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Cheung TCK, Schmuckler MA. Multisensory and biomechanical influences on postural control in children. J Exp Child Psychol 2024; 238:105796. [PMID: 37883904 DOI: 10.1016/j.jecp.2023.105796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/17/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023]
Abstract
Children's ability to maintain balance requires effective integration of multisensory and biomechanical information. The current project examined the interaction between such sensory inputs, manipulating visual input (presence vs. absence), haptic (somatosensory) input (presence vs. absence of contact with a stable or unstable finger support surface), and biomechanical (sensorimotor) input (varying stance widths). Analyses of mean velocity of the center of pressure and the percentage stability gain highlighted the role of varying multisensory inputs in postural control. Developmentally, older children (6-11 years) showed a multisensory integration advantage compared with their younger counterparts (3-5.9 years), with the impact of varying sensory inputs more closely akin to that seen in adults. Subsequent analyses of the impact of anthropometric individual difference parameters (e.g., height, leg length, weight, areas of base of support) revealed a shifting pattern across development. For younger children, these parameters were positively related to postural stability across experimental conditions (i.e., increasing body size was related to increasing postural control). This pattern transitioned for older children, who showed a nonsignificant relation between body size and balance. Interestingly, because adults show a negative relation between anthropometric factors and stability (i.e., increasing body size is related to decreasing postural control), this shift for the older children can be seen as a developmental transition from child-like to adult-like balance control.
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Affiliation(s)
| | - Mark A Schmuckler
- University of Toronto Scarborough, Toronto, Ontario M1C 1A4, Canada.
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Ketterer J, Gehring D, Gollhofer A, Ringhof S. Sensory conflicts through short, discrete visual input manipulations: Identification of balance responses to varied input characteristics. Hum Mov Sci 2024; 93:103181. [PMID: 38301342 DOI: 10.1016/j.humov.2024.103181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/03/2024]
Abstract
Human balance control relies on various sensory modalities, and conflict of sensory input may result in postural instability. Virtual reality (VR) technology allows to train balance under conflicting sensory information by decoupling visual from somatosensory and vestibular systems, creating additional demands on sensory reweighting for balance control. However, there is no metric for the design of visual input manipulations that can induce persistent sensory conflicts to perturb balance. This limits the possibilities to generate sustained sensory reweighting processes and design well-defined training approaches. This study aimed to investigate the effects that different onset characteristics, amplitudes and velocities of visual input manipulations may have on balance control and their ability to create persistent balance responses. Twenty-four young adults were recruited for the study. The VR was provided using a state-of-the-art head-mounted display and balance was challenged in two experiments by rotations of the visual scene in the frontal plane with scaled constellations of trajectories, amplitudes and velocities. Mean center of pressure speed was recorded and revealed to be greater when the visual input manipulation had an abrupt onset compared to a smooth onset. Furthermore, the balance response was greatest and most persistent when stimulus velocity was low and stimulus amplitude was large. These findings show clear dissociation in the state of the postural system for abrupt and smooth visual manipulation onsets with no indication of short-term adaption to abrupt manipulations with slow stimulus velocity. This augments our understanding of how conflicting visual information affect balance responses and could help to optimize the conceptualization of training and rehabilitation interventions.
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Affiliation(s)
- Jakob Ketterer
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany.
| | - Dominic Gehring
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Steffen Ringhof
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany; Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Tran S, Brooke C, Kim YJ, Perry SD, Nankoo JF, Rinchon C, Arora T, Tremblay L, Chen R. Visual and vestibular integration in Parkinson's disease while walking. Parkinsonism Relat Disord 2023; 116:105886. [PMID: 37866253 DOI: 10.1016/j.parkreldis.2023.105886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/24/2023]
Abstract
Postural control requires effective sensory integration. People with Parkinson's disease (PD) are reported to have impaired visual and vestibular perception. While self-motion perception is a key aspect of locomotion, visual-vestibular integration has not been directly characterized in people with PD during gait. We compared the ability of people with PD and healthy older adults (OA) to integrate multi-sensory information during straight-line walking in response to visual and vestibular perturbations, using continuous translations of the visual surround and galvanic vestibular stimulation within a virtual reality environment. We measured their endpoint deviations from midline and changes in gait parameters. We found that people with PD deviated more than OA when walking in a dark environment but did not show differences in deviations when walking in a virtual room with visual information. With visual and vestibular perturbations, people with PD did not differ from OA in endpoint deviations nor variabilities. However, people with PD did not adopt a more cautious gait when GVS was applied in a virtual room, unlike OA. Overall, we showed that people with mild PD did not perform worse than OA but did show differences in gait patterns, suggesting that visual-vestibular integration is relatively preserved during gait in PD.
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Affiliation(s)
- Stephanie Tran
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Calaina Brooke
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada; KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | | | - Stephen D Perry
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada; KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | | | - Cricia Rinchon
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Tarun Arora
- Division of Clinical Neuroscience, Department of Neurology, Oslo University Hospital, Canada
| | - Luc Tremblay
- Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Robert Chen
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada.
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Dewan BM, James CR, Kumar NA, Burgess N, Zupancic S, Sawyer SF. Adaptation in motor strategies for postural control associated with sensory reweighting. Hum Mov Sci 2023; 89:103098. [PMID: 37167903 DOI: 10.1016/j.humov.2023.103098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 02/13/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
The purpose of this study was to identify and differentiate the motor strategies associated with sensory reweighting adapted during specific sensory integration tasks by healthy young adults. Thirty-six subjects (age range: 21-33 years) performed standing computerized dynamic posturography balance tasks across progressively increasing amplitudes of visual (VIS), somatosensory (SOM) and both (VIS+SOM) systems perturbation conditions. Adaptation in the motor strategy was measured as changes in electromyographic (EMG) activities and joint angles. The contribution of the perturbed sensory input in maintaining postural stability was calculated to determine the sensory reweighting. A multivariate design was used to model a linear combination of motor adaptation variables that discriminates specific sensory integration tasks. Results showed a significant progressive decrease in postural sway per unit amplitude of sensory perturbation in each condition, indicating dynamic sensory reweighting. Linear discriminant function analysis indicated that the adaptation in motor strategy during the VIS condition was associated with increased activity of EMG and joint angles in the upper body compared to the lower body. Conversely, during the SOM and VIS+SOM conditions, the adaptation in motor strategy was associated with decreased activity of EMG and joint angles in the lower body compared to the upper body. Therefore, the adaptation in motor strategies associated with sensory reweighting were different for different sensory integration tasks.
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Affiliation(s)
- Birendra M Dewan
- Department of Physical Therapy, School of Health Professions, Long Island University, Brooklyn, NY 11301, USA.
| | - C Roger James
- Department of Rehabilitation Sciences and the Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Neeraj A Kumar
- College of Rehabilitative Sciences, University of St. Augustine, Dallas, TX 75039, USA
| | - Nathan Burgess
- Department of Rehabilitation Sciences and the Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Steven Zupancic
- Department of Speech, Language & Hearing Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Steven F Sawyer
- Department of Rehabilitation Sciences and the Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
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Mani H, Kato N, Hasegawa N, Urano Y, Aiko T, Kurogi T, Asaka T. Visual feedback in the lower visual field affects postural control during static standing. Gait Posture 2022; 97:1-7. [PMID: 35843008 DOI: 10.1016/j.gaitpost.2022.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The dorsal parietal visual system plays an important role in self-motion perception and spatial cognition. It also strongly responds to visual inputs from the lower visual field. Postural control is modified in a process called sensory reweighting based on the reliability of available sensory sources. The question of whether visual stimuli presented to either the lower or upper visual field affect postural control and sensory reweighting has not been resolved. RESEARCH QUESTION Do visual stimuli presented to the lower and upper visual fields affect postural control and sensory reweighting? METHODS Twenty-nine healthy young adults participated in the study. Four conditions (full visual field, upper visual field, lower visual field, and no optic flow condition) were simulated in a VR environment using a head-mounted display. The optic flow stimuli used were swarms of small white spheres originating from the central point of the visual field, moving radially towards the periphery, and expanding across the scene. Participants were instructed to stand quietly for 50 s under each visual condition. Using force plate signals, we measured the center of pressure (COP) signal in the horizontal plane and calculated its 95 % ellipse area, root mean square (RMS) deviations, the mean velocity, and power spectral density (PSD). RESULTS Optic flow in the full and lower visual fields produced significantly smaller 95 % ellipse area and RMS of COP in the anterior-posterior direction compared to optic flow in the upper visual field. Furthermore, the PSD of the lower frequency band (0-0.3 Hz) was decreased and that of higher frequency bands (0.3-1 Hz and 1-3 Hz) was increased for the lower compared to the upper visual field. SIGNIFICANCE Visual feedback affects static postural control more when presented in the lower visual field compared to the upper visual field.
