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Picot B, Lempereur M, Morel B, Forestier N, Rémy-Néris O. Lack of Proprioceptive Strategy Modulation Leads to At-Risk Biomechanics for Anterior Cruciate Ligament in Healthy Athletes. Med Sci Sports Exerc 2024; 56:942-952. [PMID: 38190373 DOI: 10.1249/mss.0000000000003378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
INTRODUCTION Anterior cruciate ligament (ACL) injuries are frequent in handball, and altered sensory integration may contribute to increased injury risk. Recent evidence showed that proprioceptive postural control strategies differ among athletes. The aim of this study was to evaluate the relationship between proprioceptive strategy and biomechanics during side-cutting maneuvers. METHODS A total of 47 handball players performed anticipated and unanticipated cutting tasks. Their postural proprioceptive strategy was then characterized according to the perturbation of the center of pressure displacement generated by the muscle vibration on a firm and foam surface. Individuals able to reweight proprioception from ankle to lumbar signals according to the stability of the support were defined as flexible. Conversely, athletes maintaining an ankle-steered strategy on foam surface were characterized as rigid. Statistical parametric mapping analysis was used to compare pelvic and lower limb side-cutting kinematics, kinetics, and EMG activity from seven muscles 200 ms before and after initial contact (IC) using a two-way ANOVA (group-condition). RESULTS Twenty athletes (11 females and 9 males, 18.5 yr) were characterized as flexible and 20 athletes (12 females and 8 males, 18.9 yr) as rigid. No interaction between condition and proprioceptive profile was observed. More ipsilateral pelvic tilt before IC and lower vastus lateralis (VL) activity immediately after IC was observed during CUT ant . When comparing proprioceptive strategy, rigid individuals exhibited less preactivity of the semitendinosus ( P < 0.001) and higher VL activity ( P = 0.032). Conversely, rigid showed higher gluteus medius preactivity ( P < 0.05) and higher VL activity 100 ms after IC ( P < 0.001). Ankle was also more internally rotated before and during the stance phase ( P < 0.05) among rigid athletes. CONCLUSIONS Rigid handball players exhibited at-risk determinants for anterior cruciate ligament injuries during side-cutting maneuvers.
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Affiliation(s)
| | | | - Baptiste Morel
- Interuniversity Laboratory of Human Movement Sciences, University Savoie Mont Blanc, Chambéry, FRANCE
| | - Nicolas Forestier
- Interuniversity Laboratory of Human Movement Sciences, University Savoie Mont Blanc, Chambéry, FRANCE
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Minino R, Romano A, Troisi Lopez E, Liparoti M, Sorrentino P, Fratini A. The Effects of Vibratory and Acoustic Stimulations on Postural Control in Healthy People: A Systematic Review. Ann Biomed Eng 2023; 51:643-659. [PMID: 36701031 PMCID: PMC10023618 DOI: 10.1007/s10439-023-03136-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 12/25/2022] [Indexed: 01/27/2023]
Abstract
Research on human posture and balance control has grown in recent years, leading to continued advances in their understanding. The ability to maintain balance is attributed to the interplay of the visual, vestibular, and somatosensory systems, although an important role is also played by the auditory system. The lack or deficit in any of these systems leads to a reduced stability that may be counterbalanced by the integration of all the remaining sensory information. Auditory and vibratory stimulation have been found to be useful to enhance balance alongside daily activities either in healthy or pathological subjects; nevertheless, while widely investigated, the literature relating to these approaches is still fragmented. This review aims at addressing this by collecting, organising, and discussing all the literature to date on the effects of the various acoustic and vibratory stimulation techniques available on static upright posture in healthy subjects. In addition, this review intends to provide a solid and comprehensive starting point for all the researchers interested in these research areas. A systematic search of the literature was performed and a total of 33 articles (24 on vibratory stimulation and 9 on acoustic stimulation) were included in our analysis. For all articles, several elements were highlighted including: the study sample, the characteristics of the stimulations, the recording instruments, the experimental protocols, and outcomes. Overall, both stimulations analysed were found to have a positive effect on balance but more research is needed to align those alternative approaches to the traditional ones.
