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Howe EE, Apollinaro M, Bent LR. Mechanoreceptor sensory feedback is impaired by pressure induced cutaneous ischemia on the human foot sole and can predict cutaneous microvascular reactivity. Front Neurosci 2024; 18:1329832. [PMID: 38629048 PMCID: PMC11019310 DOI: 10.3389/fnins.2024.1329832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/06/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction The foot sole endures high magnitudes of pressure for sustained periods which results in transient but habitual cutaneous ischemia. Upon unloading, microvascular reactivity in cutaneous capillaries generates an influx of blood flow (PORH: post-occlusive reactive hyperemia). Whether pressure induced cutaneous ischemia from loading the foot sole impacts mechanoreceptor sensitivity remains unknown. Methods Pressure induced ischemia was attained using a custom-built-loading device that applied load to the whole right foot sole at 2 magnitudes (15 or 50% body weight), for 2 durations (2 or 10 minutes) in thirteen seated participants. Mechanoreceptor sensitivity was assessed using Semmes-Weinstein monofilaments over the third metatarsal (3MT), medial arch (MA), and heel. Perceptual thresholds (PT) were determined for each site prior to loading and then applied repeatedly to a metronome to establish the time course to return to PT upon unload, defined as PT recovery time. Microvascular flux was recorded from an in-line laser speckle contrast imager (FLPI-2, Moor Instruments Inc.) to establish PORH peak and recovery rates at each site. Results PT recovery and PORH recovery rate were most influenced at the heel and by load duration rather than load magnitude. PT recovery time at the heel was significantly longer with 10 minutes of loading, regardless of magnitude. Heel PORH recovery rate was significantly slower with 10minutes of loading. The 3MT PT recovery time was only longer after 10 minutes of loading at 50% body weight. Microvascular reactivity or sensitivity was not influenced with loading at the MA. A simple linear regression found that PORH recovery rate could predict PT recovery time at the heel (R2=0.184, p<0.001). Conclusion In populations with degraded sensory feedback, such as diabetic neuropathy, the risk for ulcer development is heightened. Our work demonstrated that prolonged loading in healthy individuals can impair skin sensitivity, which highlights the risks of prolonged loading and is likely exacerbated in diabetes. Understanding the direct association between sensory function and microvascular reactivity in age and diabetes related nerve damage, could help detect early progressions of neuropathy and mitigate ulcer development.
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Affiliation(s)
- Erika E. Howe
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
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Chen YY, Tzeng SY, Yen YY, Cheng NY, Tseng SH. Non-invasive assessment of skin hydration and sensation with diffuse reflectance spectroscopy. Sci Rep 2023; 13:20149. [PMID: 37978237 PMCID: PMC10656448 DOI: 10.1038/s41598-023-47349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/12/2023] [Indexed: 11/19/2023] Open
Abstract
The skin is a vital organ in the human body, providing essential functions such as protection, sensation, and metabolism. Skin hydration is one of the crucial factors in maintaining normal skin function. Insufficient skin hydration can lead to dryness, shedding of the stratum corneum, a decrease in skin barrier function, and may cause skin inflammation. Therefore, maintaining or improving skin hydration is critical in promoting healthy skin. Currently, the commonly used method for measuring skin hydration is bioelectrical capacitance analysis, which is often affected by environmental humidity and can only provide limited information. To overcome these limitations, this study used diffuse reflectance spectroscopy (DRS) in the wavelength range of 400-1000 nm to quantify skin absorption and scattering modulation caused by changes in skin hydration states. The advantages of this technique include rapid measurements, non-invasiveness, a straightforward optical setup, and suitability for prolonged skin monitoring. We found that DRS-derived skin absorption coefficients had a correlation coefficient of 0.93 with the skin capacitance at various skin hydration states. In addition, our findings reveal that absorption and scattering coefficients may be useful in discerning skin hydration enhancement induced by applying soaked cotton pads or cosmeceutical facial masks, as well as evaluating skin sensation. This study verifies that the DRS method could be a convenient and effective tool for evaluating skin hydration related information.