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Affiliation(s)
- Hiroki Mani
- Faculty of Welfare and Health Science, Oita University, 700, Dannoharu, 870-1192 Oita, Japan.
| | - Norio Kato
- Department of Physical Therapy, Faculty of Health Sciences, Hokkaido University of Science, 7-Jo 15-4-1 Maeda, Teine, Sapporo, Hokkaido 006-858, Japan.
| | - Naoya Hasegawa
- Department of Rehabilitation Sciences, Faculty of Health Sciences, Hokkaido University, Sapporo, Kita 12 Nishi 5, Kita-Ku, Sapporo, Hokkaido 060-0812, Japan.
| | - Yuto Urano
- Undergraduate School of Welfare and Health Science, Oita University, 700, Dannoharu, 870-1192 Oita, Japan.
| | - Takumi Aiko
- Undergraduate School of Welfare and Health Science, Oita University, 700, Dannoharu, 870-1192 Oita, Japan.
| | - Takaki Kurogi
- Undergraduate School of Welfare and Health Science, Oita University, 700, Dannoharu, 870-1192 Oita, Japan.
| | - Tadayoshi Asaka
- Department of Rehabilitation Sciences, Faculty of Health Sciences, Hokkaido University, Sapporo, Kita 12 Nishi 5, Kita-Ku, Sapporo, Hokkaido 060-0812, Japan.
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Miwa T, Kanemaru SI. Effects of Kampo medicine hangebyakujutsutemmato on persistent postural-perceptual dizziness: A retrospective pilot study. World J Clin Cases 2022; 10:6811-6824. [PMID: 36051127 PMCID: PMC9297410 DOI: 10.12998/wjcc.v10.i20.6811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/17/2022] [Accepted: 04/24/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Persistent postural-perceptual dizziness (PPPD) is a functional disorder, typically preceded by acute vestibular disorders. It is characterized by a shift in processing spatial orientation information, to favor visual over vestibular and somatosensory inputs, and a failure of higher cortical mechanisms. To date, no therapies for PPPD have been approved. Kampo medicine hangebyakujutsutemmato (HBT) has been reported to alleviate disturbances of equilibrium. We hypothesized that HBT would be a beneficial treatment for PPPD.
AIM To examine the efficacy of HBT for the treatment of PPPD.
METHODS Patients with PPPD were enrolled and divided into two groups: The HBT group (n = 24) and the non-HBT group (n = 14). The participants completed questionnaire surveys [Niigata PPPD questionnaire (NPQ), dizziness handicap inventory, hospital anxiety and depression scale (HADS), orthostatic dysregulation questionnaire, pittsburg sleep quality index (PSQI), and motion sickness scores] before and after HBT treatment. Additionally, to identify HBT responders, multivariate regression analysis was performed using the results of the questionnaire surveys and equilibrium tests; including stabilometry, and caloric, vestibular evoked myogenic response, and head-up tilt tests.
RESULTS Thirty-eight outpatients were included in this study, of which 14 patients (3 men, 11 women; mean age, 63.5 ± 15.9 years) received treatment without HBT, and 24 (1 man, 23 women; mean age, 58.2 ± 18.7 years) received combination treatment with HBT. Following HBT treatment, NPQ scores decreased significantly (baseline 40.1 ± 10.0 vs 2 mo 24.6 ± 17.7, P < 0.001). No statistically significant changes were observed in the NPQ scores in the non-HBT group (baseline 38.6 ± 12.2 vs 2 mo 39.4 ± 14.4, P = 0.92). Multivariable regression analysis revealed that the results of stabilometry (P = 0.02) and the caloric (P = 0.03), and head-up tilt tests (P < 0.001), HADS (P = 0.003), and PSQI (P = 0.01) were associated with HBT responsiveness in PPPD patients.
CONCLUSION HBT may be an effective adjunct therapy for PPPD. Patients with autonomic dysfunction, unstable balance, semicircular canal paresis, anxiety, and poor sleep quality may be high responders to HBT.
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Affiliation(s)
- Toru Miwa
- Department of Otolaryngology-Head and Neck Surgery, Osaka Metropolitan University, Osaka 5458585, Japan
- Department of Otolaryngology-Head and Neck Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka 5308480, Japan
- Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto 7507501, Japan
| | - Shin-ichi Kanemaru
- Department of Otolaryngology-Head and Neck Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka 5308480, Japan
- Department of Otolaryngology-Head and Neck Surgery, Kyoto University, Kyoto 7507501, Japan
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Song K, Franz JR, Wikstrom EA. Optical flow balance perturbations alter gait kinematics and variability in chronic ankle instability patients. Gait Posture 2022; 92:271-276. [PMID: 34896838 DOI: 10.1016/j.gaitpost.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 11/22/2021] [Accepted: 12/03/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with chronic ankle instability (CAI) have known balance impairments thought to be the result of an inability to reweight sensory information. CAI patients place greater emphasis on visual information during single-limb stance than healthy controls but this evidence is based on removing visual information during static conditions. RESEARCH QUESTION Does perturbed optical flow effect step kinematics and variability in those with CAI differently than healthy controls? What is the relationship among ankle laxity, plantar cutaneous sensation, and susceptibility to perturbed optical flow in those with CAI? METHODS 17 CAI patients and 17 healthy individuals participated in a crossover experimental study. Participants walked on a treadmill at 1.25 m/s while watching a speed-matched virtual hallway with and without continuous mediolateral (ML) optical flow perturbations. Three-dimensional pelvic and foot kinematics were recorded at 100 Hz for at least 300 consecutive steps in each condition. Step width (SW) and step length (SL) values were calculated from consecutive heel positions. Gait variability was characterized as the standard deviation of step width (SWV), step length (SLV), and ML sacrum motion (SMV) across all steps performed in each condition. RESULTS The CAI group exhibited a greater change in SWV (p = 0.037), SLV (p = 0.040), and ML SMV (p = 0.047) from the perturbed to unperturbed conditions relative to the healthy controls. A condition main effect was also noted for SW (p < 0.001) and SL (p < 0.001) as ML optical flow perturbations resulted in significant changes in SW and SL relative to the normal walking condition. SIGNIFICANCE Walking with ML optical flow perturbations induced greater variability changes in those with CAI relative to controls. When combined with the existing literature, this finding suggests that CAI individuals have a greater reliance on visual information in both static and dynamic (i.e. walking gait) conditions relative to healthy individuals.
