The responses of muscle spindles to small, slow movements in passive muscle and during fusimotor activity

Impaired proprioception and magnified scaling of proprioceptive error responses in chronic stroke

BACKGROUND

Previous work has shown that ~ 50-60% of individuals have impaired proprioception after stroke. Typically, these studies have identified proprioceptive impairments using a narrow range of reference movements. While this has been important for identifying the prevalence of proprioceptive impairments, it is unknown whether these error responses are consistent for a broad range of reference movements. The objective of this study was to characterize proprioceptive accuracy as function of movement speed and distance in stroke.

METHODS

Stroke (N = 25) and controls (N = 21) completed a robotic proprioception test that varied movement speed and distance. Participants mirror-matched various reference movement speeds (0.1-0.4 m/s) and distances (7.5-17.5 cm). Spatial and temporal parameters known to quantify proprioception were used to determine group differences in proprioceptive accuracy, and whether patterns of proprioceptive error were consistent across testing conditions within and across groups.

RESULTS

Overall, we found that stroke participants had impaired proprioception compared to controls. Proprioceptive errors related to tested reference movement scaled similarly to controls, but some errors showed amplified scaling (e.g., significantly overshooting or undershooting reference speed). Further, interaction effects were present for speed and distance reference combinations at the extremes of the testing distribution.

CONCLUSIONS

We found that stroke participants have impaired proprioception and that some proprioceptive errors were dependent on characteristics of the movement (e.g., speed) and that reference movements at the extremes of the testing distribution resulted in significantly larger proprioceptive errors for the stroke group. Understanding how sensory information is utilized across a broad spectrum of movements after stroke may aid design of rehabilitation programs.

Reference value of knee position sense in weight-bearing and non-weight-bearing conditions

BACKGROUND

Our study aimed to identify age-related changes in knee proprioception to provide reference values for weight-bearing (WB) and non-weight-bearing (NWB) conditions and to identify factors (age, WB condition, dominance, and sex) that can affect knee proprioception.

METHODS

A total of 84 healthy adult men and women were recruited. Active knee joint position sense (JPS) was measured using a digital inclinometer for knee proprioception. The participants performed the required movements actively, with verbal feedback from the examiner, slowly moving to the target angles (30° and 50°) and maintaining them for 5 s before returning to the starting position. Afterward, without assistance from the examiner, the participants actively moved back to the same angle, and the examiner confirmed the angles. This procedure was repeated twice for each target angle, and the average values were used as the data. The participants were barefoot, wearing shorts, and closed their eyes while the measurements were obtained. The measurements were first obtained on the dominant side under the NWB conditions. When a change in posture was needed during the measurement, the participants sat in a resting position for 2 min.

RESULTS

Except for age, all other factors (WB condition, dominance, sex) were not statistically significant. Age showed a significant difference in knee JPS, except for the non-dominant side at 30° and the dominant side at 50° in the NWB condition.

CONCLUSION

This study indicates that the WB condition, dominant side, and sex need not be considered when measuring and assessing knee JPS. Age shows a negative correlation with knee joint position sense, and the reference values presented in this study can be used as objective target values during the rehabilitation process.

Proprioception: A New Era Set in Motion by Emerging Genetic and Bionic Strategies?

The generation of an internal body model and its continuous update is essential in sensorimotor control. Although known to rely on proprioceptive sensory feedback, the underlying mechanism that transforms this sensory feedback into a dynamic body percept remains poorly understood. However, advances in the development of genetic tools for proprioceptive circuit elements, including the sensory receptors, are beginning to offer new and unprecedented leverage to dissect the central pathways responsible for proprioceptive encoding. Simultaneously, new data derived through emerging bionic neural machine-interface technologies reveal clues regarding the relative importance of kinesthetic sensory feedback and insights into the functional proprioceptive substrates that underlie natural motor behaviors.