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Affiliation(s)
- Ying-Yu Chen
- Department of Photonics, National Cheng-Kung University, Tainan, 701, Taiwan, ROC
| | - Shih-Yu Tzeng
- Research Development and Innovation Center, Show Chwan Health Care System, Changhua City, 500, Taiwan, ROC
| | - Yun-Yo Yen
- Department of Photonics, National Cheng-Kung University, Tainan, 701, Taiwan, ROC
| | - Nan-Yu Cheng
- Department of Health-Business Administration, Fooyin University, Kaohsiung, 831, Taiwan, ROC
| | - Sheng-Hao Tseng
- Department of Photonics, National Cheng-Kung University, Tainan, 701, Taiwan, ROC.
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan, ROC.
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Schmidt D, Schlee G, Milani TL, Germano AMC. Vertical contact forces affect vibration perception in human hairy skin. PeerJ 2023; 11:e15952. [PMID: 37692116 PMCID: PMC10484200 DOI: 10.7717/peerj.15952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 08/01/2023] [Indexed: 09/12/2023] Open
Abstract
Background Skin is the largest organ of the human body and fulfills many important functions, like detecting mechanical stimuli. Skin can be divided into glabrous (non-hairy) and hairy skin. These two skin types differ with regard to their mechanical properties and in the distribution of mechanoreceptors. Although many investigations focus on glabrous skin, hairy skin still plays a fundamental role in various activities, e.g., with regard to the perception of pleasantness or for developing wearable vibrotactile devices for pattern recognition in persons with disabilities. Unfortunately, investigations on influencing factors, like vertical contactor force, are scarce for hairy skin. Similarly, it would also be interesting to investigate whether regional vibratory sensitivity differences are present across the human torso. Hence, this study investigated the effects of vertical contactor forces and different anatomical locations on vibration perception. Four anatomical torso regions were studied. Based on findings in glabrous skin, we generally hypothesized improved vibration perception with increasing contactor forces and regional sensitivity differences between the anatomical locations. Methods Forty young and healthy individuals participated (23.0 ± 2.0 yrs), and vibration perception thresholds (VPTs) were determined at 30 Hz for three vertical force levels (0.6, 2.4, and 4.8 N) at four torso locations (sternum, deltoid/shoulder, lower back, middle lateral torso side). Results Higher contactor forces resulted in lower VPTs corresponding to improved vibration perception, regardless of anatomical location. In addition, the sternum region was more sensitive than the remaining three regions, regardless of force level. The reasons for these findings may be a varying number and activation pattern of afferents activated under the different conditions. The findings of this study complement the understanding of vibrotactile sensitivity in hairy skin and may offer implications when developing vibrotactile devices or clothing/textiles, for example.
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Affiliation(s)
- Daniel Schmidt
- Motor Control, Cognition, and Neurophysiology, Faculty of Behavioral and Social Sciences, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Saxony, Germany
| | - Guenther Schlee
- Biophysics and Human Performance Lab, W.L. Gore and Associates, Putzbrunn, Bavaria, Germany
| | - Thomas L. Milani
- Department of Human Locomotion, Faculty of Behavioral and Social Sciences, Institute of Human Movement Science and Health, Chemnitz, Saxony, Germany
| | - Andresa M. C. Germano
- Motor Control, Cognition, and Neurophysiology, Faculty of Behavioral and Social Sciences, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Saxony, Germany
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Wynands B, Zippenfennig C, Holowka NB, Lieberman DE, Milani TL. Does plantar skin abrasion affect cutaneous mechanosensation? Physiol Rep 2022; 10:e15479. [PMID: 36259120 PMCID: PMC9579735 DOI: 10.14814/phy2.15479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023] Open
Abstract
In humans, plantar cutaneous mechanoreceptors provide critical input signals for postural control during walking and running. Because these receptors are located within the dermis, the mechanical properties of the overlying epidermis likely affect the transmission of external stimuli. Epidermal layers are highly adaptable and can form hard and thick protective calluses, but their effects on plantar sensitivity are currently disputed. Some research has shown no effect of epidermal properties on sensitivity to vibrations, whereas other research suggests that vibration and touch sensitivity diminishes with a thicker and harder epidermis. To address this conflict, we conducted an intervention study where 26 participants underwent a callus abrasion while an age-matched control group (n = 16) received no treatment. Skin hardness and thickness as well as vibration perception thresholds and touch sensitivity thresholds were collected before and after the intervention. The Callus abrasion significantly decreased skin properties. The intervention group exhibited no change in vibration sensitivity but had significantly better touch sensitivity. We argue that touch sensitivity was impeded by calluses because hard skin disperses the monofilament's standardized pressure used to stimulate the mechanoreceptors over a larger area, decreasing indentation depth and therefore stimulus intensity. However, vibration sensitivity was unaffected because the vibrating probe was adjusted to reach specific indentation depths, and thus stimulus intensity was not affected by skin properties. Since objects underfoot necessarily indent plantar skin during weight-bearing, calluses should not affect mechanosensation during standing, walking, or running.