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Affiliation(s)
- Kyeongtak Song
- Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY, USA; MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, NC, USA.
| | - Jason R Franz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA
| | - Erik A Wikstrom
- MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, NC, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Shafer RL, Wang Z, Bartolotti J, Mosconi MW. Visual and somatosensory feedback mechanisms of precision manual motor control in autism spectrum disorder. J Neurodev Disord 2021; 13:32. [PMID: 34496766 PMCID: PMC8427856 DOI: 10.1186/s11689-021-09381-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/11/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Individuals with autism spectrum disorder (ASD) show deficits processing sensory feedback to reactively adjust ongoing motor behaviors. Atypical reliance on visual and somatosensory feedback each have been reported during motor behaviors in ASD suggesting that impairments are not specific to one sensory domain but may instead reflect a deficit in multisensory processing, resulting in reliance on unimodal feedback. The present study tested this hypothesis by examining motor behavior across different visual and somatosensory feedback conditions during a visually guided precision grip force test. METHODS Participants with ASD (N = 43) and age-matched typically developing (TD) controls (N = 23), ages 10-20 years, completed a test of precision gripping. They pressed on force transducers with their index finger and thumb while receiving visual feedback on a computer screen in the form of a horizontal bar that moved upwards with increased force. They were instructed to press so that the bar reached the level of a static target bar and then to hold their grip force as steadily as possible. Visual feedback was manipulated by changing the gain of the force bar. Somatosensory feedback was manipulated by applying 80 Hz tendon vibration at the wrist to disrupt the somatosensory percept. Force variability (standard deviation) and irregularity (sample entropy) were examined using multilevel linear models. RESULTS While TD controls showed increased force variability with the tendon vibration on compared to off, individuals with ASD showed similar levels of force variability across tendon vibration conditions. Individuals with ASD showed stronger age-associated reductions in force variability relative to controls across conditions. The ASD group also showed greater age-associated increases in force irregularity relative to controls, especially at higher gain levels and when the tendon vibrator was turned on. CONCLUSIONS Our findings that disrupting somatosensory feedback did not contribute to changes in force variability or regularity among individuals with ASD suggests a reduced ability to integrate somatosensory feedback information to guide ongoing precision manual motor behavior. We also document stronger age-associated gains in force control in ASD relative to TD suggesting delayed development of multisensory feedback control of motor behavior.
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Affiliation(s)
- Robin L Shafer
- Life Span Institute, University of Kansas, Lawrence, KS, USA
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Zheng Wang
- Department of Occupational Therapy, University of Florida, Gainesville, FL, USA
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - James Bartolotti
- Life Span Institute, University of Kansas, Lawrence, KS, USA
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Matthew W Mosconi
- Life Span Institute, University of Kansas, Lawrence, KS, USA.
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA.
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
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Taneda K, Mani H, Kato N, Komizunai S, Ishikawa K, Maruya T, Hasegawa N, Takamatsu Y, Asaka T. Effects of simulated peripheral visual field loss on the static postural control in young healthy adults. Gait Posture 2021; 86:233-239. [PMID: 33774584 DOI: 10.1016/j.gaitpost.2021.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/08/2021] [Accepted: 03/05/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Integration of visual, vestibular, and proprioceptive sensations contributes to postural control. People with peripheral visual field loss have serious postural instability. However, the directional specificity of postural stability and sensory reweighting caused by gradual peripheral visual field loss remain unclear. RESEARCH QUESTION What are the effects of peripheral visual field loss on static postural control? METHODS Fifteen healthy young adults participated in this study. The participants were asked to stand quietly on a foam surface. Three conditions of virtual visual field loss (90°, 45°, and 15°) were provided by a head-mounted display, and ground reaction forces were collected using a force plate to calculate the displacements of the center of pressure (COP). RESULTS The root mean square (RMS), mean velocity, and 95% ellipse area of COP displacements in the horizontal plane increased, and RMS in the anteroposterior (AP) direction was unchanged under the smallest visual field condition compared to the largest one. The power spectrum density of COP displacements in the low-frequency band was decreased and that in the medium-frequency band was increased in the AP direction. SIGNIFICANCE During quiet standing of young healthy adults with peripheral visual field loss, increased peripheral visual field loss resulted in lower postural stability. Postural stability in the AP direction was maintained contrary to the functional sensitivity hypothesis. Peripheral visual field loss reduced the weighting of the visual input and increased that of the vestibular input in the AP direction to maintain equilibrium.
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Affiliation(s)
- Kenji Taneda
- Graduate School of Health Sciences, Hokkaido University, Japan.
| | - Hiroki Mani
- Faculty of Health Sciences, Hokkaido University, Japan.
| | - Norio Kato
- Faculty of Health Sciences, Hokkaido University of Science, Japan.
| | - Shunsuke Komizunai
- Graduate School of Information Science and Technology, Hokkaido University, Japan.
| | - Keita Ishikawa
- Graduate School of Health Sciences, Hokkaido University, Japan.
| | - Takashi Maruya
- Graduate School of Health Sciences, Hokkaido University, Japan.
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Collins KA, Turner MJ, Hubbard-Turner T, Thomas AC. Gait and plantar sensation changes following massage and textured insole application in patients after anterior cruciate ligament reconstruction. Gait Posture 2020; 81:254-260. [PMID: 32829128 DOI: 10.1016/j.gaitpost.2020.08.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 08/07/2020] [Accepted: 08/13/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Gait impairments following anterior cruciate ligament reconstruction (ACLR) may contribute to reinjury or future osteoarthritis development. Recently, plantar cutaneous sensation deficits have been reported post-ACLR. These sensory deficits may influence gait and represent a mechanism through which to improve gait. RESEARCH QUESTION Can established sensory interventions change sensation and gait in patients after ACLR and compared to healthy adults? METHODS Twenty-two adults (n = 11 post-ACLR, age:20.5 ± 1.9years, body mass index[BMI]:24.5 ± 3.6 kg/m2; n = 11 healthy, age:20.7 ± 1.4years, BMI:23.3 ± 2.7 kg/m2) completed two sessions separated by 48 h. Gait and plantar cutaneous sensation were assessed pre- and post-intervention (massage or textured insoles). Gait analysis was completed using 3D motion capture at 1.4 m/s ± 5% and standard inverse dynamics analysis. Plantar cutaneous sensation was assessed using Semmes Weinstein Monofilaments with a 4-2-1 stepping algorithm at the plantar aspect of the first metatarsal head, base of the fifth metatarsal, and lateral and medial malleoli. Plantar massage was a 5-minute massage to both feet. Textured insoles (coarse grit sandpaper) were worn while walking. Biomechanical data were assessed via mixed-models, repeated measures ANOVAs and 90 % confidence intervals. Wilcoxon Signed Rank tests and Mann-Whitney U tests evaluated plantar cutaneous sensation within and between groups, respectively. RESULTS Knee adduction moment was lower in the ACLR versus the contralateral limb pre-massage. The vGRF was lower during the first half of stance but greater during the second half of stance in the ACLR versus the control group post-massage. Massage improved ACLR limb sensation over the first metatarsal head (P = 0.042) and medial malleolus (P = 0.027). Textured insole application improved ACLR limb sensation over the first (P = 0.043) and fifth (P = 0.027) metatarsals and medial malleolus (P = 0.028). SIGNIFICANCE Plantar massage and textured insoles improved plantar cutaneous sensation in the ACLR limb. Neither intervention influenced gait. Improving plantar sensation may be beneficial for patients after ACLR; however, sensory interventions to improve gait are necessary.
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Affiliation(s)
- Katherine A Collins
- Biodynamics Research Laboratory, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Michael J Turner
- Laboratory of Systems Physiology, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Tricia Hubbard-Turner
- Biodynamics Research Laboratory, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Abbey C Thomas
- Biodynamics Research Laboratory, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA.