Effects of Ankle Angular Position and Standing Surface on Postural Control of Upright Stance

The purpose of the study was to investigate the effects of ankle angular position and standing surface type on static upright balance. Ten young adults stood on a force platform or on a firm wedge that induced 15° of either dorsiflexion or plantarflexion. In addition, a piece of foam was placed on top of the force platform and on the wedge. The center of pressure distance and velocity in the anteroposterior and mediolateral directions were calculated. Significantly larger magnitudes in most of the investigated variables were seen while standing with ankles in the dorsiflexion when compared with standing with the ankle joints in a natural position (p < .05). Plantarflexion increased the center of pressure anteroposterior velocity by 87% when compared with a natural stance (p < .05). Standing on the foam surfaces resulted in increases in all of the center of pressure measures by an average of 38% in all of the ankle conditions.

Kinesthetic Senses

The kinesthetic senses are the senses of position and movement of the body, senses we are aware of only on introspection. A method used to study kinesthesia is muscle vibration, which engages afferents of muscle spindles to trigger illusions of movement and changed position. When vibrating elbow flexors, it generates sensations of forearm extension, when vibrating extensors, sensations of forearm flexion. Vibrating the elbow joint produces no illusion. Vibrating flexors and extensors together at the same frequency also produces no illusion, because what is perceived is the signal difference between antagonist muscles of each arm and between arms. The size of the illusion depends on how the muscle has been conditioned beforehand, due to a property of muscle called thixotropy. When measuring the illusion, blindfolded subjects may carry out a matching or pointing task. In pointing, signals from muscle spindles are less important than in matching. Afferent signals from kinesthetic receptors project to areas of somatosensory cortex to generate sensations of detection and location. This is referred to the body model, which provides information about size and shape of body parts. Kinesthesia, together with vision and touch, is associated with the sense of body ownership. All three can combine or each, on its own, can generate ownership. Related is the sense of agency, the sense of being responsible for one's own actions. In recent times, much progress has been made using neuroimaging techniques to identify the various areas of the brain likely to be responsible for generating these sensations. © 2017 American Physiological Society. Compr Physiol 8:1157-1183, 2018.

Muscle spindles in human tibialis anterior encode muscle fascicle length changes

Muscle spindles provide exquisitely sensitive proprioceptive information regarding joint position and movement. Through passively driven length changes in the muscle-tendon unit (MTU), muscle spindles detect joint rotations because of their in-parallel mechanical linkage to muscle fascicles. In human microneurography studies, muscle fascicles are assumed to follow the MTU and, as such, fascicle length is not measured in such studies. However, under certain mechanical conditions, compliant structures can act to decouple the fascicles, and, therefore, the spindles, from the MTU. Such decoupling may reduce the fidelity by which muscle spindles encode joint position and movement. The aim of the present study was to measure, for the first time, both the changes in firing of single muscle spindle afferents and changes in muscle fascicle length in vivo from the tibialis anterior muscle (TA) during passive rotations about the ankle. Unitary recordings were made from 15 muscle spindle afferents supplying TA via a microelectrode inserted into the common peroneal nerve. Ultrasonography was used to measure the length of an individual fascicle of TA. We saw a strong correlation between fascicle length and firing rate during passive ankle rotations of varying rates (0.1-0.5 Hz) and amplitudes (1-9°). In particular, we saw responses observed at relatively small changes in muscle length that highlight the sensitivity of the TA muscle to small length changes. This study is the first to measure spindle firing and fascicle dynamics in vivo and provides an experimental basis for further understanding the link between fascicle length, MTU length, and spindle firing patterns.NEW & NOTEWORTHY Muscle spindles are exquisitely sensitive to changes in muscle length, but recordings from human muscle spindle afferents are usually correlated with joint angle rather than muscle fascicle length. In this study, we monitored both muscle fascicle length and spindle firing from the human tibialis anterior muscle in vivo. Our findings are the first to measure these signals in vivo and provide an experimental basis for exploring this link further.

