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Azevedo J, Moreira-Silva I, Seixas A, Fonseca P, Oliveira J, Vilas-Boas JP. The Effect of Muscle Fatigue on the Knee Proprioception: A Systematic Review. J Mot Behav 2024:1-33. [PMID: 38810655 DOI: 10.1080/00222895.2024.2341753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/07/2024] [Indexed: 05/31/2024]
Abstract
This study aimed to systematically review and summarise the evidence about the effect of muscle fatigue on the knee proprioception of trained and non-trained individuals. A search in PubMed, Scopus, Web of Science and EBSCO databases and Google Scholar was conducted using the expression: "fatigue" AND ("proprioception" OR "position sense" OR "repositioning" OR "kinesthesia" OR "detection of passive motion" OR "force sense" OR "sense of resistance") AND "knee". Forty-two studies were included. Regarding joint-position sense, higher repositioning errors were reported after local and general protocols. Kinesthesia seems to be more affected when fatigue is induced locally, and force sense when assessed at higher target forces and after eccentric protocols. Muscle fatigue, both induced locally or generally, has a negative impact on the knee proprioception.
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Affiliation(s)
- Joana Azevedo
- FP-I3ID, FP-BHS, Escola Superior de Saúde Fernando Pessoa, Porto, Portugal
- Faculty of Sport, University of Porto, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Porto, Portugal
| | - Isabel Moreira-Silva
- FP-I3ID, FP-BHS, Escola Superior de Saúde Fernando Pessoa, Porto, Portugal
- Research Centre in Physical Activity, Health and Leisure-CIAFEL, Faculty of Sports, University of Porto, Porto, Portugal
| | - Adérito Seixas
- FP-I3ID, FP-BHS, Escola Superior de Saúde Fernando Pessoa, Porto, Portugal
- LABIOMEP, INEGI-LAETA, Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Pedro Fonseca
- Faculty of Sport, University of Porto, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Porto, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure-CIAFEL, Faculty of Sports, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - João Paulo Vilas-Boas
- Porto Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Porto, Portugal
- Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
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van Dieën JH, Kistemaker DA. Increased velocity feedback gains in the presence of sensory noise can explain paradoxical changes in trunk motor control related to back pain. J Biomech 2024; 162:111876. [PMID: 37989619 DOI: 10.1016/j.jbiomech.2023.111876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
Literature reports paradoxical findings regarding effects of low-back pain (LBP) on trunk motor control. Compared to healthy individuals, patients with LBP, especially those with high pain-related anxiety, showed stronger trunk extensor reflexes and more resistance against perturbations. On the other hand, LBP patients and especially those with high pain-related anxiety showed decreased precision in unperturbed trunk movement and posture. These paradoxical effects might be explained by arousal potentially increasing average and variance of muscle spindle firing rates. Increased average firing rates could increase resistance against perturbations, but increased variance could decrease precision. We performed a simulation study to test this hypothesis. We modeled the trunk as a 2D inverted pendulum, stabilized by two antagonistic Hill-type muscles, based on their open-loop muscle activation dependent intrinsic stiffness and damping and through 25 ms-delayed, noisy contractile element length and velocity feedback. Reference feedback gains and sensory noise levels were tuned based on previously reported experimental data. We assessed the effect of increasing feedback gains on precision of trunk orientation at different perturbation magnitudes and assessed sensitivity of the effects to open-loop muscle stimulation and noise levels. At low perturbation magnitudes, increasing reflex gains consistently caused an increase in the variance of trunk orientation. At larger perturbation magnitudes, increasing reflex gains consistently caused a decrease in the variance of trunk orientation. Our results support the notion that LBP and related anxiety may increase reflex gains, resulting in an increase in the average and variance of spindle afference, which in turn increase resistance against perturbations and decrease movement precision.
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Affiliation(s)
- Jaap H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| | - Dinant A Kistemaker
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
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Rodrigues A, Bevilaqua-Grossi D, Florencio LL, Pinheiro CF, Dach F, Bigal M, Carvalho GF. Balance alterations are associated with neck pain and neck muscle endurance in migraine. Musculoskelet Sci Pract 2023; 66:102811. [PMID: 37357054 DOI: 10.1016/j.msksp.2023.102811] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/16/2023] [Accepted: 06/18/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Migraine patients may present with both cervical and balance dysfunctions. The neck plays an important role in balance by providing substantial proprioceptive input, which is integrated in the central nervous system and influences the balance control systems. Whether balance and neck dysfunctions are associated in patients with migraine is still to be explored. OBJECTIVES This study aimed to assess the association between the sensory organization test of balance with neck pain features, cervical strength, endurance, and range of motion in patients with migraine. METHODS Sixty-five patients with migraine underwent the sensory organization test assessed with the Equitest-Neurocom® device. Maximum voluntary isometric contraction, cervical flexion and extension range of motion, and cervical flexor and extensor endurance were assessed. In addition, the features of migraine and neck pain were collected. Patients were dichotomized according to cut-off scores of balance performance and the association between outcomes were explored. RESULTS Patients with reduced balance performance presented a higher frequency of migraine (p = 0.035), a higher frequency of aura (p = 0.002), greater neck pain intensity (p = 0.013), and decreased endurance of cervical flexors (p = 0.010) and extensors (p < 0.0001). The total balance score was correlated with age (r = -0.33; p = 0.007), migraine frequency (r = -0.29; p = 0.021), neck pain intensity (r = -0.26; p = 0.038), and endurance of the cervical flexors (r = 0.39; p = 0.001) and extensors (r = 0.36; p = 0.001). Migraine frequency, neck pain intensity, and endurance of the cervical flexors can predict 21% of the sensory organization test variability. CONCLUSION Neck pain features and endurance of the cervical muscles are related to reduced balance performance in patients with migraine. These results shed light to a better understanding of balance alterations in migraine patients.
