessed in 30 PwPD and 15 matched controls. Measurements with significant impairment in PwPD were chosen as outcome parameters for a standardized 4 weeks amplitude-based training intervention (LSVT-BIG) in 11 PwPD. Proprioceptive performance served as primary outcome measure. Secondary outcome measures included the motor part of the MDS-UPDRS, the nine-hole-peg test, and a questionnaire on quality of life. Post-interventional assessments were conducted at weeks 4 and 8.
RESULTS
Compared to the control group, PwPD showed significantly larger pointing errors. After 4 weeks of LSVT-BIG therapy and even more so after an additional 4 weeks of continued training, proprioceptive performance improved significantly. In addition, quality of life improved as indicated by a questionnaire.
CONCLUSION
LSVT-BIG training may achieve a recalibration of proprioceptive processing in PwPD. Our data indicates a probable physiological mechanism of a symptom-specific, amplitude-based behavioral intervention in PwPD.
Topics: Aged; Exercise Therapy; Female; Humans; Male; Middle Aged; Parkinson Disease; Proprioception; Quality of Life
PubMed: 32652957
DOI: 10.1186/s12883-020-01858-2 -
Journal of Musculoskeletal & Neuronal... Dec 2019To evaluate the effect of simultaneous proprioceptive - visual training on gait parameters in children with spastic diplegic cerebral palsy. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To evaluate the effect of simultaneous proprioceptive - visual training on gait parameters in children with spastic diplegic cerebral palsy.
METHOD
Gait parameters of 30 spastic diplegic children (age range 4-6 years) were evaluated before and after treatment by Tekscan's Walkway Pressure system. They were randomly and equally assigned into two groups (study and control). All children received regular therapeutic exercise program for one hour. In control group walked for 30 minutes without feedback, while those in study group walked for 30 minutes with proprioceptive-visual feedback. Duration of treatment was 3 times/week for 8 successive weeks.
RESULTS
There were significant differences after treatment in spatial parameters and temporal parameters of both groups with more improvement in study group than control one, and insignificant difference in kinetic gait parameters.
CONCLUSION
The simultaneous proprioceptive - visual training might improve spatial and temporal gait parameters with no effect on kinetic gait parameters of children with spastic diplegic cerebral palsy.
Topics: Cerebral Palsy; Child; Child, Preschool; Feedback, Sensory; Female; Gait; Humans; Male; Muscle Spasticity; Physical Therapy Modalities; Postural Balance; Proprioception; Treatment Outcome; Visual Perception; Walking
PubMed: 31789301
DOI: No ID Found -
Journal of Sports Science & Medicine Sep 2018Maintaining balance while performing "Hakdariseogi" in Taekwondo, which involves standing on one leg, is a critical aspect of the Poomsae competition. The purpose of... (Randomized Controlled Trial)
Randomized Controlled Trial
Maintaining balance while performing "Hakdariseogi" in Taekwondo, which involves standing on one leg, is a critical aspect of the Poomsae competition. The purpose of this study was to investigate the effect of proprioceptive training and lower-limb muscular strength training on the balance of Taekwondo Poomsae athletes over a 6-week period. Thirty Taekwondo Poomsae athletes were randomly assigned to three groups, namely, a proprioception training group, a lower-limb muscular strength training group, and a control group. Biomechanics data were collected using eight infrared cameras (Qualysis, Sweden) at 200 Hz and a force plate (Kistler, Switzerland) at 2,000 Hz while the participants performed "Hakdariseogi" before and after the 6-week intervention. Balance and stability variables were calculated using customized MATLAB R2014b software (Mathworks, Inc., USA). The medio-lateral (M/L) center of pressure (CoP) range, M/L CoP mean velocity, antero-posterior (A/P) CoP range, A/P CoP mean velocity, and the vertical ground reaction torque after the training were reduced at P1 in the PG groups (p < 0.05). A decrease in the A/P CoP range, A/P CoP mean velocity, and vertical ground reaction torque after the training were observed at P2 in the PG and SG groups (p < 0.05). The PG exhibited a smaller A/P CoP range and A/P CoP mean velocity, in comparison to CG (p < 0.05). The A/P CoP position at P1 was negatively correlated with the vertical ground reaction torque, A/P CoP range, and A/P CoP mean velocity at P2(r = -0.438, r = -0.626, r = -0.638). Based on the above results, this study determined that both proprioception training and lower-extremity muscle strength training resulted in an improvement of athletic performance. It was also desirable to move the CoP position through conscious effort forward at P2 in order to maintain the crane stance without sway.
Topics: Athletes; Female; Humans; Male; Martial Arts; Muscle Strength; Physical Conditioning, Human; Postural Balance; Proprioception; Resistance Training; Young Adult
PubMed: 30116118
DOI: No ID Found -
Journal of Neurophysiology Feb 2022Hand proprioception, the sense of the posture and movements of the wrist and digits, is critical to dexterous manual behavior and to stereognosis, the ability to sense...