Feeling form: the neural basis of haptic shape perception

The tactile perception of the shape of objects critically guides our ability to interact with them. In this review, we describe how shape information is processed as it ascends the somatosensory neuraxis of primates. At the somatosensory periphery, spatial form is represented in the spatial patterns of activation evoked across populations of mechanoreceptive afferents. In the cerebral cortex, neurons respond selectively to particular spatial features, like orientation and curvature. While feature selectivity of neurons in the earlier processing stages can be understood in terms of linear receptive field models, higher order somatosensory neurons exhibit nonlinear response properties that result in tuning for more complex geometrical features. In fact, tactile shape processing bears remarkable analogies to its visual counterpart and the two may rely on shared neural circuitry. Furthermore, one of the unique aspects of primate somatosensation is that it contains a deformable sensory sheet. Because the relative positions of cutaneous mechanoreceptors depend on the conformation of the hand, the haptic perception of three-dimensional objects requires the integration of cutaneous and proprioceptive signals, an integration that is observed throughout somatosensory cortex.

The shoulder and elbow joints and right and left sides demonstrate similar joint position sense

Proper orientation of the shoulder and elbow is necessary for accurate and precise positioning of the hand. The authors' goal was to compare these joints with an active joint position sense task, while also taking into account the effects of joint flexion angle and arm dominance. Fifteen healthy subjects were asked to replicate presented joint angles with a single degree of freedom active positioning protocol. There were no significant differences in angular joint position sense errors with respect to joint (shoulder vs. elbow) and side (left vs. right). However, when considering linear positioning, errors were lower for the elbow, due to a shorter lever arm. Also, as flexion angles increased toward 90°, there was a consistent pattern of lower errors for both joints.

The spinal reflex cannot be perceptually separated from voluntary movements

Both voluntary and involuntary movements activate sensors in the muscles, skin, tendon and joints. As limb movement can result from a mixture of spinal reflexes and voluntary motor commands, the cortical centres underlying conscious proprioception might either aggregate or separate the sensory inputs generated by voluntary movements from those generated by involuntary movements such as spinal reflexes. We addressed whether healthy volunteers could perceive the contribution of a spinal reflex during movements that combined both reflexive and voluntary contributions. Volunteers reported the reflexive contribution in leg movements that were partly driven by the knee-jerk reflex induced by a patellar tendon tap and partly by voluntary motor control. In one condition, participants were instructed to kick back in response to a tendon tap. The results were compared to reflexes in a resting baseline condition without voluntary movement. In a further condition, participants were instructed to kick forwards after a tap. Volunteers reported the perceived reflex contribution by repositioning the leg to the perceived maximum displacement to which the reflex moved the leg after each tendon tap. In the resting baseline condition, the reflex was accurately perceived. We found a near-unity slope of linear regressions of perceived on actual reflexive displacement. Both the slope value and the quality of regression fit in individual volunteers were significantly reduced when volunteers were instructed to generate voluntary backward kicks as soon as they detected the tap. In the kick forward condition, kinematic analysis showed continuity of reflex and voluntary movements, but the reflex contribution could be estimated from electromyography (EMG) recording on each trial. Again, participants' judgements of reflexes showed a poor relation to reflex EMG, in contrast to the baseline condition. In sum, we show that reflexes can be accurately perceived from afferent information. However, the presence of voluntary movement significantly impairs reflex perception. We suggest that perceptual separation between voluntary and reflex movement is poor at best. Our results imply that the brain has no clear marker for perceptually separating voluntary and involuntary movement. Attribution of body movement to voluntary or involuntary motor commands is surprisingly poor when both are present.

Experimentally induced deep cervical muscle pain distorts head on trunk orientation

PURPOSE

We wanted to explore the specific proprioceptive effect of cervical pain on sensorimotor control. Sensorimotor control comprises proprioceptive feedback, central integration and subsequent muscular response. Pain might be one cause of previously reported disturbances in joint kinematics, head on trunk orientation and postural control. However, the causal relationship between the impact of cervical pain on proprioception and thus on sensorimotor control has to be established.

METHODS

Eleven healthy subjects were examined in their ability to reproduce two different head on trunk targets, neutral head position (NHP) and 30° target position, with a 3D motion analyser before, directly after and 15 min after experimentally induced neck pain. Pain was induced by hypertonic saline infusion at C2/3 level in the splenius capitis muscle on one side (referred to as "injected side").