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Affiliation(s)
- Amanda Rodrigues
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Lidiane Lima Florencio
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain.
| | - Carina Ferreira Pinheiro
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | | | - Gabriela Ferreira Carvalho
- Institut für Gesundheitswissenschaften, Studiengang Physiotherapie, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Lübeck, Germany.
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Li L, Li YX, Zhang CL, Zhang DH. Recovery of pinch force sense after short-term fatigue. Sci Rep 2023; 13:9429. [PMID: 37296199 PMCID: PMC10256726 DOI: 10.1038/s41598-023-36476-8] [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: 06/15/2022] [Accepted: 06/04/2023] [Indexed: 06/12/2023] Open
Abstract
The aim of this study was to identify the exact origin of force sense and identify whether it arises centrally or peripherally. The present study was designed to analyze the effects of short-term fatigue on pinch force sense and the duration of these effects. During the fatigue protocol, twenty (10 men and 10 women; Mage = 22.0 years old) young Chinese participants were asked to squeeze maximally until the pinch grip force decreased to 50% of its maximal due to fatigue. Participants were instructed to produce the target force (10% of maximal voluntary isometric contraction) using the same hand before and after fatigue (immediately, 10, 30, 60, 180, 300 s). The results showed significantly higher absolute error immediately after fatigue (1.22 ± 1.06 N) than before fatigue (0.68 ± 0.34 N), and 60 s (0.76 ± 0.69 N), 180 s (0.67 ± 0.42 N), and 300 s (0.75 ± 0.37 N) after fatigue (all P < 0.05) but with no effect on the variable error (P > 0.05). It was also revealed that there was a significant overestimate of the constant error values before (0.32 ± 0.61 N) and immediately after fatigue (0.80 ± 1.38 N, all P < 0.05), while no significant overestimation or underestimation exceeded 300 s after fatigue (P > 0.05). Our study results revealed that short-term fatigue resulted in a significant decrease in force sense accuracy, but it did not affect force sense consistently; however, force sense accuracy recovered to a certain extent within 10 s and 30 s, whereas it recovered fully within 60 s, and force sense directivity improvement exceeded 300 s after fatigue. The present study shows that the sense of tension (peripherally) is also an important factor affecting force sense. Our study supports the view that the periphery is part of the origin of force sense.
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Affiliation(s)
- Lin Li
- Department of Physical Education, Renmin University of China, No. 59 Zhongguancun Street, Beijing, 100872, China
| | - Yan-Xia Li
- College of Physical Education, Langfang Normal University, Langfang, Hebei, China.
| | - Chong-Long Zhang
- College of Physical Education, Langfang Normal University, Langfang, Hebei, China
| | - Dong-Hai Zhang
- College of Physical Education, Langfang Normal University, Langfang, Hebei, China
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Li L, Li S. Grip force makes wrist joint position sense worse. Front Hum Neurosci 2023; 17:1193937. [PMID: 37323932 PMCID: PMC10264640 DOI: 10.3389/fnhum.2023.1193937] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/10/2023] [Indexed: 06/17/2023] Open
Abstract
Background The purpose of this study was to investigate how grip force affects wrist joint position sense. Methods Twenty-two healthy participants (11 men and 11 women) underwent an ipsilateral wrist joint reposition test at 2 distinct grip forces [0 and 15% of maximal voluntary isometric contraction (MVIC)] and 6 different wrist positions (pronation 24°, supination 24°, radial deviation 16°, ulnar deviation 16°, extension 32°, and flexion 32°). Results The findings demonstrated significantly elevated absolute error values at 15% MVIC (3.8 ± 0.3°) than at 0% MVIC grip force [3.1 ± 0.2°, t(20) = 2.303, P = 0.032]. Conclusion These findings demonstrated that there was significantly worse proprioceptive accuracy at 15% MVIC than at 0% MVIC grip force. These results may contribute to a better comprehension of the mechanisms underlying wrist joint injuries, the development of preventative measures to lower the risk of injuries, and the best possible design of engineering or rehabilitation devices.