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Kim KM. Higher visual reliance during single-leg balance bilaterally occurring following acute lateral ankle sprain: A potential central mechanism of bilateral sensorimotor deficits. Gait Posture 2020; 78:26-29. [PMID: 32179458 DOI: 10.1016/j.gaitpost.2020.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 01/28/2020] [Accepted: 03/03/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Single-leg balance (SLB) impairment from eyes-open to eyes-closed trials is significantly greater in patients with chronic ankle instability than in uninjured controls, indicating higher reliance on visual information. It is of clinical interest to see if the visual adaptation occurs immediately after injury. RESEARCH QUESTION We aimed to investigate visual reliance in patients with acute lateral ankle sprain (ALAS) during SLB with both injured and uninjured limbs and during double-leg balance (DLB). METHODS The study assessed visual reliance of 53 participants: 27 ALAS patients and 26 persons without a history of ALAS. All participants executed DLB with eyes open and closed, and then completed SLB with both the injured and uninjured limbs (side-matched limbs of the uninjured control group) in both visual conditions. Order of limb and visual condition for SLB was randomly selected. Visual reliance was quantified for each postural task with a percent change between the two visual conditions, with the greater change representing higher visual reliance. We performed separate group-by-limb analysis-of-variance with repeated measures for SLB percent scores and independent t-tests for DLB outcomes. RESULTS For all SLB measures there were no significant group-by-limb interactions (p > 0.05) but significant group main effects (p = 0.013-0.029). With no side-to-side differences, the ALAS group presented higher declines in SLB from the eyes-open to eyes-closed conditions than did the uninjured control group, indicating higher visual reliance. Similarly, for DLB there were significant group differences for almost all measures (p = <.001-0.037), with the ALAS group showing greater visual reliance. SIGNIFICANCE Moderately higher visual reliance occurs acutely and bilaterally during SLB in ALAS patients. Similar visual adaptions also occur during DLS. These findings will provide insight into a central mechanism underlying bilateral sensorimotor deficits following ALAS and allow clinicians to improve current rehabilitation strategies for acute patients.
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Affiliation(s)
- Kyung-Min Kim
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA.
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Almajid R, Tucker C, Wright WG, Vasudevan E, Keshner E. Visual dependence affects the motor behavior of older adults during the Timed Up and Go (TUG) test. Arch Gerontol Geriatr 2019; 87:104004. [PMID: 31877530 DOI: 10.1016/j.archger.2019.104004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Older adults show greater postural instabilities under misleading visual cues relative to younger adults. We investigated the effects of age-related visual dependence on motor performance under increased attention demands by adding a motor task and visual stimulus to the Timed Up and Go (TUG) test sub-components. METHOD We designed a cross-sectional quantitative study. Twenty-eight younger (n = 12) and older (n = 16) adults completed the TUG test while wearing a head-mounted display (HMD) that presented a visual stimulus and/or carrying a cup of water. Outcome measures were turning cadence; gait speed; pitch, yaw, and roll peak trunk velocities (PTVs); and acceleration ranges of sit-to-stand and stand-to-sit. RESULTS Wearing the HMD caused significant performance differences in the TUG test tasks due to age and visual dependence, although performance was lower across all groups with the HMD (p < 0.01). Older adults showed lower roll PTV in turning compared to younger adults (p = 0.03). Visually dependent older adults showed smaller mediolateral and vertical acceleration ranges (p < 0.04) in sit-to-stand compared to visually independent older adults. CONCLUSION The demand for orienting posture to a vertical position during sit-to-stand may differentiate older adults who are more visually dependent-and thus at greater fall risk- from those who are more visually independent. Age-related differences in turning behavior suggest a relationship with fall risk that warrants further investigation.
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Affiliation(s)
- Rania Almajid
- Department of Physical Therapy, West Coast University, 590 N Vermont Ave, Los Angeles, CA, 90004, USA; Department of Physical Therapy, Temple University, 1801 N Broad St., Philadelphia, PA, 19122, USA.
| | - Carole Tucker
- Department of Physical Therapy, Temple University, 1801 N Broad St., Philadelphia, PA, 19122, USA.
| | - William Geoffrey Wright
- Department of Physical Therapy, Temple University, 1801 N Broad St., Philadelphia, PA, 19122, USA; Department of Bioengineering, Temple University, 1801 N Broad St., Philadelphia, PA, 19122, USA.
| | - Erin Vasudevan
- Department of Health and Rehabilitation Sciences, School of Health Technology and Management, Stony Brook University, 101 Nicolls Road, Health Sciences Center, Stony Brook, 11794, USA.
| | - Emily Keshner
- Department of Physical Therapy, Temple University, 1801 N Broad St., Philadelphia, PA, 19122, USA.
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Lim YH, Lee HC, Falkmer T, Allison GT, Tan T, Lee WL, Morris SL. Postural control adaptation to optic flow in children and adults with autism spectrum disorder. Gait Posture 2019; 72:175-81. [PMID: 31220791 DOI: 10.1016/j.gaitpost.2019.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/04/2019] [Accepted: 06/07/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sensory reweighting is important for humans to flexibly up-weigh and down-weigh sensory information in dynamic environments. There is an element of time involved in the sensory reweighting process. A longer time spent on sensory reweighting may increase the destabilizing effect of postural control. Individuals with autism spectrum disorder (ASD) are reported to have poor postural control. It is uncertain if a different sensory reweighting process underlies the postural control deficit in children and adults with ASD. RESEARCH QUESTION To explore the sensory reweighting capability in ASD, the present study examined whether the temporal domains of postural control differed in children and adults, with and without ASD under various optic flow conditions. METHODS Thirty-three children (8-12 years old) and 33 adults (18-50 years old) with and without ASD underwent quiet standing in six radial optic flow conditions. Each condition lasted for 60 s and was shown twice to all participants. For each optic flow condition, changes in postural response within-trial and between-trials were measured. RESULTS Under various optic flow illusions, both children with and without ASD took a longer time to restore their posture compared with adults with and without ASD. Nonetheless, all groups demonstrated comparable abilities to adjust their posture to one that is close to the baseline position after one exposure to the optic flow stimulation. SIGNIFICANCE The present study showed that the temporal domains of postural control under different optic flow conditions were similar between individuals with and without ASD from the same age group. The ability to down-weigh visual information efficiently comes with the developmental progression of the sensory reweighting system. These findings suggest that the sensory reweighting process does not elucidate the postural control deficits in individuals with ASD and thus alternative explanations to determine the underlying mechanism for postural instability are needed.
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Kenny RPW, Eaves DL, Martin D, Hatton AL, Dixon J. The effects of textured insoles on quiet standing balance in four stance types with and without vision. BMC Sports Sci Med Rehabil 2019; 11:5. [PMID: 30992992 PMCID: PMC6449971 DOI: 10.1186/s13102-019-0117-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 03/27/2019] [Indexed: 11/10/2022]
Abstract
Background Wearing a textured shoe insole can decrease postural sway during static balance. Previous studies assessed bipedal and/or unipedal standing. In contrast, we aimed to investigate if textured insoles modulated postural sway during four stance types (bipedal, standard Romberg, tandem Romberg, and unipedal), with and without vision. Methods The repeated measures design involved 28 healthy young adults (13 females; mean age = 26.86 ± 6.6 yrs) performing quiet standing in the four stance types on a force platform, under two different insole conditions (textured insole; TI vs. smooth insole; SI), with eyes open and eyes closed. Postural sway was assessed via the range and standard deviation of the COP excursions in the anterior-posterior and medial-lateral sway, and overall mean velocity. Results The main effect of insole type was statistically significant at the alpha p = 0.05 level (p = 0.045). Compared to smooth insoles, textured insoles reduced the standard deviation of anterior-posterior excursions (APSD). While simple main effect analyses revealed this was most pronounced during eyes closed bipedal standing, insole type did not provide a statistically significant interaction with either stance or vision in this measure, or any other. Postural sway showed statistically significant increases across both stance type (bipedal < standard Romberg < tandem Romberg < unipedal), and vision (eyes closed < eyes open), in almost all measures. Stance and vision did have a statistically significant interaction in each measure, reflecting greater postural disturbances with eyes closed when stance stability decreased. Conclusions Overall, these results support textured insole use in healthy young adults to reduce postural sway measures. This is because APSD is an index of spatial variability, where a decrease is associated with improved balance and possibly translates to reduced falls risk. Placing a novel texture in the shoe presumably modulated somatosensory inputs. It is important to understand the underlying mechanisms by which textured insoles influence postural sway. As such, utilising a healthy adult group allows us to investigate possible mechanisms of textured insoles. Future research could investigate the potential underlying mechanisms of textured insole effects at a neuromuscular and cortical level, in healthy young adults.
