Sensorimotor control during peripheral muscle vibration: an experimental study

Influence of Proprioceptive Inputs and Force Feedback Modality on Force Reproduction Performance

The sense of force can be assessed using a force reproduction task (FRT), which consists of matching a target force with visual feedback (TARGET phase) and reproducing it without visual feedback (REPRODUCTION phase). We investigated the relevance of muscle proprioception during the TARGET phase (EXP1) and the influence of the sensory source used for the force feedback (EXP2). Accordingly, EXP1 compared the force reproduction error (RE) between trials with (LV) and without (NoLV) local tendon vibration applied on the first dorsal interosseous during the TARGET phase, while EXP2 compared RE between trials performed with visual (VISIO) or auditory (AUDIO) feedback. The FRT was performed with the index finger at 5% and 20% of the maximal force (MVC). RE was greater with LV compared with NoLV at 5% (p = 0.004) but not 20% MVC (p = 0.65). The involvement of muscle proprioception in RFT was further supported by the increase in RE with LV frequency (supplementary experiment). RE was greater for VISIO than AUDIO at 5% (p < 0.001) but not 20% MVC (p = 0.054). This study evidences the relevance of proprioceptive inputs during the target PHASE and the influence of the force feedback modality on RE, and thereby on the assessment of the sense of force.

Effects of tendon vibration and age on force reproduction task performed with wrist flexors

The sense of force is suggested to rely in part on proprioceptive inputs when assessed with a force reproduction task. The age-related alterations in proprioceptive system could, therefore, alter the sense of force. This study investigated the effects of tendon vibration on a force reproduction task performed with the wrist flexors in 18 young (20-40 year) and 18 older adults (60-90 year). Participants matched a target force (5% or 20% of their maximal force) with visual feedback of the force produced (target phase), and reproduced the target force without visual feedback (reproduction phase) after a 5-s rest period with or without vibration. The force reproduction error was expressed as the ratio between the force produced during the reproduction and the target phases. For the trials with vibration, the error was expressed as the ratio between the force produced during the reproduction phase performed with and without vibration. Tactile acuity was assessed with a two-point discrimination test. The error was greater at 5% than at 20% contraction intensity (p < 0.001), and in older [56.5 (32.2)%; mean (SD)] than in young adults [33.5 (13.6)%] at 5% (p = 0.002) but not 20% target (p = 0.46). Tendon vibration had a greater effect at 5% than 20% contraction intensity, and in older [41.7 (32.4)%, p < 0.001] than young adults [20.0 (16.1)%]. Tactile acuity was lesser in older than young adults (p < 0.001). The results support the contribution of proprioception in the sense of force, and highlight a decrease in performance with ageing restricted to low-force contractions.

Sense of effort is distorted in people with chronic low back pain

BACKGROUND

Proprioceptive deficits in people with low back pain (LBP) have traditionally been attributed to altered paraspinal muscle spindle afference and its central processing. Studies conducted in the upper limb demonstrated that sense of effort is also an important source of kinaesthetic information.

OBJECTIVES

To better understand proprioceptive deficits in people with chronic LBP (cLBP), this study aimed to test whether sense of effort is affected in people with cLBP.

DESIGN

Cross-sectional study.

METHOD

Fourteen participants with cLBP and fourteen healthy participants performed a 120 s force matching task with their trunk extensor muscles at a low intensity.

RESULTS

When visual feedback of the generated force was provided, both groups performed the task accurately. Removal of visual feedback resulted in an increase in error for both groups (p < 0.0001), but the increase in error was significantly larger for the cLBP group (p = 0.023). This larger error could be attributed to undershooting of the target force (p = 0.020). The control group did not consistently undershoot or overshoot the target force (p = 0.93). Furthermore, the amount of undershooting for the cLBP group increased as the task progressed (p = 0.016), which was not observed for the control group (p = 0.80).

CONCLUSIONS

The results of this study revealed that sense of effort is affected in cLBP. People with cLBP overestimated the trunk extension force they generated, and the error increased as the trial progressed. With visual feedback however, people with cLBP were able to compensate and perform the task as accurately as people without cLBP.

A Novel and Safe Approach to Simulate Cutting Movements Using Ground Reaction Forces

Control of shear ground reaction forces (sGRF) is important in performing running and cutting tasks as poor sGRF control has implications for those with knee injuries, such as anterior cruciate ligament (ACL) ruptures. The goal of this study was to develop a novel and safe task to evaluate control or accurate modulation of shear ground reaction forces related to those generated during cutting. Our approach utilized a force control task using real-time visual feedback of a subject’s force production and evaluated control capabilities through accuracy and divergence measurements. Ten healthy recreational athletes completed the force control task while force control via accuracy measures and divergence calculations was investigated. Participants were able to accurately control sGRF in multiple directions based on error measurements. Forces generated during the task were equal to or greater than those measured during a number of functional activities. We found no significant difference in the divergence of the force profiles using the Lyapunov Exponent of the sGRF trajectories. Participants using our approach produced high accuracy and low divergence force profiles and functional force magnitudes. Moving forward, we will utilize this task in at-risk populations who are unable to complete a cutting maneuver in early stages of rehabilitation, such as ACL deficient and newly reconstructed individuals, allowing insight into force control not obtainable otherwise.