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Özüdoğru A, Canlı M, Kuzu Ş, Aslan M, Ceylan İ, Alkan H. Muscle strength, balance and upper extremity function are not predictors of cervical proprioception in healthy young subjects. Somatosens Mot Res 2023; 40:78-82. [PMID: 36877602 DOI: 10.1080/08990220.2023.2183832] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Purpose/Aim: The aim of this study is to examine the relationship between cervical proprioception sense and balance, hand grip strength, cervical region muscle strength and upper extremity functionality in healthy young subjects.Methods: A total of 200 people with a mean age of 20.8 ± 1.8 participated in the study. Cervical proprioception sense of the participants was evaluated with Cervical Joint Position Error Test (CJPET), balance with Biodex Stability System, hand grip strength with hand dynamometer, and upper extremity functionality with Perdue Pegboard test. The relationship of variables with cervical proprioception was evaluated with Pearson Correlation analysis.Results: According to this study results, there was no significant relationship between CJPET (extension, left rotation, right rotation) and sub-parameters of dynamic balance (anteroposterior, mediolateral, overall), cervical muscle strength and hand grip strength (p > 0.05). There was a significant correlation between CJPET flexion and static balance variables (p < 0.05).Conclusion: According to this study, there is no relationship between cervical proprioception and balance, hand grip muscle strength, cervical region muscle strength and upper extremity functionality in healthy young subjects.
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Affiliation(s)
- Anıl Özüdoğru
- School of Physical Therapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Mehmet Canlı
- School of Physical Therapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Şafak Kuzu
- School of Physical Therapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Mensure Aslan
- School of Physical Therapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - İsmail Ceylan
- School of Physical Therapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Halil Alkan
- Department of Physiotherapy and Rehabilitation, Muş Alparslan University, Muş, Turkey
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Özel Aslıyüce Y, Demirel A, Ülger Ö. Investigation of Joint Position Sense and Balance in Individuals With Chronic Idiopathic Neck Pain: A Cross-Sectional Study. J Manipulative Physiol Ther 2022; 45:188-195. [PMID: 35906105 DOI: 10.1016/j.jmpt.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/26/2022] [Accepted: 06/09/2022] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim of this study was to determine the relationship between joint position sense and static and dynamic balance in female patients with chronic neck pain compared with healthy controls. METHODS The study sample comprised 25 female patients with chronic neck pain and 25 healthy (asymptomatic) female controls. Pain severity with the visual analog scale, joint position sense with the laser pointer method, static balance with the Single-Leg Balance Test, and dynamic balance with the Y Balance Test were assessed. RESULTS The deviation in cervical joint position sense was greater in extension (P < .001), right rotation (P < .001), and left lateral rotation (P < .05) in the patients with chronic neck pain compared with the healthy controls. The results of the patients with chronic neck pain were worse than the healthy controls in the Single-Leg Balance Test with both eyes open (P < .05) and eyes closed (P < .05). The patients with chronic neck pain had worse dynamic balance only in the anterior direction reach of the left leg (P < .05). CONCLUSION Cervical joint position sense and static balance were worse in female patients with chronic idiopathic neck pain when compared with asymptomatic controls. Dynamic balance in all other directions except for the anterior direction was not negatively affected in individuals with chronic idiopathic neck pain.
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Affiliation(s)
- Yasemin Özel Aslıyüce
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Aynur Demirel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Özlem Ülger
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
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Impairment of Proprioception in Young Adult Nonradicular Patients with Lumbar Derangement Syndrome. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5550257. [PMID: 34660792 PMCID: PMC8516538 DOI: 10.1155/2021/5550257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 08/17/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022]
Abstract
Maintaining body balance is a complex function based on the information deriving from the vestibular, visual, and proprioceptive systems. The aim of the study was to evaluate quiet single stance stability in young adults with lumbar derangement syndrome (LDS) and in the control group of the healthy subjects. The second aim of this study was to determine whether pain intensity, degree of disability, and the level of physical activity can influence postural control in patients with LDS. It is important to underline that selecting a homogeneous group of LBP patients using, for example, mechanical diagnosis and therapy method and Quebec Task Force Classification, can result in an increased sensitivity of the study. The study included 126 subjects: 70 patients with LDS (37 women, 33 men) and the control group 56 healthy volunteers (36 women, 20 men). In case of multiple group comparisons for variables with normal distribution, ANOVA post hoc test was used or, as the nonparametric equivalent, Kruskal-Wallis test. In all these calculations, the statistical significance level was set to p < 0.05. The stability index eyes open for the study group was 88.34 and for the control group 89.86. There was no significant difference in the level of postural control between the study and control groups (p > 0.05). The level of stability index eyes closed (SI EC) for the study group was 71.44 and for the control group 77.1. SI EC results showed significant differences in proprioceptive control during single leg stance between the study and control groups (p < 0.05). The level of pain intensity, the degree of disability, and physical activity level did not influence postural control in the study group with LDS. In summary, patients with LDS showed significantly worse proprioceptive control.