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Affiliation(s)
- Ryan P W Kenny
- 1School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX UK
| | - Daniel L Eaves
- 1School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX UK
| | - Denis Martin
- 1School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX UK
| | - Anna L Hatton
- 2School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, AU Australia
| | - John Dixon
- 1School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX UK
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Jamali S, Azad A, Mehdizadeh H, Doostdar A, Hoseinpour F, Mehdizadeh M, Niazi-Khatoon J, Shokouhyan MR, Parnianpour M, Taghizadeh G, Khalaf K. Time-course investigation of postural sway variability: Does anxiety exacerbate the sensory reweighting impairment in chronic stroke survivors? Neuropsychologia 2019; 127:185-194. [PMID: 30858061 DOI: 10.1016/j.neuropsychologia.2019.01.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 01/07/2019] [Accepted: 01/21/2019] [Indexed: 11/28/2022]
Abstract
Although anxiety is one of the most prevalent psychological disorders in stroke survivors, its effect on sensory reweighting has not yet been fully studied. The aim of this work was to investigate how anticipation of collision avoidance events affects sensory reweighting in chronic stroke survivors with low and high levels of anxiety (LA-stroke and HA-stroke, respectively), as compared with healthy controls (HC), under the condition of perturbed proprioception. Eighteen LA-stroke and 18 HA-stroke survivors, as well as 18 gender- and age-matched HC, participated in this study. Postural sway variability (i.e. Root Mean Square (RMS) of the COP velocity) was measured for a duration of 180 s under two conditions: quiet standing and standing while predicting random virtual spheres to be avoided. Proprioceptive perturbation was simulated using bilateral Achilles tendon vibration at mid duration (60 s) for both conditions. The results showed that the HC were able to timely use visual anticipation to reduce the postural sway variability induced by tendon vibration. However, marked delay in using such anticipation was observed in stroke participants, especially in the HA-stroke group, as indicated by a significant decrease in the RMS of the COP velocity late in the vibration phase. This is the first study to consider the effect of anxiety while comparing sensory reweighting between stroke and healthy participants. The results indicated that chronic stroke survivors, particularly those with HA, could not efficiently use sensory reweighting to maintain balance in sensory conflicting conditions, which may subject them to loosing balance and/or falling. These findings are critical for future assessment and planning of rehabilitation interventions and balance in chronic stroke survivors.
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Affiliation(s)
- Shamsi Jamali
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Akram Azad
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hajar Mehdizadeh
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Asgar Doostdar
- Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hoseinpour
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Maryam Mehdizadeh
- Department of Neurosciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran; Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Javad Niazi-Khatoon
- Department of Occupational Therapy, School of Allied Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mohamad Parnianpour
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Ghorban Taghizadeh
- Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran; Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Kinda Khalaf
- Department of Biomedical Engineering, Khalifa University of Science, Abu Dhabi, United Arab Emirates
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17
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Doumas M, Valkanidis TC, Hatzitaki V. Putting proprioception for balance to the test: Contrasting and combining sway referencing and tendon vibration. Gait Posture 2019; 67:201-206. [PMID: 30368206 DOI: 10.1016/j.gaitpost.2018.10.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 10/07/2018] [Accepted: 10/09/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Postural control relies on sensory information from visual, vestibular and proprioceptive channels, with proprioception being the key sensory modality in this task. Two well-established ways of manipulating proprioceptive information in postural control are tendon vibration and sway referencing. The aim of the present study was to assess postural adaptation when inaccurate proprioceptive information is introduced using tendon vibration and sway referencing in isolation and combination. METHODS Seventeen young adults were asked to stand, without vision, for 2 min on a fixed surface (baseline) immediately followed by 3 min of bilateral Achilles tendon vibration, sway reference, or combined presentation of the two manipulations (adaptation) and finally 3 min of standing on a fixed surface (aftereffect). RESULTS During adaptation, vibration showed the lowest sway variability, followed by sway reference and the combined condition. Spectral analyses focusing on the dominant frequencies in this task (0-0.4 Hz) showed that in the first half of adaptation sway amplitude was greater when the two manipulations were combined compared with each manipulation alone. However, in the second half differences between sway reference and the combined condition disappeared but differences between vibration and the other two conditions increased. CONCLUSION We interpret these findings primarily as due to a prolonged attenuation in effects of vibration over the course of the adaptation phase and we offer two explanations for this phenomenon. One is a decline in neurotransmitter release from the group Ia terminals and the other is sensory reweighting which down-weights proprioception and up-weights the accurate, vestibular information.
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Affiliation(s)
- Michail Doumas
- School of Psychology, Queen's University Belfast, Belfast, UK.
| | | | - Vassilia Hatzitaki
- Laboratory of Motor Behavior and Adapted Physical Activity, School of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Cheng S, Ma J, Sun J, Wang J, Xiao X, Wang Y, Hu W. Differences in sensory reweighting due to loss of visual and proprioceptive cues in postural stability support among sleep-deprived cadet pilots. Gait Posture 2018; 63:97-103. [PMID: 29727778 DOI: 10.1016/j.gaitpost.2018.04.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 04/10/2018] [Accepted: 04/24/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sleep deprivation is known to diminish postural control. RESEARCH QUESTION We investigated whether sleep deprivation affects sensory reweighting for postural control due to loss of visual and proprioceptive cues. METHODS Two cohorts of cadet pilots were deprived of sleep for 40 h. Variabilty in force-platform center of pressure was analyzed based on the whole path length (WPL); circumference area (CA); mean of displacement along x and y axes and corresponding standard deviations (SDx, SDy); and frequency of body-sway intensity, all of which were recorded while the cadets stood with eyes open (NEO), eyes closed (NEC), and eyes closed on a foam platform base (FEC) A sleepiness index (SUBI) based on principal component analysis of selected Cohort 1 data (n = 37) was used to compare Cohort 2 data (n = 29) with scores for the Stanford Sleepiness Scale (SSS) and Pittsburg Sleep Quality Index (PSQI). RESULTS Balance began to deteriorate at 16 h for NEO and at 28 h for NEC and FEC (p < 0.05). At 40 h, WPL, CA, and SDy of COP for NEO indicated balance deteriorated further while WPL and SDy for NEC and WPL, CA, SDx, and SDy for FEC indicated balance incrementally improved. Frequency bias of body-sway differed between NEO, NEC, and FEC. In Cohort 2, the SUBI correlated significantly with SSS (p < 0.05), but not with PSQI. SIGNIFICANCE Effects of sleep deprivation were mitigated over time, suggesting that compensatory mechanisms influenced sensory reweighting for NEC and FEC between 28 and 40 h of sleep deprivation, but not for NEO. Frequency bias of body-sway suggested that sensory reweighting in the absence of visual cues differed from that in the absence of both visual and proprioceptive cues.