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Affiliation(s)
- Roberta Minino
- Department of Motor Sciences and Wellness, University of Naples "Parthenope", Naples, Italy
| | - Antonella Romano
- Department of Motor Sciences and Wellness, University of Naples "Parthenope", Naples, Italy
| | - Emahnuel Troisi Lopez
- Department of Motor Sciences and Wellness, University of Naples "Parthenope", Naples, Italy
| | - Marianna Liparoti
- Department of Social and Developmental Psychology, University of Rome "Sapienza", Rome, Italy
| | - Pierpaolo Sorrentino
- Institut de Neuroscience des Systemès, Aix-Marseille University, Marseille, France
| | - Antonio Fratini
- Department of Mechanical, Biomedical and Design Engineering, Aston University, Aston Triangle, Birmingham, B4 7ET, UK.
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Picot B, Dury J, Néron G, Samozino P, Terrier R, Rémy-Neris O, Forestier N. Validity and reliability of video analysis to evaluate ankle proprioceptive reintegration during postural control. Gait Posture 2022; 91:155-160. [PMID: 34736093 DOI: 10.1016/j.gaitpost.2021.10.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 09/09/2021] [Accepted: 10/13/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The ability to dynamically reintegrate proprioceptive signals after they have been perturbated is impaired in certain pathologies. Evaluation of proprioceptive reintegration is useful for clinical practice but currently requires expensive laboratory tools. We developed a simple method, accessible to clinicians. RESEARCH QUESTION Is two-dimensional (2D) video analysis of earlobe displacement a valid and reliable tool for the evaluation of ankle proprioceptive reintegration following muscle vibration? METHODS Thirty-eight healthy individuals underwent vibration of the triceps surae while standing on a force plate (FP). Anterior (sagittal plane) earlobe displacement ('overshoot') was recorded at vibration cessation using 2D video analysis and rated by 3 blind examiners. Correlation analysis was performed between earlobe and center of pressure displacement (dCoP, recorded with the FP) to determine validity. Intra and interrater reliability were determined by calculation of the intraclass correlation coefficient (ICC), change in the mean (CiM), standard error of measurement (SEM) and the minimal detectable change (MDC). RESULTS AND SIGNIFICANCE Strong positive correlations (r = 0.82-0.94, p < .001) were found between video and FP data. Intra- and interrater reliability were excellent (ICC from 0.99 to 1.00 and from 0.90 to 0.97 respectively). For intrarater analysis, the CiM was 0.01 cm, SEM were 0.27 cm (95% CI: 0.23-0.33) and 3.43% (95% CI: 2.92-4.20) and the MDC was 0.74 cm. For interrater reliability, the CiM ranged from - 0.81-0.55 cm, the SEM from 0.61 to 1.12 cm and the MDC from 1.69 to 3.10 cm. 2D video analysis of anterior (sagittal) earlobe displacement is therefore a valid and reliable method to assess postural recovery following muscle vibration. This simple method could be used by clinicians to evaluate the ability of the central nervous system to reintegrate proprioceptive signals from the ankle. Further studies are needed to assess its validity in individuals with proprioceptive impairment.
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Affiliation(s)
- Brice Picot
- Fédération Française de Handball, Creteil, France; Société Française des Masseurs-Kinésithérapeutes du Sport (SFMKS Lab), Pierrefite sur Seine, France; Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la motricité EA 7424, 73000 Chambéry, France; Université de Bretagne Occidentale, Laboratoire de Traitement de l'Information Médicale, INSERM U1101 Brest, France.