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Abdin MMN, Abdelazeim F, Elshennawy S. Immediate effect of induced fatigue of the unaffected limb on standing balance, proprioception and vestibular symptoms in children with hemiplegia. J Pediatr Rehabil Med 2020; 13:119-125. [PMID: 32444572 DOI: 10.3233/prm-180587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To study the effect of induced fatigue of the unaffected limb on the sensory components of standing balance; proprioception and vestibular symptoms in children with hemiplegic cerebral palsy. METHODS Setting: Outpatient Clinic of Faculty of Physical Therapy, Cairo University. PATIENTS Twenty-nine children with hemiplegic cerebral palsy [(ages 8.9 ± 2.3 years), motor ability I/II according to the GMFCS and spasticity of I/I+ according to the Modified Ashworth Scale]. OUTCOME MEASURES Before and after the induced fatigue of the unaffected limb, the following measures were recorded: postural balance, using the Biodex Balance System and the Timed Up and Go test; vestibular sense, using the Paediatric Vestibular Symptom Questionnaire; and proprioception measures of both knees, using the Biodex isokinetic dynamometer. RESULTS There was a significant increase in the post-fatigue values for the overall stability index (p< 0.05), the Timed Up and Go test (p< 0.05), reposition errors of proprioception of the unaffected limb (p< 0.05) and the vestibular questionnaire (p< 0.05); there was a non-significant decrease in the post-fatigue values for reposition errors of proprioception of the affected limb (p= 0.859). CONCLUSION Fatigue of the unaffected limb negatively affects postural balance and related sensory systems (proprioception of the fatigued limb and vestibular function) but does not have an impact on proprioception of the unfatigued limb.
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Affiliation(s)
| | - Faten Abdelazeim
- Paediatrics Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Shorouk Elshennawy
- Paediatrics Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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Mugnosso M, Zenzeri J, Hughes CML, Marini F. Coupling Robot-Aided Assessment and Surface Electromyography (sEMG) to Evaluate the Effect of Muscle Fatigue on Wrist Position Sense in the Flexion-Extension Plane. Front Hum Neurosci 2019; 13:396. [PMID: 31736733 PMCID: PMC6838006 DOI: 10.3389/fnhum.2019.00396] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/22/2019] [Indexed: 11/13/2022] Open
Abstract
Proprioception is a crucial sensory modality involved in the control and regulation of coordinated movements and in motor learning. However, the extent to which proprioceptive acuity is influenced by local muscle fatigue is obscured by methodological differences in proprioceptive and fatiguing protocols. In this study, we used high resolution kinematic measurements provided by a robotic device, as well as both frequency and time domain analysis of signals captured via surface electromyography (sEMG) to examine the effects of local muscle fatigue on wrist proprioceptive acuity in 16 physically and neurologically healthy young adults. To this end, participants performed a flexion/extension ipsilateral joint position matching test (JPM), after which a high-resistive robotic task was used to induce muscle fatigue of the flexor carpi radialis (FCR) muscle. The JPM test was then repeated in order to analyze potential changes in proprioceptive acuity. Results indicated that the fatigue protocol had a significant effect on movements performed in flexion direction, with participants exhibiting a tendency to undershoot the target before the fatigue protocol (−1.218°), but overshooting after the fatigue protocol (0.587°). In contrast, in the extension direction error bias values were similar before and after the fatigue protocol as expected (pre = −1.852°, post = −1.237°) and reflected a tendency to undershoot the target. Moreover, statistical analysis indicated that movement variability was not influenced by the fatigue protocol or movement direction. In sum, results of the present study demonstrate that an individual’s estimation of wrist joint displacement (i.e., error bias), but not precision (i.e., variability), is affected by muscular fatigue in a sample of neurologically and physically healthy adults.
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Affiliation(s)
- Maddalena Mugnosso
- Motor Learning, Assistive and Rehabilitation Robotics Laboratory, Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia, Genoa, Italy.,Department of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, Genoa, Italy
| | - Jacopo Zenzeri
- Motor Learning, Assistive and Rehabilitation Robotics Laboratory, Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Charmayne M L Hughes
- NeuroTech Laboratory, Health Equity Institute, San Francisco State University, San Francisco, CA, United States
| | - Francesca Marini
- Motor Learning, Assistive and Rehabilitation Robotics Laboratory, Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia, Genoa, Italy
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Reddy RS, Tedla JS, Dixit S, Abohashrh M. Cervical proprioception and its relationship with neck pain intensity in subjects with cervical spondylosis. BMC Musculoskelet Disord 2019; 20:447. [PMID: 31615495 PMCID: PMC6794723 DOI: 10.1186/s12891-019-2846-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/20/2019] [Indexed: 02/06/2023] Open
Abstract
Background Cervical proprioception is critical in the maintenance of posture and movements, so its assessment in different cervical conditions has gained importance in recent clinical practice. Studies reporting this assessment in subjects with cervical spondylosis (CS) have not previously been investigated. The goals of the study are (1) comparison of joint position error (JPE) in subjects with CS to healthy control group. (2) Correlation of neck pain intensity to cervical proprioception in patients with CS. Methods In a Cross-sectional study, 132 subjects with CS and 132 healthy age-matched control subjects were evaluated for cervical JPE with the cervical range of motion device. The subjects were blindfolded and repositioned their heads to a target position, which was determined by the examiner previously and their repositioning accuracy (absolute error in degrees) was measured in the frontal (flexion and extension) and transverse planes (left rotation and right rotation). The CS subjects resting neck pain intensity was assessed using visual analog scale (VAS). Results CS subjects showed statistically significantly larger JPEs compared to healthy control subjects in all the directions tested (flexion - 95% CI = 2.38–3.55, p < 0.001, extension - 95% CI =3.26–4.33, p < 0.001, left rotation - 95% CI = 2.64 - 3.83, p < 0.001, right rotation − 95% CI = 3.77–4.76, p < 0.001). The mean JPE errors in the CS group ranged from 6.27° to 8.28° and in the control group ranged from 2.36° to 4.48°. Pearson’s correlation coefficient showed a significant and positive relationship between neck pain intensity and cervical proprioception (p ≤ 0.001). Conclusions Proprioception is impaired in subjects with CS when compared to healthy control group. Higher pain intensity was associated with greater cervical JPE in patients with CS.