RESULTS

All subjects experienced temporary pain and the head repositioning error increased significantly during head repositioning to the 30° target to the injected side (p = 0.011). A post hoc analysis showed that pain interfered with proprioception to the injected side during acute pain (p < 0.001), but also when the pain had waned (p = 0.002). Accuracy decreased immediately after pain induction for the 30° target position to the side where pain was induced (3.3 → 5.3°, p = 0.033), but not to the contralateral side (4.9 → 4.1°, p = 0.657). There was no significant impact of pain on accuracy for NHP. A sensory mismatch appeared in some subjects, who experienced dizziness.

CONCLUSIONS

Acute cervical pain distorts sensorimotor control with side-specific changes, but also has more complex effects that appear when pain has waned.

The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force

This is a review of the proprioceptive senses generated as a result of our own actions. They include the senses of position and movement of our limbs and trunk, the sense of effort, the sense of force, and the sense of heaviness. Receptors involved in proprioception are located in skin, muscles, and joints. Information about limb position and movement is not generated by individual receptors, but by populations of afferents. Afferent signals generated during a movement are processed to code for endpoint position of a limb. The afferent input is referred to a central body map to determine the location of the limbs in space. Experimental phantom limbs, produced by blocking peripheral nerves, have shown that motor areas in the brain are able to generate conscious sensations of limb displacement and movement in the absence of any sensory input. In the normal limb tendon organs and possibly also muscle spindles contribute to the senses of force and heaviness. Exercise can disturb proprioception, and this has implications for musculoskeletal injuries. Proprioceptive senses, particularly of limb position and movement, deteriorate with age and are associated with an increased risk of falls in the elderly. The more recent information available on proprioception has given a better understanding of the mechanisms underlying these senses as well as providing new insight into a range of clinical conditions.

Lengthening but not shortening history of paraspinal muscle spindles in the low back alters their dynamic sensitivity

Proprioception is considered important for maintaining spinal stability and for controlling posture and movement in the low back. Previous studies demonstrate the presence of thixotropic properties in lumbar muscle spindles, wherein a vertebra's positional history alters spindle responsiveness to position and movement. This study investigated whether a vertebra's movement history affects the velocity sensitivity of paraspinal muscle spindles in the low back. Afferent activity from multifidus and longissimus muscle spindles was recorded in the L(6) dorsal root in 30 anesthetized cats. To alter movement history, a feedback-controlled motor attached to the L(6) spinous process held (conditioned for 4 s) the L(6) vertebra at an intermediate position or at positions that either lengthened or shortened the muscles. With the vertebra returned to the intermediate position, resting spindle discharge was measured over the next 0.5 s (static test) and then during a dynamic test consisting of ramp vertebral movement at four velocities (0.2, 0.5, 1.0, 2.0 mm/s). Spindle activity during the tests was measured relative to hold-intermediate. For both tests, hold-long decreased and hold-short increased muscle spindle responsiveness. For the static test position responsiveness was not different among the velocity protocols for either hold-long or hold-short (P = 0.42 and 0.24, respectively). During the dynamic test, hold-long conditioning significantly decreased [F((3,119)) = 7.99, P < 0.001] spindle responsiveness to increasing velocity. Mean velocity sensitivity was 4.44, 3.39, and 1.41 (impulses/s)/(mm/s) for the hold-short, hold-intermediate, and hold-long protocols, respectively. The nearly 2.5-fold decrease in velocity sensitivity following hold-long was significantly less than that for either hold-intermediate (P = 0.005) or hold-short conditioning (P < 0.001). Hold-short conditioning had little effect on velocity responses during the dynamic test [F((3,119)) = 0.23, P = 0.87]. In conclusion, only movement histories that stretch but not shorten muscle spindles alter their velocity sensitivity. In the low back, forward flexion and lateral bending postures would likely be the most provocative.