A Simple Non-invasive Method for Temporary Knockdown of Upper Limb Proprioception

Proprioception may be the least well measured of all contributors to the neural control of movement. New precise, reliable measures of proprioception are needed for clinical diagnosis of impairment, and to measure outcomes of proprioceptive training. The purpose of this simple, non-invasive method is to temporarily knockdown upper limb proprioception in healthy adults, to an extent that would be useful in the development and testing of upper limb proprioception measures. Knockdown models have two main advantages over studying humans with impaired proprioception: participant availability and the ability to control the extent of impairment across participants. Current published methods of temporary proprioception knockdown of the upper limb, such as ischemic nerve blocks and cryotherapy, are invasive, impractical, or uncomfortable for the participant. Here, vibration over the ulnar groove was used to reduce upper limb proprioception. High frequency vibration may reduce proprioceptive acuity by inhibiting pacinian corpuscle-induced input. The effect of vibration used in this protocol was confirmed using two quantitative measures. This method was simple to administer, comfortable for participants, and practical.

WHOLE-BODY VIBRATION EXERCISE IS WELL TOLERATED IN PATIENTS WITH DUCHENNE MUSCULAR DYSTROPHY: A SYSTEMATIC REVIEW

BACKGROUND

Duchenne muscular dystrophy (DMD) is caused by a defective gene located on the X-chromosome, responsible for the production of the dystrophin protein. Complications in the musculoskeletal system have been previously described in DMD patients. Whole body vibration exercise (WBVE) is a treatment that improves musculoskeletal function in movement disorders. The aim of this study was to review the effects of WBVE on functional mobility, bone and muscle in DMD patients.

MATERIALS AND METHODS

Four databases were searched. Three eligible studies were found; all three conclude the management of DMD patients with WBV was clinically well tolerated. The studies used a side-alternating WBV system, frequencies 7 - 24 Hz; and amplitudes 2 - 4 mm.

RESULTS

A work indicates that a temporary increase in creatine kinase in DMD during the first days of WBV was observed, but other authors did not find changes. No significant changes in bone mass, muscle strength or bone markers. Some patients reported subjective functional improvement during training. Interpretation.

CONCLUSION

It is concluded that WBV seems to be a feasible and well tolerated exercise modality in DMD patients.

Low back skin sensitivity has minimal impact on active lumbar spine proprioception and stability in healthy adults

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.

The Effects of Vibration and Muscle Fatigue on Trunk Sensorimotor Control in Low Back Pain Patients

INTRODUCTION

Changes in sensorimotor function and increased trunk muscle fatigability have been identified in patients with chronic low back pain (cLBP). This study assessed the control of trunk force production in conditions with and without local erector spinae muscle vibration and evaluated the influence of muscle fatigue on trunk sensorimotor control.

METHODS

Twenty non-specific cLBP patients and 20 healthy participants were asked to perform submaximal isometric trunk extension torque with and without local vibration stimulation, before and after a trunk extensor muscle fatigue protocol. Constant error (CE), variable error (VE) as well as absolute error (AE) in peak torque were computed and compared across conditions. Trunk extensor muscle activation during isometric contractions and during the fatigue protocol was measured using surface electromyography (sEMG).

RESULTS

Force reproduction accuracy of the trunk was significantly lower in the patient group (CE = 9.81 ± 2.23 Nm; AE = 18.16 ± 3.97 Nm) than in healthy participants (CE = 4.44 ± 1.68 Nm; AE = 12.23 ± 2.44 Nm). Local erector spinae vibration induced a significant reduction in CE (4.33 ± 2.14 Nm) and AE (13.71 ± 3.45 Nm) mean scores in the patient group. Healthy participants conversely showed a significant increase in CE (8.17 ± 2.10 Nm) and AE (16.29 ± 2.82 Nm) mean scores under vibration conditions. The fatigue protocol induced erector spinae muscle fatigue as illustrated by a significant decrease in sEMG median time-frequency slopes. Following the fatigue protocol, patients with cLBP showed significant decrease in sEMG root mean square activity at L4-5 level and responded in similar manner with and without vibration stimulation in regard to CE mean scores.

CONCLUSIONS

Patients with cLBP have a less accurate force reproduction sense than healthy participants. Local muscle vibration led to significant trunk neuromuscular control improvements in the cLBP patients before and after a muscle fatigue protocol. Muscle vibration stimulation during motor control exercises is likely to influence motor adaptation and could be considered in the treatment of cLBP. Further work is needed to clearly identify at what levels of the sensorimotor system these gains are achievable.