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Affiliation(s)
- Ravi Shankar Reddy
- Department of Medical Rehabilitation (Physical Therapy), College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia.
| | - Jaya Shanker Tedla
- Department of Medical Rehabilitation (Physical Therapy), College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Snehil Dixit
- Department of Medical Rehabilitation (Physical Therapy), College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Mohammed Abohashrh
- Department of Basic Medical Sciences, College of applied medical sciences, King Khalid University, Abha, Saudi Arabia
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Exercise, fatigue and proprioception: a retrospective. Exp Brain Res 2019; 237:2447-2459. [DOI: 10.1007/s00221-019-05634-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 08/17/2019] [Indexed: 10/26/2022]
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Abutaleb EE, Mohamed AH. Effect of induced fatigue on dynamic postural balance in healthy young adults. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2015. [DOI: 10.4103/1110-6611.174699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Vieira MF, de Avelar IS, Silva MS, Soares V, Lobo da Costa PH. Effects of four days hiking on postural control. PLoS One 2015; 10:e0123214. [PMID: 25902060 PMCID: PMC4406731 DOI: 10.1371/journal.pone.0123214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 02/28/2015] [Indexed: 11/19/2022] Open
Abstract
Hiking is a demanding form of exercise that may cause delayed responses of the postural muscles and a loss of somatosensory information, particularly when repeatedly performed for several days. These effects may negatively influence the postural control of hikers. Therefore, the aim of this study was to investigate the effects of a four-day hike on postural control. Twenty-six adults of both sexes travelled 262 kilometers, stopping for lunch and resting in the early evening each day. Force platforms were used to collect center of pressure (COP) data at 100 Hz for 70 seconds before hiking started and immediately after arriving at the rest station each day. The COP time course data were analyzed according to global stabilometric descriptors, spectral analysis and structural descriptors using sway density curve (SDC) and stabilometric diffusion analysis (SDA). Significant increases were found for global variables in both the anterior-posterior and medial-lateral directions (COP sway area, COP total sway path, COP mean velocity, COP root mean square value and COP range). In the spectral analysis, only the 80% power frequency (F80) in the anterior-posterior direction showed a significant increase, reflecting the increase of the sway frequencies. The SDC revealed a significant increase in the mean distance between peaks (MD) and a significant decrease in the mean peak amplitudes (MP), suggesting that a larger torque amplitude is required for stabilization and that the postural stability is reduced. The SDA revealed a decrease in the long-term slope (Hl) and increases in the short-term (Ks) and the long-term (Kl) intercepts. We considered the likelihood that the presence of local and general fatigue, pain and related neuromuscular adaptations and somatosensory deficits may have contributed to these postural responses. Together, these results demonstrated that four days of hiking increased sway frequencies and deteriorated postural control in the standing position.
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Affiliation(s)
- Marcus Fraga Vieira
- Bioengineering and Biomechanics Laboratory, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
- * E-mail:
| | - Ivan Silveira de Avelar
- Bioengineering and Biomechanics Laboratory, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Maria Sebastiana Silva
- Bioengineering and Biomechanics Laboratory, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Viviane Soares
- Bioengineering and Biomechanics Laboratory, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
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Abstract
STUDY DESIGN A cross-sectional, observational study. OBJECTIVE To determine whether pain and fear of pain have competing effects on postural sway in patients with low back pain (LBP). SUMMARY OF BACKGROUND DATA Competing effects of pain and pain-related fear on postural control can be proposed as the likely explanation for inconsistent results regarding postural sway in the LBP literature. We hypothesized that although pain might increase postural sway, fear of pain might reduce sway through an increased cognitive effort or increased cocontraction to restrict body movement. The cognitive strategy would be less effective under dual-task conditions and the cocontraction strategy was expected to be less effective when standing on a narrow base of support surface. METHODS Postural sway was measured in combined conditions of base of support (full and narrow) and cognitive loading (single and dual tasks) in 3 experimental groups with current LBP, recent LBP, and no LBP. Sway amplitude, path length, mean power frequency, and sample entropy were extracted from center-of-pressure data. RESULTS The current-LBP group and recent-LBP group reported significantly different levels of pain, but similar levels of pain catastrophizing and kinesiophobia. The current-LBP group tended to display larger sway amplitudes in the anteroposterior direction compared with the other 2 groups. Mean power frequency values in mediolateral direction were lower in patients with the current LBP compared with recent LBP. Smaller sample entropy was found in the current-LBP group than the other groups in most experimental conditions, particularly when standing on a narrow base of support. CONCLUSION Alterations of postural sway are mostly mediated by pain but not pain-related fear. LBP tends to increase sway amplitude, which seems to be counteracted by increased effort invested in postural control leading to decreased frequency and increased regularity of sway particularly under increased task demands. LEVEL OF EVIDENCE Cross-sectional study.