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Affiliation(s)
- Shan Cheng
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Jin Ma
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Jicheng Sun
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Jian Wang
- Bureau of Health, Air Force Logistics Command, Beijing, 100009, PR China
| | - Xiao Xiao
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Yihan Wang
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Wendong Hu
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China.
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Ueta Y, Matsugi A, Oku K, Okuno K, Tamaru Y, Nomura S, Tanaka H, Douchi S, Mori N. Gaze stabilization exercises derive sensory reweighting of vestibular for postural control. J Phys Ther Sci 2017; 29:1494-1496. [PMID: 28931974 PMCID: PMC5599807 DOI: 10.1589/jpts.29.1494] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 05/31/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to investigate whether gaze stabilization exercise
derives sensory reweighting of vestibular for upright postural control. [Subjects and
Methods] Twenty-three healthy volunteers participated in this study. The center of
pressure of the total trajectory length was measured before (pre), immediately after
(post), and 10 min after (post10) gaze stabilization exercise, in the static standing
position, with the eyes open or closed, on the floor or on foam rubber. The sensory
contribution values of the visual, somatosensory, and vestibular systems were calculated
using center of pressure of the total trajectory length value in these measuring
conditions. [Results] The center of pressure of the total trajectory length on foam rubber
in post and post10 were significantly lower than that in the pre. The sensory contribution
values of vestibular in post10 stages were significantly higher than that in pre-stage.
[Conclusion] Gaze stabilization exercise can improve the static body balance in a
condition that particularly requires vestibular function. The possible mechanism involves
increasing sensory contribution of the vestibular system for postural control by the gaze
stabilization exercise, which may be useful to derive sensory reweighting of the
vestibular system for rehabilitation.
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Affiliation(s)
- Yusuke Ueta
- Department of Rehabilitation, National Hospital Organization Kyoto Medical Center, Japan
| | - Akiyoshi Matsugi
- Faculty of Rehabilitation, Shijonawate Gakuen University: 5-11-10 Hojo, Daitou city, Osaka 574-0011, Japan
| | - Kosuke Oku
- Faculty of Rehabilitation, Shijonawate Gakuen University: 5-11-10 Hojo, Daitou city, Osaka 574-0011, Japan
| | - Kojiro Okuno
- Department of Rehabilitation, Wakakusa Tatsuma Rehabilitation Hospital, Japan
| | - Yoshiki Tamaru
- Faculty of Rehabilitation, Shijonawate Gakuen University: 5-11-10 Hojo, Daitou city, Osaka 574-0011, Japan
| | - Shohei Nomura
- Department of Rehabilitation, Baba Memorial Hospital, Japan
| | - Hiroaki Tanaka
- Department of Rehabilitation, Baba Memorial Hospital, Japan
| | - Shinya Douchi
- Department of Rehabilitation, National Hospital Organization Hyogo-chuo National Hospital, Japan
| | - Nobuhiko Mori
- Department of Rehabilitation, Wakayama Medical University, Kihoku Hospital, Japan
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Gimmon Y, Millar J, Pak R, Liu E, Schubert MC. Central not peripheral vestibular processing impairs gait coordination. Exp Brain Res 2017; 235:3345-3355. [PMID: 28819687 DOI: 10.1007/s00221-017-5061-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/08/2017] [Indexed: 11/29/2022]
Abstract
Gait coordination is generated by neuronal inter-connections between central pattern generators in the spinal cord governed by cortical areas. Malfunction of central vestibular processing areas generates vestibular symptoms in the absence of an identifiable peripheral vestibular system lesion. Walking in the dark enforces a coordinated afference primarily from the vestibular and somatosensory systems. We hypothesized that patients with aberrant central vestibular processing would demonstrate unique gait characteristics, and have impaired gait coordination compared with those patients with abnormal peripheral vestibular function and healthy controls. One-hundred and eighteen subjects were recruited. Peripheral vestibular function was determined based on laboratory and clinical examinations. Patients with abnormal central vestibular processing had normal peripheral vestibular function. Subjects were instructed to walk at a comfortable pace during three visual conditions; eyes open, eyes open and closed intermittently, and eyes closed. Both patient groups showed a similar spatiotemporal gait pattern, significantly different from the pattern of the healthy controls. However, only the central vestibular patient group had an abnormal coordination of gait as measured by the phase coordination index (PCI). There were no significant interactions between the groups and walking conditions. Peripheral vestibular deficits impair gait though our data suggest that it is the central processing of such peripheral vestibular information that has a greater influence. This impairment may be related to a neural un-coupling between the brain and central pattern generator of the spinal cord based on the abnormal PCI, which seems to be a good indicator of the integrity of this linkage.
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Affiliation(s)
- Yoav Gimmon
- Laboratory of Vestibular NeuroAdaptation, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline Street, 6th Floor, Baltimore, MD, 21287-0910, USA
| | - Jennifer Millar
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rebecca Pak
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth Liu
- Laboratory of Vestibular NeuroAdaptation, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline Street, 6th Floor, Baltimore, MD, 21287-0910, USA
| | - Michael C Schubert
- Laboratory of Vestibular NeuroAdaptation, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline Street, 6th Floor, Baltimore, MD, 21287-0910, USA. .,Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Xu I, Laurendeau S, Teasdale N, Simoneau M. Change in the natural head-neck orientation momentarily altered sensorimotor control during sensory transition. Gait Posture 2017; 53:80-85. [PMID: 28119230 DOI: 10.1016/j.gaitpost.2017.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 02/02/2023]
Abstract
Achilles tendon vibration generates proprioceptive information that is incongruent with the actual body position; it alters the perception of body orientation leading to a vibration-induced postural response. When a person is standing freely, vibration of the Achilles tendon shifts the internal representation of the verticality backward thus the vibration-induced postural response realigned the whole body orientation with the shifted subjective vertical. Because utricular otoliths information participates in the creation of the internal representation of the verticality, changing the natural orientation of the head-neck system during Achilles tendon vibration could alter the internal representation of the earth vertical to a greater extent. Consequently, it was hypothesized that compared to neutral head-neck orientation, alteration in the head-neck orientation should impair balance control immediately after Achilles tendon vibration onset or offset (i.e., sensory transition) as accurate perception of the earth vertical is required. Results revealed that balance control impairment was observed only immediately following Achilles tendon vibration offset; both groups with the head-neck either extended or flexed showed larger body sway (i.e., larger root mean square scalar distance between the center of pressure and center of gravity) compared to the group with the neutral head-neck orientation. The fact that balance control was uninfluenced by head-neck orientation immediately following vibration onset suggests the error signal needs to accumulate to a certain threshold before the internal representation of the earth vertical becomes incorrect.
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Affiliation(s)
- Isabelle Xu
- Faculté de médecine, Université Laval, Canada
| | - Simon Laurendeau
- Faculté de médecine, Département de kinésiologie, Université Laval, Canada; Centre de recherche du CHU de Québec, Québec, Québec, Canada
| | - Normand Teasdale
- Faculté de médecine, Département de kinésiologie, Université Laval, Canada; Centre de recherche du CHU de Québec, Québec, Québec, Canada
| | - Martin Simoneau
- Faculté de médecine, Département de kinésiologie, Université Laval, Canada; Centre de recherche du CHU de Québec, Québec, Québec, Canada.