Hand proprioception, the sense of the posture and movements of the wrist and digits, is critical to dexterous manual behavior and to stereognosis, the ability to sense the three-dimensional structure of objects held in the hand. To better understand this sensory modality and its role in hand function, we sought to characterize the acuity with which the postures and movements of finger joints are sensed. To this end, we measured the ability of human subjects to discriminate changes in posture and speed around the three joints of the index finger. In these experiments, we isolated the sensory component by imposing the postures on an otherwise still hand, to complement other studies in which subjects made judgments on actively achieved postures. We found that subjects could reliably sense 12-16% changes in joint angle and 18-32% changes in joint speed. Furthermore, the acuity for posture and speed was comparable across the three joints of the finger. Finally, task performance was unaffected by the presence of a vibratory stimulus, calling into question the role of cutaneous cues in hand proprioception. Manual dexterity and stereognosis are supported by two exquisite sensory systems, namely touch and proprioception. Here, we measure the sensitivity of hand proprioception and show that humans can sense the posture and movements of the fingers with great accuracy. We also show that application of a skin vibration does not impair sensitivity, suggesting that proprioceptive acuity relies primarily on receptors in the muscles (and possibly tendons) rather than the skin.
Topics: Adult; Female; Fingers; Humans; Male; Movement; Muscle Spindles; Posture; Proprioception; Psychomotor Performance; Young Adult
PubMed: 35020504
DOI: 10.1152/jn.00513.2021 -
Trends in Neurosciences Dec 2023Proprioception, the sense of body position in space, has a critical role in the control of posture and movement. Aside from skin and joint receptors, the main sources of... (Review)
Review
Proprioception, the sense of body position in space, has a critical role in the control of posture and movement. Aside from skin and joint receptors, the main sources of proprioceptive information in tetrapods are mechanoreceptive end organs in skeletal muscle: muscle spindles (MSs) and Golgi tendon organs (GTOs). The sensory neurons that innervate these receptors are divided into subtypes that detect discrete aspects of sensory information from muscles with different biomechanical functions. Despite the importance of proprioceptive neurons in motor control, the developmental mechanisms that control the acquisition of their distinct functional properties and positional identity are not yet clear. In this review, we discuss recent findings on the development of mouse proprioceptor subtypes and challenges in defining them at the molecular and functional level.
Topics: Mice; Animals; Sensory Receptor Cells; Mechanoreceptors; Muscle Spindles; Muscle, Skeletal; Proprioception
PubMed: 37858440
DOI: 10.1016/j.tins.2023.09.008 -
Experimental Physiology Jan 2024Proprioception is the sense that lets us perceive the location, movement and action of the body parts. The proprioceptive apparatus includes specialized sense organs... (Review)
Review
Proprioception is the sense that lets us perceive the location, movement and action of the body parts. The proprioceptive apparatus includes specialized sense organs (proprioceptors) which are embedded in the skeletal muscles. The eyeballs are moved by six pairs of eye muscles and binocular vision depends on fine-tuned coordination of the optical axes of both eyes. Although experimental studies indicate that the brain has access to eye position information, both classical proprioceptors (muscle spindles and Golgi tendon organ) are absent in the extraocular muscles of most mammalian species. This paradox of monitoring extraocular muscle activity in the absence of typical proprioceptors seemed to be resolved when a particular nerve specialization (the palisade ending) was detected in the extraocular muscles of mammals. In fact, for decades there was consensus that palisade endings were sensory structures that provide eye position information. The sensory function was called into question when recent studies revealed the molecular phenotype and the origin of palisade endings. Today we are faced with the fact that palisade endings exhibit sensory as well as motor features. This review aims to evaluate the literature on extraocular muscle proprioceptors and palisade endings and to reconsider current knowledge of their structure and function.
Topics: Animals; Oculomotor Muscles; Sensory Receptor Cells; Mechanoreceptors; Proprioception; Muscle Spindles; Mammals
PubMed: 36869596
DOI: 10.1113/EP090765 -
Computational and Mathematical Methods... 2022In individuals with traumatic shoulder instability, there is a loss of proprioception. This paper reviews the academic literature on shoulder instability and functional... (Review)
Review
In individuals with traumatic shoulder instability, there is a loss of proprioception. This paper reviews the academic literature on shoulder instability and functional impairment in recent years and combines it with clinical practice experience to summarize several techniques of proprioceptive regeneration following traumatic shoulder instability. Many issues were discovered, including a lack of literature on the role of sensory input, a lack of basic proprioceptive research, insufficient sample size in proprioceptive research, and a lack of systematic and standardized standards for the evaluation and training of proprioception in clinical practice, among others. In the future, we will need to better understand the mechanism of proprioception and conduct research on various groups of people, with a focus on discussing the optimal intensity, frequency, and duration of various training methods, as well as implementing proprioceptive training in stages throughout the rehabilitation process. The reestablishment of shoulder joint function, the restoration of proprioception, and the enhancement of daily activities are all critical.
Topics: Humans; Joint Instability; Proprioception; Shoulder; Shoulder Joint
PubMed: 35495889
DOI: 10.1155/2022/1429375