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Degache F, Van Zaen J, Oehen L, Guex K, Trabucchi P, Millet G. Alterations in postural control during the world's most challenging mountain ultra-marathon. PLoS One 2014; 9:e84554. [PMID: 24465417 PMCID: PMC3897373 DOI: 10.1371/journal.pone.0084554] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 11/15/2013] [Indexed: 11/18/2022] Open
Abstract
We investigated postural control (PC) effects of a mountain ultra-marathon (MUM): a 330-km trail run with 24000 m of positive and negative change in elevation. PC was assessed prior to (PRE), during (MID) and after (POST) the MUM in experienced ultra-marathon runners (n = 18; finish time = 126 ± 16 h) and in a control group (n = 8) with a similar level of sleep deprivation. Subjects were instructed to stand upright on a posturographic platform over a period of 51.2 seconds using a double-leg stance under two test conditions: eyes open (EO) and eyes closed (EC). Traditional measures of postural stability (center of pressure trajectory analysis) and stabilogram-diffusion analysis (SDA) parameters were analysed. For the SDA, a significantly greater short-term effective diffusion was found at POST compared with PRE in the medio-lateral (ML; Dxs) and antero-posterior (AP) directions (Dys) in runners (p<0.05) The critical time interval (Ctx) in the ML direction was significantly higher at MID (p<0.001) and POST (p<0.05) than at PRE in runners. At MID (p<0.001) and POST (p<0.05), there was a significant difference between the two groups. The critical displacement (Cdx) in the ML was significantly higher at MID and at POST (p<0.001) compared with PRE for runners. A significant difference in Cdx was observed between groups in EO at MID (p<0.05) and POST (p<0.005) in the ML direction and in EC at POST in the ML and AP directions (p<0.05). Our findings revealed significant effects of fatigue on PC in runners, including, a significant increase in Ctx (critical time in ML plan) in EO and EC conditions. Thus, runners take longer to stabilise their body at POST than at MID. It is likely that the mountainous characteristics of MUM (unstable ground, primarily uphill/downhill running, and altitude) increase this fatigue, leading to difficulty in maintaining balance.
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Affiliation(s)
- Francis Degache
- School of Health Sciences, Health Research Unit, University of Applied Sciences Western Switzerland, Lausanne, Switzerland
| | - Jérôme Van Zaen
- Applied Signal Processing Group, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Lukas Oehen
- Institute of Sports Sciences, Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Kenny Guex
- School of Health Sciences, Department of Physiotherapy, University of Applied Sciences Western Switzerland, Lausanne, Switzerland
| | | | - Gégoire Millet
- Institute of Sports Sciences, Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Liang Z, Clark R, Bryant A, Quek J, Pua YH. Neck musculature fatigue affects specific frequency bands of postural dynamics during quiet standing. Gait Posture 2013; 39:397-403. [PMID: 24021526 DOI: 10.1016/j.gaitpost.2013.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 07/05/2013] [Accepted: 08/10/2013] [Indexed: 02/02/2023]
Abstract
Proprioceptive input from the neck is important for maintenance of upright standing. Although neck musculature fatigue has been demonstrated to impair standing balance, there is limited understanding of the underlying postural mechanisms. This study aimed to further examine the effects of neck musculature fatigue on standing by using modern analysis of center of pressure (CoP) data. Forty-eight young healthy adults stood quietly on a balance board for 1 min before and after performing repeated weight-resisted scapular elevation exercises. In a supplementary study on 20 participants, we examined (i) the effects of visual deprivation and (ii) the test-retest reliability of the traditional and wavelet-based CoP measures. Test-retest reliability of the CoP measures was moderate to good (intraclass correlation coefficients ranged from 0.58 to 0.94). With neck muscle fatigue or without vision, traditional measures of CoP velocity and standard deviation increased monotonically. Wavelet analysis revealed that CoP velocity within the ultralow (<0.10 Hz) and moderate (1.56-6.25 Hz) frequency bands increased post-fatigue. Without vision, CoP velocity increased in all but the ultralow frequency band. Our data suggest that post-fatigue, vision may be the main compensatory postural mechanism for altered neck proprioception. In conclusion, our findings reveal more nuances than the simple assertion that neck musculature fatigue increased postural sway and they advocate the use of wavelet analysis in examining postural mechanisms associated with neck proprioception.
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Affiliation(s)
- Zhiqi Liang
- Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore.