| | - Jeanne Dury
- Société Française des Masseurs-Kinésithérapeutes du Sport (SFMKS Lab), Pierrefite sur Seine, France; Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la motricité EA 7424, 73000 Chambéry, France
| | - Guillaume Néron
- Fédération Française de Handball, Creteil, France; Société Française des Masseurs-Kinésithérapeutes du Sport (SFMKS Lab), Pierrefite sur Seine, France
| | - Pierre Samozino
- Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la motricité EA 7424, 73000 Chambéry, France
| | - Romain Terrier
- Société Française des Masseurs-Kinésithérapeutes du Sport (SFMKS Lab), Pierrefite sur Seine, France
| | - Olivier Rémy-Neris
- Université de Bretagne Occidentale, Laboratoire de Traitement de l'Information Médicale, INSERM U1101 Brest, France; CHRU de Brest, Hôpital Morvan, Service de médecine Physique et de Réadaptation, Brest, France
| | - Nicolas Forestier
- Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la motricité EA 7424, 73000 Chambéry, France
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Proprioceptive postural control strategies differ among non-injured athletes. Neurosci Lett 2021; 769:136366. [PMID: 34852284 DOI: 10.1016/j.neulet.2021.136366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 12/28/2022]
Abstract
Postural control during complex tasks requires adequate sensory integration and somaesthetic reweighting: suboptimal postural strategies can lead to injury. We assessed the ability of healthy athletes to reweight somaesthetic signals during postural perturbations on different surfaces. Thirty-five young (16 ± 1 years), healthy, elite handball players participated in this cross-sectional study. Proprioceptive reweighting was evaluated via vibration of the triceps surae and lumbar muscles on firm and foam surfaces. Postural variables and the electromyographic activity of the gluteus medius (GM), semitendinosus (ST) and fibularis longus (FL) were recorded during the PRE (10 s), VIBRATION (20 s) and POST (20 s) periods. Ankle proprioception was predominantly used on the firm compared to foam support. However, two opposing behaviours were observed: a "rigid" strategy in which reliance on ankle proprioception increased on the foam, and a "plastic" strategy that involved a proximal shift of proprioceptive reliance (p < 0.001). The plastic strategy was associated with a more effective recovery of balance after vibration cessation (p < 0.05). ST activation was higher during POST in the rigid strategy and did not return to the PRE level (p < 0.05) whereas it did in the plastic strategy. Proprioceptive strategies for postural control are highly variable and future studies should evaluate their contribution to injury.
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Pinto SM, Cheung JPY, Samartzis D, Karppinen J, Zheng YP, Pang MYC, Wong AYL. Differences in Proprioception Between Young and Middle-Aged Adults With and Without Chronic Low Back Pain. Front Neurol 2020; 11:605787. [PMID: 33408687 PMCID: PMC7779670 DOI: 10.3389/fneur.2020.605787] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/24/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: While young adults with chronic low back pain (CLBP) exhibit impaired lumbar proprioception, it remains unclear if the same phenomenon is observed in middle-aged adults with CLBP. Objectives: This study aimed to investigate whether young or middle-aged adults with CLBP displayed different proprioception ability as compared to age-matched asymptomatic controls. Methods: Sixty-four young adults with [median age:34 [interquartile range (IQR): 29–37] years] and without [median age:29 (IQR; 23–34) years] CLBP, and 87 middle-aged adults with [median age:53 (IQR: 49–58) years] and without [median age: 54 (IQR: 45–64) years] CLBP underwent postural sway tests on a force-plate with (unstable surface) and without a foam (stable surface), while bilateral L5/S1 multifidi and triceps-surae were vibrated separately. An individual's proprioception reweighting ability was estimated by relative proprioceptive reweighting (RPW). Higher RPW values indicate less reliance on lumbar multifidus proprioceptive signals for balance. Participants also underwent lumbar repositioning tests in sitting to determine repositioning errors in reproducing target lumbar flexion/extension positions. Results: Young adults with CLBP demonstrated significantly higher median RPW values than age-matched asymptomatic controls for maintaining standing balance [stable surface: CLBP: 0.9 (IQR: 0.7–0.9), asymptomatic: 0.7 (IQR: 0.6–0.8), p < 0.05; unstable surface: CLBP: 0.6 (IQR: 0.4–0.8), asymptomatic: 0.5 (IQR: 0.3–0.7), p < 0.05]. No significant differences in repositioning error were noted between young or middle-aged adults with and without CLBP (p > 0.05). RPW values were unrelated to repositioning errors in all groups (p > 0.05). Conclusion: Young adults with CLBP, and middle-aged adults with and without CLBP had inferior proprioceptive reweighting capability. This finding may indicate potential age-related deterioration in central and peripheral processing of lumbar proprioceptive signals. Future studies should use advanced imaging and/or electroencephalogram to determine mechanisms underlying changes in proprioceptive reweighting in middle-aged adults.