The proprioceptive and agonist roles of gastrocnemius, soleus and tibialis anterior muscles in maintaining human upright posture

Humans can stand using sensory information solely from the ankle muscles. Muscle length and tension in the calf muscles (gastrocnemius and soleus) are unlikely to signal postural sways on account of balance-related modulation in agonist activity. These facts pose two questions: (1) Which ankle muscles provide the proprioceptive information? (2) Which peripheral mechanism could modulate agonist activity? To address these issues, subjects were asked to stand normally on two force plates. Ultrasound and surface EMG were recorded from the calf and tibialis anterior (TA) muscles. For all nine subjects, changes in muscle length of TA were mainly (84 +/- 9% whole trial duration) orthodoxly correlated with bodily sway (centre of gravity, CoG), i.e. in accordance with passive ankle rotation. When orthodox, TA had the highest correlation with CoG (-0.66 +/- 0.07, deep compartment, P < 0.001). For five subjects, the superficial TA compartment showed counter-intuitive changes in muscle length with CoG, probably due to the flattening of the foot and proximal attachment geometry. Gastrocnemius and soleus were usually (duration 71 +/- 23 and 81 +/- 16%, respectively) active agonists (paradoxically correlated with CoG) but, for short periods of time, they could be orthodox and then presented a moderate correlation (0.38 +/- 0.16 and 0.28 +/- 0.09, respectively) with CoG. Considering the duration and extent to which muscle length is orthodox and correlated with CoG, TA may be a better source of proprioceptive information than the active agonists (soleus and gastrocnemius). Therefore, if a peripheral feedback mechanism modulates agonist activity then reciprocal inhibition acted by TA on the calf muscles is more likely to be effective than the autogenic pathway.

Low-threshold afferent signalling of viscous loads during voluntary movements of the human digits

Humans can discriminate changes in load viscosity during voluntary contractions. The afferent signal origin is unknown. Microneurographic recordings from 83 single low-threshold afferents were made while participants performed triangular ramps either unloaded or with a viscous load. The neural discharges for each cycle were compared across load and velocity. Fifty-eight afferents did not respond. Afferents with sufficient activity were classified as ambiguous--discharges correlated to velocity and load (n=4), infinite viscosity--strong load and weak velocity signal (n=6), no viscosity--strong velocity and weak load signal (n=10) and those with neither (n=5). No single class of afferent provides a coherent signal of viscosity. These data suggest that the central nervous system compares the population response of different inputs to discriminate viscosity.

Proprioception of the shoulder after stroke

OBJECTIVE

To investigate position sense and kinesthesia of the shoulders of stroke patients.

DESIGN

Case-control study.

SETTING

A rehabilitation center.

PARTICIPANTS

A total of 22 inpatients with stroke and 10 healthy control subjects.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Angular displacement (in degrees) for threshold to detection of passive motion (TDPM) tests and absolute error (in degrees) for passive reproduction of joint position tests.

RESULTS

For patients, the TDPM for internal and external rotation was significantly higher for both the contralateral (paretic) side (internal, 7.92 degrees +/-7.19 degrees ; external, 8.46 degrees +/-8.87 degrees ) and the ipsilateral (nonparetic) side (internal, 4.86 degrees +/-5.03 degrees ; external, 6.09 degrees +/-9.15 degrees ) compared with the control group (internal, 1.83 degrees +/-1.09 degrees ; external, 1.71 degrees +/-.85 degrees ). Also, for internal rotation, TDPM was significantly higher for patients on the contralateral side compared with the ipsilateral side. For passive reproduction of joint position tests, no differences were found.

CONCLUSIONS

Both the contralateral and ipsilateral shoulders of stroke patients showed impaired TDPM. Passive reproduction of joint position does not seem to be affected as a result of a stroke. The control of the muscle spindles and central integration or processing problems of the afferent signals provided by muscle spindles might cause these effects.

Specific modulation of motor unit discharge for a similar change in fascicle length during shortening and lengthening contractions in humans