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Fuller JR, Fung J, Côté JN. Posture-movement responses to stance perturbations and upper limb fatigue during a repetitive pointing task. Hum Mov Sci 2013; 32:618-32. [PMID: 24054899 DOI: 10.1016/j.humov.2013.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 01/18/2013] [Accepted: 03/08/2013] [Indexed: 12/11/2022]
Abstract
Localized muscle fatigue and postural perturbation have separately been shown to alter whole-body movement but little is known about how humans respond when subjected to both factors combined. Here we sought to quantify the kinematics of postural control and repetitive upper limb movement during standing surface perturbations and in the presence of fatigue. Subjects stood on a motion-based platform and repetitively reached between two shoulder-height targets until noticeably fatigued (rating of perceived exertion=8/10). Every minute, subjects experienced a posterior and an anterior platform translation while reaching to the distal target. Outcomes were compared prior to and with fatigue (first vs. final minute data). When fatigued, regardless of the perturbation condition, subjects decreased their shoulder abduction and increased contralateral trunk flexion, a strategy that may relieve the load on the fatiguing upper limb musculature. During perturbations, kinematic adaptations emerged across the trunk and arm to preserve task performance. In contrast to our expectation, the kinematic response to the perturbations did not alter in the presence of fatigue. Kinematic adaptations in response to the perturbation predominantly occurred in the direction of the reach whereas fatigue adaptations occurred orthogonal to the reach. These findings suggest that during repetitive reaching, fatigue and postural perturbation compensations organize so as to minimize interaction with each other and preserve the global task characteristics of endpoint motion.
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Affiliation(s)
- Jason R Fuller
- Department of Kinesiology and Physical Education, McGill University, Montreal, Canada; Feil & Oberfeld/CRIR Research Center, Jewish Rehabilitation Hospital, Laval, Quebec, Canada.
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Vie B, Gomez N, Brerro-Saby C, Weber JP, Jammes Y. Changes in stationary upright standing and proprioceptive reflex control of foot muscles after fatiguing static foot inversion. J Biomech 2013; 46:1676-82. [PMID: 23672950 DOI: 10.1016/j.jbiomech.2013.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 04/04/2013] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
Abstract
We searched for the consequences of a maximal static foot inversion sustained until exhaustion on the post-exercise stationary upright standing and the proprioceptive control of the foot muscles. Twelve healthy subjects executed an unilateral maximal static foot inversion during which continuous power spectrum analyses of surface electromyograms of the tibialis anterior (TA), peroneus longus (PL), and gastrocnemius medialis (GM) muscles were performed. Superimposed pulse trains (twitch interpolation) were delivered to the TA muscle to identify "central" or "peripheral" fatigue. Before and after the fatiguing task, we measured (1) the repartition of the plantar and barycentre surfaces with a computerized stationary platform, (2) the peak contractile TA response to electrical stimulation (TA twitch), (3) the tonic vibratory response (TVR) of TA and GM muscles, and (4) the Hoffman reflex. During static exercise, "central" fatigue was diagnosed in 5/12 subjects whereas in the 7 others "peripheral" TA fatigue was deduced from the absence of response to twitch interpolation and the post-exercise decrease in twitch amplitude. The sustained foot inversion was associated with reduced median frequency in TA but not in PL and GM muscles. After static exercise, in all subjects both the mean plantar and rearfoot surfaces increased, indicating a foot eversion, the TVR amplitude decreased in TA but did not vary in GM, and the Hoffman reflex remained unchanged. Whatever was the mechanism of fatigue during the maximal foot inversion task, the facilitating myotatic reflex was constantly altered in foot invertor muscles. This could explain the prevailing action of the antagonistic evertor muscles.
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Affiliation(s)
- Bruno Vie
- Ecole de Podologie de Marseille, Marseille, France
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Mazaheri M, Coenen P, Parnianpour M, Kiers H, van Dieën JH. Low back pain and postural sway during quiet standing with and without sensory manipulation: a systematic review. Gait Posture 2013; 37:12-22. [PMID: 22796243 DOI: 10.1016/j.gaitpost.2012.06.013] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Revised: 05/08/2012] [Accepted: 06/17/2012] [Indexed: 02/02/2023]
Abstract
A previous review concluded that postural sway is increased in patients with low back pain (LBP). However, more detailed analysis of the literature shows that postural deficit may be dependent on experimental conditions in which patients with LBP have been assessed. The research question to be answered in this review was: "Is there any difference in postural sway between subjects with and without LBP across several sensory manipulation conditions?". A literature search in Pubmed, Scopus, Embase and PsychInfo was performed followed by hand search and contact with authors. Studies investigating postural sway during bipedal stance without applying external forces in patients with specific and non-specific LBP compared to healthy controls were included. Twenty three articles fulfilled the eligibility criteria. Most studies reported an increased postural sway in LBP, or no effect of LBP on postural sway. In a minority of studies, a decreased sway was found in LBP patients. There were no systematic differences between studies finding an effect and those reporting no effect of LBP. The proportion of studies finding between-group differences did not increase with increased complexity of sensory manipulations. Potential factors that may have caused inconsistencies in the literature are discussed in this systematic review.