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Affiliation(s)
- Sabina M Pinto
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jason P Y Cheung
- Department of Orthopedics and Traumatology, The University of Hong Kong, Hong Kong, China
| | - Dino Samartzis
- Department of Orthopedics Surgery, Rush University Medical Center, Chicago, IL, United States.,International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, United States
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Marco Y C Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Changes in the Organization of the Secondary Somatosensory Cortex While Processing Lumbar Proprioception and the Relationship With Sensorimotor Control in Low Back Pain. Clin J Pain 2020; 35:394-406. [PMID: 30730445 DOI: 10.1097/ajp.0000000000000692] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Patients with nonspecific low back pain (NSLBP) rely more on the ankle compared with the lower back proprioception while standing, perform sit-to-stand-to-sit (STSTS) movements slower, and exhibit perceptual impairments at the lower back. However, no studies investigated whether these sensorimotor impairments relate to a reorganization of the primary and secondary somatosensory cortices (S1 and S2) and primary motor cortex (M1) during proprioceptive processing. MATERIALS AND METHODS Proprioceptive stimuli were applied at the lower back and ankle muscles during functional magnetic resonance imaging in 15 patients with NSLBP and 13 controls. The location of the activation peaks during the processing of proprioception within S1, S2, and M1 were determined and compared between groups. Proprioceptive use during postural control was evaluated, the duration to perform 5 STSTS movements was recorded, and participants completed the Fremantle Back Awareness Questionnaire (FreBAQ) to assess back-specific body perception. RESULTS The activation peak during the processing of lower back proprioception in the right S2 was shifted laterally in the NSLBP group compared with the healthy group (P=0.007). Moreover, patients with NSLSP performed STSTS movements slower (P=0.018), and reported more perceptual impairments at the lower back (P<0.001). Finally, a significant correlation between a more lateral location of the activation peak during back proprioceptive processing and a more disturbed body perception was found across the total group (ρ=0.42, P=0.025). CONCLUSIONS The results suggest that patients with NSLBP show a reorganization of the higher-order processing of lower back proprioception, which could negatively affect spinal control and body perception.
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Goossens N, Janssens L, Caeyenberghs K, Albouy G, Brumagne S. Differences in brain processing of proprioception related to postural control in patients with recurrent non-specific low back pain and healthy controls. NEUROIMAGE-CLINICAL 2019; 23:101881. [PMID: 31163385 PMCID: PMC6545448 DOI: 10.1016/j.nicl.2019.101881] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 04/19/2019] [Accepted: 05/25/2019] [Indexed: 12/11/2022]
Abstract
Patients with non-specific low back pain (NSLBP) show an impaired postural control during standing and a slower performance of sit-to-stand-to-sit (STSTS) movements. Research suggests that these impairments could be due to an altered use of ankle compared to back proprioception. However, the neural correlates of these postural control impairments in NSLBP remain unclear. Therefore, we investigated brain activity during ankle and back proprioceptive processing by applying local muscle vibration during functional magnetic resonance imaging in 20 patients with NSLBP and 20 controls. Correlations between brain activity during proprioceptive processing and (Airaksinen et al., 2006) proprioceptive use during postural control, evaluated by using muscle vibration tasks during standing, and (Altmann et al., 2007) STSTS performance were examined across and between groups. Moreover, fear of movement was assessed. Results revealed that the NSLBP group performed worse on the STSTS task, and reported more fear compared to healthy controls. Unexpectedly, no group differences in proprioceptive use during postural control were found. However, the relationship between brain activity during proprioceptive processing and behavioral indices of proprioceptive use differed significantly between NSLBP and healthy control groups. Activity in the right amygdala during ankle proprioceptive processing correlated with an impaired proprioceptive use in the patients with NSLBP, but not in healthy controls. Moreover, while activity in the left superior parietal lobule, a sensory processing region, during back proprioceptive processing correlated with a better use of proprioception in the NSLBP group, it was associated with a less optimal use of proprioception in the control group. These findings suggest that functional brain changes during proprioceptive processing in patients with NSLBP may contribute to their postural control impairments.