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Affiliation(s)
- Bert Wynands
- Department of Human Locomotion, Institute of Human Movement Science and HealthChemnitz University of TechnologyChemnitzGermany
| | - Claudio Zippenfennig
- Department of Human Locomotion, Institute of Human Movement Science and HealthChemnitz University of TechnologyChemnitzGermany
| | - Nicholas B. Holowka
- Department of Anthropology, College of Arts and SciencesUniversity at BuffaloBuffaloNew YorkUSA
| | - Daniel E. Lieberman
- Department of Human Evolutionary BiologyHarvard UniversityCambridgeMassachusettsUSA
| | - Thomas L. Milani
- Department of Human Locomotion, Institute of Human Movement Science and HealthChemnitz University of TechnologyChemnitzGermany
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Cristina T, Mara T, Arianna S, Gennaro S, Rosaria C, Pantaleo G. Impact of waterbirth on post-partum hemorrhage, genital trauma, retained placenta and shoulder dystocia: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2022; 276:26-37. [DOI: 10.1016/j.ejogrb.2022.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/11/2022] [Accepted: 06/17/2022] [Indexed: 11/28/2022]
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Papoutsis D. Novel insights on the possible effects of water exposure on the structural integrity of the perineum during a waterbirth. Eur J Midwifery 2021; 4:40. [PMID: 33537641 PMCID: PMC7841965 DOI: 10.18332/ejm/127263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 09/04/2020] [Indexed: 12/31/2022] Open
Affiliation(s)
- Dimitrios Papoutsis
- Department of Midwifery, University of Western Macedonia, Ptolemaida, Greece
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Rizzo JR, Beheshti M, Fang Y, Flanagan S, Giudice NA. COVID-19 and Visual Disability: Can't Look and Now Don't Touch. PM R 2020; 13:415-421. [PMID: 33354903 DOI: 10.1002/pmrj.12541] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/23/2020] [Accepted: 12/04/2020] [Indexed: 01/13/2023]
Affiliation(s)
- John-Ross Rizzo
- Department of Rehabilitation Medicine, NYU Langone Health, New York, NY.,Department of Neurology, NYU Langone Health, New York, NY.,Department of Biomedical Engineering, NYU Tandon School of Engineering, New York, NY.,Department of Mechanical & Aerospace Eng., NYU Tandon School of Engineering, New York, NY
| | - Mahya Beheshti
- Department of Rehabilitation Medicine, NYU Langone Health, New York, NY.,Department of Mechanical & Aerospace Eng., NYU Tandon School of Engineering, New York, NY
| | - Yi Fang
- Department of Electrical and Computer Eng, NYU Tandon School of Engineering, New York, NY
| | - Steven Flanagan
- Department of Rehabilitation Medicine, NYU Langone Health, New York, NY
| | - Nicholas A Giudice
- Virtual Environments and Multimodal Interaction (VEMI) Lab, The University of Maine, Orono, ME.,School of Computing and Information Science, The University of Maine, Orono, ME.,Department of Psychology, The University of Maine, Orono, ME
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Papoutsis D, Antonakou A, Gornall A, Tzavara C. The Incidence of and Predictors for Severe Perineal Trauma and Intact Perineum in Women Having a Waterbirth in England: A Hospital-Based Study. J Womens Health (Larchmt) 2020; 30:681-688. [PMID: 32907460 DOI: 10.1089/jwh.2019.8244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: To determine the incidence of and predictors for obstetric anal sphincter injuries (OASIS) and intact perineum in women giving birth in the water and compare with the general obstetric population. Materials and Methods: Data were retrospectively collected for women who had singleton cephalic presentation vaginal births in the water and the general obstetric population between August 2007 and December 2017. Results: We identified 1,007 women who had a waterbirth and 36,924 women from the general obstetric population. There was no significant difference in the incidence of OASIS between waterbirths and the general obstetric population (2.3% vs. 2.0%). Having a waterbirth was associated with a lower probability for an intact perineum (odds ratio [OR] = 0.83; confidence interval [95% CI]: 0.73-0.94) when compared with the general obstetric population (44.7% vs. 51.3%). Nulliparous women with a waterbirth when compared with multiparous women had an eightfold higher likelihood for the occurrence of OASIS (OR = 8.28; 95% CI: 2.64-25.86). The risk for a higher degree of OASIS was associated