This study examines the effect of a change in fascicle length on motor unit recruitment and discharge rate in the human tibialis anterior during shortening and lengthening contractions that involved a similar change in torque. The dorsiflexor torque and the surface and intramuscular electromyograms (EMGs) from the tibialis anterior were recorded in eight subjects. The behaviour of the same motor unit (n=63) was compared during submaximal shortening and lengthening contractions performed at a constant velocity (10 deg s-1) with the dorsiflexor muscles over a 20 deg range of motion around the ankle neutral position. Muscle fascicle length was measured non-invasively using ultrasonography. Motor units that were active during a shortening contraction were always active during the subsequent lengthening contraction. Furthermore, additional motor units (n=18) of higher force threshold that were recruited during the shortening contraction to maintain the required torque were derecruited first during the following lengthening contraction. Although the change in fascicle length was linear (r2>0.99), and similar for both shortening and lengthening contractions, modulation of discharge rate differed during the two contractions. Compared with an initial isometric contraction at short (11.9+/-2.4 Hz) or long (11.7+/-2.2 Hz) muscle length, discharge rate increased only slightly and stayed nearly constant throughout the lengthening contraction (12.6+/-2.0 Hz; P<0.05) whereas it augmented progressively and more substantially during the shortening contraction, reaching 14.5+/-2.5 Hz (P<0.001) at the end of the movement. In conclusion, these observations indicate a clear difference in motor unit discharge rate modulation with no change in their recruitment order between shortening and lengthening contractions when performed with a similar change in muscle fascicle length and torque.

Fluctuations in plantar flexion force are reduced after prolonged tendon vibration

The purpose of the study was to examine the effect of prolonged vibration on the force fluctuations during a force-matching task performed at low-force levels. Fourteen young healthy men performed a submaximal force-matching task of isometric plantar flexion before and after Achilles tendon vibration (n = 8, vibration subjects) or lying without vibration (n = 6, control subjects) for 30 min. The target forces were 2.5-10% of the previbration maximal voluntary contraction force. The standard deviation of force decreased by a mean of 29 +/- 20% across target forces after vibration, whereas it did not decrease significantly in control subjects (-5 +/- 12%). This change was significantly greater compared with control subjects (P < 0.01 for both). Power spectral density of the force was predominantly composed of signals of low-frequency bandwidth (<or =5 Hz) with few higher frequency components. In vibration subjects, there was a significant decrease in power in the frequency range < or =2 Hz after vibration. The decrease in power at this frequency range was linearly related to the decrease in the force fluctuations (r = 0.96, P < 0.001). The results indicate that prolonged Achilles tendon vibration reduces the fluctuations in plantar flexion force in the frequency range < or =2 Hz during low-level contractions. It suggests that Ia afferent inputs contribute to the low-frequency force fluctuations in plantar flexion.

Cortical neuromagnetic fields evoked by voluntary and passive hand movements in healthy adults

Neuromagnetic fields were recorded from the left cerebral hemisphere of six healthy right-handed subjects under three different conditions: (1) externally triggered rapid voluntary extension and flexion of the right hand, (2) passive extension and flexion of the right hand, and (3) stimulation of the skin of the right index finger by means of air pressure. Location analysis using the current density analysis did not reveal any differences between motor evoked field I (MEF I) in active and passive movements, and met the maximum of cerebral activation in the contralateral precentral region. In contrast, the sensory evoked field was located clearly in the contralateral postcentral region. Additionally, a significantly shorter latency of MEF I (with respect to movement onset) was observed in flexion compared with extension in both passive and active movements. These results support the assumption that MEF I is generated by cortical activation resulting from proprioceptive, probably muscle spindle, input. The current density analysis has proved to be an appropriate method for investigating movement-related fields. Furthermore, the described method seems to be appropriate for evaluating the processes of cortical reorganization and the influence of neurorehabilitation within longitudinal studies in patients with lesions in motor centers of the brain.

The effect of muscle contraction on kinaesthesia

Kinaesthesia is our conscious awareness of body position and movement. Experiments are described examining kinaesthetic acuity in human subjects. The results showed a reduced ability to detect limb movement and match limb position during co-contraction of elbow extensors and flexors compared to when these muscles were relaxed. We also report results from animal experiments showing a reduction in muscle spindle stretch sensitivity during fusimotor and skeletomotor activation, a factor that might contribute to the decreased kinaesthetic acuity observed during muscle contraction.