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Affiliation(s)
- Nina Goossens
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, box 1501, Leuven 3001, Belgium.
| | - Lotte Janssens
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, box 1501, Leuven 3001, Belgium; REVAL Rehabilitation Research Center, Hasselt University, Agoralaan A, Diepenbeek 3590, Belgium
| | - Karen Caeyenberghs
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne Campus (St Patrick), Locked Bag 4115, Fitzroy, VIC 3065, Australia
| | - Geneviève Albouy
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, box 1501, Leuven 3001, Belgium
| | - Simon Brumagne
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, box 1501, Leuven 3001, Belgium
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Low back skin sensitivity has minimal impact on active lumbar spine proprioception and stability in healthy adults. Exp Brain Res 2016; 234:2215-26. [PMID: 27010722 DOI: 10.1007/s00221-016-4625-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 03/10/2016] [Indexed: 12/18/2022]
Abstract
The purpose of the current work was to (1) determine whether low back cutaneous sensitivity could be reduced through the use of a topical lidocaine-prilocaine anesthetic (EMLA(®)) to mirror reductions reported in chronic lower back pain (CLBP) patients, as well as to (2) identify whether reductions in cutaneous sensitivity resulted in decreased lumbar spine proprioception, neuromuscular control and dynamic stability. Twenty-eight healthy participants were divided equally into matched EMLA and PLACEBO treatment groups. Groups completed cutaneous minimum monofilament and two-point discrimination (TPD) threshold tests, as well as tests of sagittal and axial lumbar spine active repositioning error, seated balance and repeated lifting dynamic stability. These tests were administered both before and after the application of an EMLA or PLACEBO treatment. Results show that low back minimum monofilament and TPD thresholds were significantly increased within the EMLA group. Skin sensitivity remained unchanged in the PLACEBO group. In the EMLA group, decreases in low back cutaneous sensitivity had minimal effect on low back proprioception (active sagittal and axial repositioning) and dynamic stability (seated balance and repeated lifting). These findings demonstrate that treating the skin of the low back with an EMLA anesthetic can effectively decrease the cutaneous sensitivity of low back region. Further, these decreases in peripheral cutaneous sensitivity are similar in magnitude to those reported in CLBP patients. Within this healthy population, decreased cutaneous sensitivity of the low back region has minimal influence on active lumbar spine proprioception, neuromuscular control and dynamic stability.
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Pavailler S, Hintzy F, Horvais N, Forestier N. Cutaneous stimulation at the ankle: a differential effect on proprioceptive postural control according to the participants' preferred sensory strategy. J Foot Ankle Res 2016; 9:9. [PMID: 26958080 PMCID: PMC4782337 DOI: 10.1186/s13047-016-0140-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 02/24/2016] [Indexed: 12/26/2022] Open
Abstract
Background Ankle movements can be partially encoded by cutaneous afferents. However, little is known about the central integration of these cutaneous signals, and whether individual differences exist in this integration. The aim of this study was to determine whether the effect of cutaneous stimulation at the ankle would differ depending on the participants’ preferred sensory strategy appraised by relative proprioceptive weighting (RPw). Methods Forty-seven active young individuals free of lower-limb injury stood on a force platform either barefoot or wearing a custom-designed bootee. Vibrations (60 Hz, 0.5 mm) were applied either to the peroneal tendons or to the lumbar paraspinal muscles. Results The barefoot RPw was strongly negatively correlated to the absolute change in RPw measured in the bootee condition (r = −0.81, P < 0.001). Participants were then grouped depending on their barefoot RPw value. The RPw was significantly higher in the bootee condition than in the barefoot condition only for participants with low barefoot RPw. Conclusions The external cutaneous stimulation given by the bootee increased the weight of ankle proprioceptive signals only for participants with low barefoot RPw. This result confirmed that optimization of the ankle proprioceptive signals provided by cutaneous afferent stimulation has a differential effect depending on the participants’ preferred sensory strategy. Electronic supplementary material The online version of this article (doi:10.1186/s13047-016-0140-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sébastien Pavailler
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université de Savoie, UFR SceM - Technolac, 73376 Le Bourget du Lac, France ; Salomon SAS, Amer Sports Footwear Innovation and Sport Science Lab, 14 chemin des Croiselets, 74996 Annecy, Cedex 9 France
| | - Frédérique Hintzy
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université de Savoie, UFR SceM - Technolac, 73376 Le Bourget du Lac, France