with increased maternal age in the total sample (OR = 1.08; 95% CI: 1.06-1.11) and with a lower body mass index (BMI) at booking in multiparous women (OR = 0.96; 95% CI: 0.92-0.99). The risk for any type of perineal trauma was associated with increased maternal age in the total sample (OR = 1.10; 95% CI: 1.07-1.13) and with a lower BMI at booking in multiparous women (OR = 0.95; 95% CI: 0.91-0.99). Conclusions: We found that giving birth in the water reduced the chance of having an intact perineum. We have also shown that nulliparity, increased maternal age in all women, and a lower BMI at booking in multiparous were associated with OASIS and lower rates of intact perineum in waterbirths.
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Affiliation(s)
- Dimitrios Papoutsis
- Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospitals NHS Trust, Telford, United Kingdom.,School of Health Sciences, University of Western Macedonia, Kozani, Greece
| | - Angeliki Antonakou
- Department of Midwifery, Midwifery School, International Hellenic University, Thessaloniki, Greece
| | - Adam Gornall
- Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospitals NHS Trust, Telford, United Kingdom
| | - Chara Tzavara
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
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Schmidt D, Schlee G, Germano AMC, Milani TL. Larger contactor area increases low-frequency vibratory sensitivity in hairy skin. PeerJ 2020; 8:e8479. [PMID: 32117615 PMCID: PMC7003686 DOI: 10.7717/peerj.8479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/27/2019] [Indexed: 12/16/2022] Open
Abstract
Background In research, assessing vibratory cutaneous sensitivity is an important research branch to quantify various diseases or to develop devices for pattern recognition. The measured vibration perception thresholds (VPTs), however, are subjective and usually result in a large data variability. This might induce difficulties to detect differences, for example, when comparing different anatomical locations. Hence, a higher ability to detect changes is desirable. Another feature of VPTs is spatial summation, but in the literature it is controversially discussed whether or not this phenomenon is also present in the lower frequency range. For these reasons, the present study aimed to investigate whether an enlarged matrix contactor area (measured at the hairy skin) induces improvements in subjective sensitivity using high and low frequencies, and whether a large contactor area is better able to identify changes of VPTs than a small contactor area of a single contactor. For each frequency, we hypothesized an increased sensitivity for the matrix compared to the single contactor. We also hypothesized that changes can be better-detected between the anatomical locations when using the matrix than the single contactor. Methods Twenty healthy and young participants voluntarily took part in this study. Three anatomical locations at the torso were measured at the middle aspect of the lower back, middle lateral aspect of the upper arm, and the region just below the armpit. At each location, two frequencies (30, 200 Hz) and two contactor conditions (single contactor: 0.48 cm2 , contactor matrix: 9 × 0.48 cm2 = 4.32 cm2) were tested in a randomized order. Results Supporting our hypothesis, we found that improved cutaneous sensitivity after increasing the contactor size occurs not only at high, but also at low frequencies at all anatomical locations. Large contactor sizes resulted in higher sensitivity and in a superior ability to detect changes. The superior behavior of the matrix to exhibit a lower variability could not always be proven. This work may be relevant for future studies aiming to identify changes of VPTs in various patient groups, for example.
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Affiliation(s)
- Daniel Schmidt
- Department of Human Locomotion, Faculty of Behavioral and Social Sciences, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Guenther Schlee
- Biophysics and Human Performance Lab, W.L. Gore and Associates, Putzbrunn, Germany
| | - Andresa M C Germano
- Department of Human Locomotion, Faculty of Behavioral and Social Sciences, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Thomas L Milani
- Department of Human Locomotion, Faculty of Behavioral and Social Sciences, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
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