The role of weightbearing in the clinical assessment of knee joint position sense

Knee joint position sense was assessed by active tests with active limb matching responses in supine lying and in unilateral weightbearing (WB) stance using (re)positioning of the whole limb whilst focusing on the knee, and in supine lying using (re)positioning confined to the knee. Following five tests at approximately 45 degrees knee flexion in all three test conditions, position sense was found to be significantly more accurate and reliable following the WB procedure. Possible explanations are, first, that during WB the subjects were more able to assist identification of the test positions using cues obtained during movement of the knee to and from these positions. Second, a larger volume of proprioceptive afferent information may have been derived from sources outside the examined knee, and even outside the examined limb. Whilst WB joint position sense assessments are more functional, the obtained results may not characterise the capacity of the proprioceptors in and around the examined (knee) joint. Since the WB and NWB results were not correlated, one procedure cannot be used to predict results from the others. Also, predominantly unilateral WB stance is often impractical for subjects with limited balance or WB pain.

The role of joint afferents in sensory processing in osteoarthritic knees

OBJECTIVE

To test the role of joint receptors for proprioception in patients with bilateral knee osteoarthritis (OA) and patients who had undergone unilateral total knee arthroplasty (TKA).

METHODS

Nine patients were tested bilaterally with a conventional movement detection paradigm that evaluated conscious detection perception and a newly developed hunting paradigm that measured maximal sensory performance (hunting perception).

RESULTS

For detection perception, patients exhibited a slightly lower threshold on the arthritic side than on their TKA side. For hunting perception, the patients showed threshold values that were an order of magnitude smaller than for the conventional paradigm in both knees. Performance was much better on prosthetic knees than on OA knees.

CONCLUSION

The joint receptors of OA knees might have an adverse effect on the maximal proprioceptive performance, being important for the normal reflexive knee joint functions. These deficits may be overcome by joint receptor removal during knee replacement.

Tension changes in the cat soleus muscle following slow stretch or shortening of the contracting muscle

1. The permanent extra tension after a stretch and the deficit of tension after a shortening in the soleus muscle of the anaesthetised cat were measured using distributed nerve stimulation across five channels. At low rates of stimulation the optimum length for a contraction was several millimetres longer than that when higher rates of stimulation were used, so that movements applied over the same length range could be on the descending limb of the full activation curve but on the ascending limb of the submaximal activation curve. 2. The extra tension after stretch and the depression after shortening were present only near the peak and on the descending limb of the length-tension curve. Effects on final tension of changing the speed and amplitude of stretches or shortenings were found to be small. 3. Statistical analysis showed that variations in the tension excess or deficit due to changing stimulus rate could be entirely attributed to the effect of stimulus rate on the length-tension relation, as when length was expressed relative to optimum for each rate, stimulus rate was no longer a significant determinant of the tension excess or deficit. 4. The extra tension after stretch and the depression after shortening disappeared if stimulation was interrupted and tension briefly fell to zero. 5. These effects were explained in terms of a non-uniform distribution of sarcomere length changes at long muscle lengths. During stretch some sarcomeres are stretched to beyond overlap while others lengthen hardly at all. During shortening some sarcomeres shorten much further than others. 6. These mechanisms have important implications for exercise physiology and sports medicine.

The role of muscle receptors in the detection of movements

This review discusses the role of muscle receptors, in particular, that of muscle spindles, in the detection of movements, both passive and active. Emphasis is placed on the importance of conditioning the muscles acting at a joint before making measurements of thresholds to passive movements, to take into account muscle's thixotropic property. The detection threshold:movement velocity relation is discussed and described for a number of different joints. Implications for muscle spindles are considered from the generalisation that, when expressed in terms of proportion of muscle fascicle length change, detection thresholds are about the same at different joints. It is concluded that the available data supports the view that muscle spindles lie in parallel with only a portion of a muscle fascicle and not the whole fascicle. At the elbow joint, where it has been tested, movement detection threshold is lower during passive movements than during contraction of elbow muscles. Both peripheral mechanisms and mechanisms operating within the central nervous system may be responsible for the rise in threshold. The signalling of movements by spindles during a contraction raises the question of how the central nervous system is able to extract the length signal under such circumstances, given that there is likely to be co-activation of alpha and gamma motoneurones. The evidence for a central subtraction of fusimotor-evoked impulses and some recent experiments relevant to this idea are described. In conclusion, a number of points of uncertainly have been revealed in this area and these should be the subject of future experiments.