| | - Nicolas Horvais
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université de Savoie, UFR SceM - Technolac, 73376 Le Bourget du Lac, France ; Salomon SAS, Amer Sports Footwear Innovation and Sport Science Lab, 14 chemin des Croiselets, 74996 Annecy, Cedex 9 France
| | - Nicolas Forestier
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université de Savoie, UFR SceM - Technolac, 73376 Le Bourget du Lac, France
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Janssens L, McConnell AK, Pijnenburg M, Claeys K, Goossens N, Lysens R, Troosters T, Brumagne S. Inspiratory muscle training affects proprioceptive use and low back pain. Med Sci Sports Exerc 2016; 47:12-9. [PMID: 24870567 DOI: 10.1249/mss.0000000000000385] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE We have shown that individuals with recurrent nonspecific low back pain (LBP) and healthy individuals breathing against an inspiratory load decrease their reliance on back proprioceptive signals in upright standing. Because individuals with LBP show greater susceptibility to diaphragm fatigue, it is reasonable to hypothesize that LBP, diaphragm dysfunction, and proprioceptive use may be interrelated. The purpose of this study was to investigate whether inspiratory muscle training (IMT) affects proprioceptive use during postural control in individuals with LBP. METHODS Twenty-eight individuals with LBP were assigned randomly into a high-intensity IMT group (high IMT) and low-intensity IMT group (low IMT). The use of proprioception in upright standing was evaluated by measuring center of pressure displacement during local muscle vibration (ankle, back, and ankle-back). Secondary outcomes were inspiratory muscle strength, severity of LBP, and disability. RESULTS After high IMT, individuals showed smaller responses to ankle muscle vibration, larger responses to back muscle vibration, higher inspiratory muscle strength, and reduced LBP severity (P < 0.05). These changes were not seen after low IMT (P > 0.05). No changes in disability were observed in either group (P > 0.05). CONCLUSIONS After 8 wk of high IMT, individuals with LBP showed an increased reliance on back proprioceptive signals during postural control and improved inspiratory muscle strength and severity of LBP, not seen after low IMT. Hence, IMT may facilitate the proprioceptive involvement of the trunk in postural control in individuals with LBP and thus might be a useful rehabilitation tool for these patients.
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Affiliation(s)
- Lotte Janssens
- 1KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, BELGIUM; 2Centre for Sports Medicine and Human Performance, Brunel University, Uxbridge, UNITED KINGDOM; 3KU Leuven Department of Rehabilitation Sciences, University of Leuven, Kulab, Bruges, BELGIUM; 4Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, BELGIUM; 5Respiratory Rehabilitation and Respiratory Division, University Hospitals Leuven, Leuven, BELGIUM
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Goossens N, Janssens L, Pijnenburg M, Caeyenberghs K, Van Rompuy C, Meugens P, Sunaert S, Brumagne S. Test–Retest Reliability and Concurrent Validity of an fMRI-Compatible Pneumatic Vibrator to Stimulate Muscle Proprioceptors. Multisens Res 2016; 29:465-92. [DOI: 10.1163/22134808-00002526] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Processing proprioceptive information in the brain is essential for optimal postural control and can be studied with proprioceptive stimulation, provided by muscle vibration, during functional magnetic resonance imaging (fMRI). Classic electromagnetic muscle vibrators, however, cannot be used in the high-strength magnetic field of the fMRI scanner. Pneumatic vibrators offer an fMRI-compatible alternative. However, whether these devices produce reliable and valid proprioceptive stimuli has not been investigated, although this is essential for these devices to be used in longitudinal research. Test–retest reliability and concurrent validity of the postural response to muscle vibration, provided by custom-made fMRI-compatible pneumatic vibrators, were assessed in a repeated-measures design. Mean center of pressure (CoP) displacements during, respectively, ankle muscle and back muscle vibration (45–60 Hz, 0.5 mm) provided by an electromagnetic and a pneumatic vibrator were measured in ten young healthy subjects. The test was repeated on the same day and again within one week. Intraclass correlation coefficients (ICC) were calculated to assess (a) intra- and interday reliability of the postural responses to, respectively, pneumatic and electromagnetic vibration, and (b) concurrent validity of the response to pneumatic compared to electromagnetic vibration. Test–retest reliability of mean CoP displacements during pneumatic vibration was good to excellent (ICCs = 0.64–0.90) and resembled that of responses to electromagnetic vibration (ICCs = 0.64–0.94). Concurrent validity of the postural effect of pneumatic vibration was good to excellent (ICCs = 0.63–0.95). In conclusion, the proposed fMRI-compatible pneumatic vibrator can be used with confidence to stimulate muscle spindles during fMRI to study central processing of proprioception.