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22
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Maheu M, Sharp A, Landry SP, Champoux F. Sensory reweighting after loss of auditory cues in healthy adults. Gait Posture 2017; 53:151-4. [PMID: 28157577 DOI: 10.1016/j.gaitpost.2017.01.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 12/05/2016] [Accepted: 01/20/2017] [Indexed: 02/02/2023]
Abstract
We maintain our balance using information provided by the visual, somatosensory, and vestibular systems on the position of our body in space. Recent evidence has suggested that auditory input also plays a significant role for postural control, yet further investigations are required to better understand the contributions of audition to this process in healthy adults. To date, the process of sensory reweighting when auditory cues are disturbed during postural control has been overlooked. The aim of this study is to determine the impact of hearing protection on sensory reweighting for postural control in healthy adults. For this, we studied 14 healthy adults on a force platform using four different postural conditions either with or without attenuation of auditory cues. Our results suggest that disturbing auditory cues increases the reliance on visual cues for postural control. This is the first study to demonstrate such a sensory reweighting occurs in the event of a sudden disturbance of auditory cues in healthy adults.
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23
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Schut IM, Engelhart D, Pasma JH, Aarts RGKM, Schouten AC. Compliant support surfaces affect sensory reweighting during balance control. Gait Posture 2017; 53:241-247. [PMID: 28231556 DOI: 10.1016/j.gaitpost.2017.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 01/30/2017] [Accepted: 02/03/2017] [Indexed: 02/02/2023]
Abstract
To maintain upright posture and prevent falling, balance control involves the complex interaction between nervous, muscular and sensory systems, such as sensory reweighting. When balance is impaired, compliant foam mats are used in training methods to improve balance control. However, the effect of the compliance of these foam mats on sensory reweighting remains unclear. In this study, eleven healthy subjects maintained standing balance with their eyes open while continuous support surface (SS) rotations disturbed the proprioception of the ankles. Multisine disturbance torques were applied in 9 trials; three levels of SS compliance, combined with three levels of desired SS rotation amplitude. Two trials were repeated with eyes closed. The corrective ankle torques, in response to the SS rotations, were assessed in frequency response functions (FRF). Lower frequency magnitudes (LFM) were calculated by averaging the FRF magnitudes in a lower frequency window, representative for sensory reweighting. Results showed that increasing the SS rotation amplitude leads to a decrease in LFM. In addition there was an interaction effect; the decrease in LFM by increasing the SS rotation amplitude was less when the SS was more compliant. Trials with eyes closed had a larger LFM compared to trials with eyes open. We can conclude that when balance control is trained using foam mats, two different effects should be kept in mind. An increase in SS compliance has a known effect causing larger SS rotations and therefore greater down weighting of proprioceptive information. However, SS compliance itself influences the sensitivity of sensory reweighting to changes in SS rotation amplitude with relatively less reweighting occurring on more compliant surfaces as SS amplitude changes.
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Affiliation(s)
- I M Schut
- Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands.
| | - D Engelhart
- Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
| | - J H Pasma
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - R G K M Aarts
- Department of Mechanical Automation, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
| | - A C Schouten
- Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
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24
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Kabbaligere R, Lee BC, Layne CS. Balancing sensory inputs: Sensory reweighting of ankle proprioception and vision during a bipedal posture task. Gait Posture 2017; 52:244-250. [PMID: 27978501 DOI: 10.1016/j.gaitpost.2016.12.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 12/01/2016] [Accepted: 12/06/2016] [Indexed: 02/02/2023]
Abstract
During multisensory integration, it has been proposed that the central nervous system (CNS) assigns a weight to each sensory input through a process called sensory reweighting. The outcome of this integration process is a single percept that is used to control posture. The main objective of this study was to determine the interaction between ankle proprioception and vision during sensory integration when the two inputs provide conflicting sensory information pertaining to direction of body sway. Sensory conflict was created by using bilateral Achilles tendon vibration and contracting visual flow and produced body sway in opposing directions when applied independently. Vibration was applied at 80Hz, 1mm amplitude and the visual flow consisted of a virtual reality scene with concentric rings retreating at 3m/s. Body sway elicited by the stimuli individually and in combination was evaluated in 10 healthy young adults by analyzing center of pressure (COP) displacement and lower limb kinematics. The magnitude of COP displacement produced when vibration and visual flow were combined was found to be lesser than the algebraic sum of COP displacement produced by the stimuli when applied individually. This suggests that multisensory integration is not merely an algebraic summation of individual cues. Instead the observed response might be a result of a weighted combination process with the weight attached to each cue being directly proportional to the relative reliability of the cues. The moderating effect of visual flow on postural instability produced by vibration points to the potential use of controlled visual flow for balance training.
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Affiliation(s)
- Rakshatha Kabbaligere
- Department of Health and Human Performance, University of Houston, Houston, TX, United States; Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX, United States.
| | - Beom-Chan Lee
- Department of Health and Human Performance, University of Houston, Houston, TX, United States; Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX, United States
| | - Charles S Layne
- Department of Health and Human Performance, University of Houston, Houston, TX, United States; Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX, United States; Center for Neuro-Engineering and Cognitive Science, University of Houston, Houston, TX, United States
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25
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Song K, Kang TK, Wikstrom EA, Jun HP, Lee SY. Effects of reduced plantar cutaneous sensation on static postural control in individuals with and without chronic ankle instability. J Sci Med Sport 2016; 20:910-914. [PMID: 28571626 DOI: 10.1016/j.jsams.2016.04.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/21/2016] [Accepted: 04/30/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this study was to determine how reduced plantar cutaneous sensation influences static postural control in individuals with and without CAI. DESIGN A case-control study design. METHODS Twenty-six individuals with self-reported CAI and 26 matched healthy controls participated in this study. The plantar aspect of the participants' foot was then submersed in ice water (0°C) for 10min to reduce plantar sensation. Before and after the cooling procedure, plantar cutaneous sensation thresholds and single leg balance with eyes open and closed were assessed. RESULTS Significantly, higher scores were observed in both groups after ice water submersion (p<0.001) indicating a significant reduction in the plantar cutaneous sensitivity after the cooling procedure. In single limb balance with eyes open, there were significant intervention main effects for the TTB ML mean (p<0.001), TTB AP mean (p=0.035) and TTB ML SD (p=0.021); indicating postural control improvement in both groups post-cooling. In single limb balance with eyes closed, Group×Intervention interactions were observed for the TTB AP mean (p=0.003) and TTB AP SD (p=0.017); indicating postural control deficits in CAI group post-cooling, but no changes in the control group. CONCLUSIONS The main finding of this study was that reduced plantar cutaneous sensation induced by an ice submersion procedure caused eyes closed postural control impairments in those with CAI but not healthy controls. The present investigation demonstrated that the ability to dynamically reweight among sensory inputs to maintain postural stability appears to be diminished in CAI patients compared to healthy controls.
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Affiliation(s)
- Kyeongtak Song
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, USA
| | - Tae Kyu Kang
- Yonsei Institute of Sports Science and Exercise Medicine, Yonsei University, Republic of Korea
| | - Erik A Wikstrom
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, USA
| | - Hyung-Pil Jun
- Department of Movement Sciences, University of Idaho, USA
| | - Sae Yong Lee
- Yonsei Institute of Sports Science and Exercise Medicine, Yonsei University, Republic of Korea.
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26
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Tjernström F, Zur O, Jahn K. Current concepts and future approaches to vestibular rehabilitation. J Neurol 2016; 263 Suppl 1:S65-70. [PMID: 27083886 DOI: 10.1007/s00415-015-7914-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 09/16/2015] [Accepted: 09/18/2015] [Indexed: 02/05/2023]
Abstract
Over the last decades methods of vestibular rehabilitation to enhance adaptation to vestibular loss, habituation to changing sensory conditions, and sensory reweighting in the compensation process have been developed. However, the use of these techniques still depends to a large part on the educational background of the therapist. Individualized assessment of deficits and specific therapeutic programs for different disorders are sparse. Currently, vestibular rehabilitation is often used in an unspecific way in dizzy patients irrespective of the clinical findings. When predicting the future of vestibular rehabilitation, it is tempting to foretell advances in technology for assessment and treatment only, but the current intense exchange between clinicians and basic scientists also predicts advances in truly understanding the complex interactions between the peripheral senses and central adaptation mechanisms. More research is needed to develop reliable techniques to measure sensory dependence and to learn how this knowledge can be best used--by playing off the patient's sensory strength or working on the weakness. To be able using the emerging concepts, the neuro-otological community must strive to educate physicians, physiotherapists and nurses to perform the correct examinations for assessment of individual deficits and to look for factors that might impede rehabilitation.