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Affiliation(s)
- Nina Goossens
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
| | - Lotte Janssens
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
- Biomedical Research Institute, Hasselt University, Agoralaan A, 3590 Diepenbeek, Belgium
| | - Madelon Pijnenburg
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
| | - Karen Caeyenberghs
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne Campus (St Patrick), Locked Bag 4115, Fitzroy MDC, VIC 3065, Australia
| | - Charlotte Van Rompuy
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
| | - Paul Meugens
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
| | - Stefan Sunaert
- Department of Imaging & Pathology, KU Leuven — University of Leuven, UZ Herestraat 49, Box 7003, 3000 Leuven, Belgium
| | - Simon Brumagne
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
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Claeys K, Dankaerts W, Janssens L, Pijnenburg M, Goossens N, Brumagne S. Young individuals with a more ankle-steered proprioceptive control strategy may develop mild non-specific low back pain. J Electromyogr Kinesiol 2015; 25:329-38. [DOI: 10.1016/j.jelekin.2014.10.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 10/17/2014] [Accepted: 10/21/2014] [Indexed: 12/22/2022] Open
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Postural sway and integration of proprioceptive signals in subjects with LBP. Hum Mov Sci 2015; 39:109-20. [DOI: 10.1016/j.humov.2014.05.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 05/06/2014] [Accepted: 05/30/2014] [Indexed: 12/20/2022]
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Pijnenburg M, Caeyenberghs K, Janssens L, Goossens N, Swinnen SP, Sunaert S, Brumagne S. Microstructural integrity of the superior cerebellar peduncle is associated with an impaired proprioceptive weighting capacity in individuals with non-specific low back pain. PLoS One 2014; 9:e100666. [PMID: 24949796 PMCID: PMC4065054 DOI: 10.1371/journal.pone.0100666] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 05/27/2014] [Indexed: 12/13/2022] Open
Abstract
Introduction Postural control is a complex sensorimotor task that requires an intact network of white matter connections. The ability to weight proprioceptive signals is crucial for postural control. However, research into central processing of proprioceptive signals for postural control is lacking. This is specifically of interest in individuals with non-specific low back pain (NSLBP), because impairments in postural control have been observed as possible underlying mechanisms of NSLBP. Therefore, the objective was to investigate potential differences in sensorimotor white matter microstructure between individuals with NSLBP and healthy controls, and to determine whether the alterations in individuals with NSLBP are associated with the capacity to weight proprioceptive signals for postural control. Methods The contribution of proprioceptive signals from the ankle and back muscles to postural control was evaluated by local muscle vibration in 18 individuals with NSLBP and 18 healthy controls. Center of pressure displacement in response to muscle vibration was determined during upright standing on a stable and unstable support surface. Diffusion magnetic resonance imaging was applied to examine whether this proprioceptive contribution was associated with sensorimotor white matter microstructure. Results Individuals with NSLBP showed a trend towards a reduced fractional anisotropy along the left superior cerebellar peduncle compared to healthy controls (p = 0.039). The impaired microstructural integrity of the superior cerebellar peduncle in individuals with NSLBP was significantly correlated with the response to ankle muscle vibration (p<0.003). Conclusions In individuals with NSLBP, a decreased integrity of the superior cerebellar peduncle was associated with an increased reliance on ankle muscle proprioception, even on unstable support surface, which implies an impaired proprioceptive weighting capacity. Our findings emphasize the importance of the superior cerebellar peduncle in proprioceptive weighting for postural control in individuals with NSLBP.
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Affiliation(s)
- Madelon Pijnenburg
- KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium
- * E-mail:
| | - Karen Caeyenberghs
- Department of Physical Therapy and Motor Rehabilitation, University of Ghent, Ghent, Belgium
- Department of Movement and Sports Sciences, University of Ghent, Ghent, Belgium
| | - Lotte Janssens
- KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium
| | - Nina Goossens
- KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium
| | - Stephan P. Swinnen
- KU Leuven Department of Kinesiology, University of Leuven, Leuven, Belgium
| | - Stefan Sunaert
- KU Leuven Department of Imaging and Pathology, University of Leuven, Leuven, Belgium
| | - Simon Brumagne
- KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium
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