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27
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Hwang S, Agada P, Grill S, Kiemel T, Jeka JJ. A central processing sensory deficit with Parkinson's disease. Exp Brain Res 2016; 234:2369-79. [PMID: 27059036 DOI: 10.1007/s00221-016-4642-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 03/30/2016] [Indexed: 10/22/2022]
Abstract
Parkinson's disease (PD) is a progressive degenerative disease manifested by tremor, rigidity, bradykinesia, and postural instability. Deficits in proprioceptive integration are prevalent in individuals with PD, even at early stages of the disease. These deficits have been demonstrated primarily during investigations of reaching. Here, we investigated how PD affects sensory fusion of multiple modalities during upright standing. We simultaneously perturbed upright stance with visual, vestibular, and proprioceptive stimulation, to understand how these modalities are reweighted so that overall feedback remains suited to stabilizing upright stance in individuals with PD. Eight individuals with PD stood in a visual cave with a moving visual scene at 0.2 Hz while an 80-Hz vibratory stimulus was applied bilaterally to their Achilles tendons (stimulus turns on-off at 0.28 Hz) and a ±1 mA bilateral monopolar galvanic stimulus was applied at 0.36 Hz. The visual stimulus was presented at different amplitudes (0.2°, 0.8° rotation about ankle axis) to measure: the change in gain (weighting) to vision, an intramodal effect; and a simultaneous change in gain to vibration and galvanic stimulation, both intermodal effects. Trunk/leg gain relative to vision decreased when visual amplitude was increased, reflecting an intramodal visual effect. In contrast, when vibration was turned on/off, leg gain relative to vision was equivalent in individuals with PD, indicating no reweighting of visual information when proprioception was disrupted through vibration (i.e., no intermodal effect). Trunk and leg angle gain relative to GVS also showed no reweighting in individuals with PD. These results are in contrast to previous results with healthy adults, who showed clear intermodal effects in the same paradigm, suggesting that individuals with PD not only have a proprioceptive deficit during standing, but also have a cross-modal sensory fusion deficit that is crucial for upright stance control.
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Affiliation(s)
- Sungjae Hwang
- Department of Kinesiology, Temple University, Philadelphia, PA, 19122, USA.
| | - Peter Agada
- Department of Kinesiology, Temple University, Philadelphia, PA, 19122, USA
| | - Stephen Grill
- Parkinson's & Movement Disorders Center of Maryland, Elkridge, MD, 21075, USA
| | - Tim Kiemel
- Department of Kinesiology, University of Maryland, College Park, MD, 20742, USA
| | - John J Jeka
- Department of Kinesiology, Temple University, Philadelphia, PA, 19122, USA.,Department of Bioengineering, Temple University, Philadelphia, PA, 19122, USA.,Department of Kinesiology, University of Maryland, College Park, MD, 20742, USA
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28
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Beinert K, Keller M, Taube W. Neck muscle vibration can improve sensorimotor function in patients with neck pain. Spine J 2015; 15:514-21. [PMID: 25452010 DOI: 10.1016/j.spinee.2014.10.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 07/11/2014] [Accepted: 10/16/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT People with neck pain display a diminished joint position sense and disturbed postural control, which is thought to be a result of impaired somatosensory afferent activity and/or integration. Afferent processing can be artificially manipulated by vibration and was shown to reduce motor performance in healthy subjects. However, the effect of vibration on sensorimotor function in neck pain patients is scarcely investigated. PURPOSE To assess the effect of neck muscle vibration on joint position sense and postural control in neck pain subjects and healthy controls. STUDY DESIGN Case control study. PATIENT SAMPLE Thirteen neck pain patients and 10 healthy controls participated in the present study. OUTCOME MEASUREMENTS Cervical joint position sense and dynamic and static postural stability. METHODS Short-term, targeted neck muscle vibration with 100 Hz was applied after baseline measurement. RESULTS Vibration had opposite effects in patients and healthy subjects. Patients showed improved joint position sense (p<.01) and reduced dynamic postural sway (p<.05) after vibration, whereas vibration resulted in reduced joint position sense acuity (p<.05) and a nonsignificant increase in postural sway in healthy controls. CONCLUSIONS This is the first study showing an improved motor performance after neck muscle vibration in patients with neck pain. Thus, vibration may be used to counteract sensorimotor impairment of the cervical spine. Potential underlying mechanisms are discussed.
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Affiliation(s)
- Konstantin Beinert
- University of Fribourg, Department of Medicine, Unit of Sports Science, Chemin du Musée 3, 1700 Fribourg, Switzerland; Academy for Health Professions, Institute of Applied Science of the Human Movement System, Maximilianstraße 20, 67433 Neustadt an der Weinstraße, Germany.
| | - Martin Keller
- University of Fribourg, Department of Medicine, Unit of Sports Science, Chemin du Musée 3, 1700 Fribourg, Switzerland
| | - Wolfgang Taube
- University of Fribourg, Department of Medicine, Unit of Sports Science, Chemin du Musée 3, 1700 Fribourg, Switzerland
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Billot M, Handrigan GA, Simoneau M, Teasdale N. Reduced plantar sole sensitivity induces balance control modifications to compensate ankle tendon vibration and vision deprivation. J Electromyogr Kinesiol 2014; 25:155-60. [PMID: 24993669 DOI: 10.1016/j.jelekin.2014.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/30/2014] [Accepted: 06/05/2014] [Indexed: 10/25/2022] Open
Abstract
The aim of this study was to investigate if sensory reweighting occurred to control balance when the sensitivity of the plantar sole is reduced using cooling. To address this question, visual information was manipulated and/or ankle proprioception was altered by Achilles tendon vibration. It was expected that Achilles tendon vibration and vision deprivation would induce greater center of pressure (CoP) excursions and/or increase of electromyographic (EMG) activity of the ankle muscles (triceps surea and tibialis anterior) with than without cooling of the plantar sole. To verify these hypotheses, the CoP and EMG activity of the ankle muscles were simultaneously recorded during quiet standing trials of 30s before and after feet cooling procedure. Results showed that plantar sole sensitivity alteration did not lead to larger CoP excursions even during Achilles tendon vibration in absence of vision. This could be explained by an increase in the EMG activity of the triceps surae after the cooling procedure without modification of tibialis anterior EMG activity. This study suggests that to compensate alteration in plantar sole sensitivity, the central nervous system increased the muscular activity of the triceps surae to limit CoP excursions.
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Affiliation(s)
- Maxime Billot
- GRAME, Faculté de médecine, Département de kinésiologie, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec, Centre d'excellence sur le vieillissement de Québec, Québec, Canada.
| | - Grant A Handrigan
- GRAME, Faculté de médecine, Département de kinésiologie, Université Laval, Québec, Canada; Faculté des sciences de la santé et des services communautaires, École de Kinésiologie et Récréologie, Université de Moncton, Moncton, Nouveau-Brunswick, Canada
| | - Martin Simoneau
- GRAME, Faculté de médecine, Département de kinésiologie, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec, Centre d'excellence sur le vieillissement de Québec, Québec, Canada
| | - Normand Teasdale
- GRAME, Faculté de médecine, Département de kinésiologie, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec, Centre d'excellence sur le vieillissement de Québec, Québec, Canada
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