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Affiliation(s)
- Masood Mazaheri
- Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Reddy RS, Maiya AG, Rao SK. Effect of dorsal neck muscle fatigue on cervicocephalic kinaesthetic sensibility. Hong Kong Physiother J 2012. [DOI: 10.1016/j.hkpj.2012.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Hassanlouei H, Arendt-Nielsen L, Kersting U, Falla D. Effect of exercise-induced fatigue on postural control of the knee. J Electromyogr Kinesiol 2012; 22:342-7. [DOI: 10.1016/j.jelekin.2012.01.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 01/26/2012] [Accepted: 01/28/2012] [Indexed: 10/28/2022] Open
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Tjell C, Halling WI, Tenenbaum A. Why Do Not All Recover After a Whiplash Injury? ACTA ACUST UNITED AC 2011. [DOI: 10.3109/j180v05n02_02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gimmon Y, Riemer R, Oddsson L, Melzer I. The effect of plantar flexor muscle fatigue on postural control. J Electromyogr Kinesiol 2011; 21:922-8. [PMID: 21917475 DOI: 10.1016/j.jelekin.2011.08.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 07/21/2011] [Accepted: 08/09/2011] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE Previous studies have demonstrated that ankle muscle fatigue alters postural sway. Our aim was to better understand postural control mechanisms during upright stance following plantar flexor fatigue. METHOD Ten healthy young volunteers, 25.7±2.2 years old, were recruited. Foot center-of-pressure (CoP) displacement data were collected during narrow base upright stance and eyes closed (i.e. blindfolded) conditions. Subjects were instructed to stand upright and as still as possible on a force platform under five test conditions: (1) non-fatigue standing on firm surface; (2) non-fatigue standing on foam; (3) ankle plantar flexor fatigue, standing on firm surface; (4) ankle plantar flexor fatigue, standing on foam; and (5) upper limb fatigue, standing on firm surface. An average of the ten 30-s trials in each of five test conditions was calculated to assess the mean differences between the trials. Traditional measures of postural stability and stabilogram-diffusion analysis (SDA) parameters were analyzed. RESULTS Traditional center of pressure parameters were affected by plantar flexor fatigue, especially in the AP direction. For the SDA parameters, plantar flexor fatigue caused significantly higher short-term diffusion coefficients, and critical displacement in both mediolateral (ML) and anteroposterior (AP) directions. Long-term postural sway was different only in the AP direction. CONCLUSIONS Localized plantar flexor fatigue caused impairment to postural control mainly in the Sagittal plane. The findings indicate that postural corrections, on average, occurred at a higher threshold of sway during plantar flexor fatigue compared to non-fatigue conditions.
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Affiliation(s)
- Yoav Gimmon
- Schwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Global effect on multi-segment physiological tremors due to localized fatiguing contraction. Eur J Appl Physiol 2011; 112:899-910. [DOI: 10.1007/s00421-011-2044-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 06/07/2011] [Indexed: 10/18/2022]
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Mezaour M, Yiou E, Le Bozec S. Effect of lower limb muscle fatigue on anticipatory postural adjustments associated with bilateral-forward reach in the unipedal dominant and non-dominant stance. Eur J Appl Physiol 2010; 110:1187-97. [DOI: 10.1007/s00421-010-1595-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2010] [Indexed: 12/31/2022]
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Trigeminal electrophysiology: a 2 x 2 matrix model for differential diagnosis between temporomandibular disorders and orofacial pain. BMC Musculoskelet Disord 2010; 11:141. [PMID: 20594304 PMCID: PMC2909162 DOI: 10.1186/1471-2474-11-141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Accepted: 07/01/2010] [Indexed: 12/03/2022] Open
Abstract
Background Pain due to temporomandibular disorders (TMDs) often has the same clinical symptoms and signs as other types of orofacial pain (OP). The possible presence of serious neurological and/or systemic organic pathologies makes differential diagnosis difficult, especially in early disease stages. In the present study, we performed a qualitative and quantitative electrophysiological evaluation of the neuromuscular responses of the trigeminal nervous system. Using the jaw jerk reflex (JJ) and the motor evoked potentials of the trigeminal roots (bR-MEPs) tests, we investigated the functional and organic responses of healthy subjects (control group) and patients with TMD symptoms (TMD group). Method Thirty-three patients with temporomandibular disorder (TMD) symptoms and 36 control subjects underwent two electromyographic (EMG) tests: the jaw jerk reflex test and the motor evoked potentials of the trigeminal roots test using bilateral electrical transcranial stimulation. The mean, standard deviation, median, minimum, and maximum values were computed for the EMG absolute values. The ratio between the EMG values obtained on each side was always computed with the reference side as the numerator. For the TMD group, this side was identified as the painful side (pain side), while for the control group this was taken as the non-preferred masticatory side (non-preferred side). The 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles were also calculated. Results Analysis of the ratios (expressed as percentages) between the values obtained on both sides revealed a high degree of symmetry in the bR-MEPs % in the control (0.93 ± 0.12%) and TMD (0.91 ± 0.22%) groups. This symmetry indicated organic integrity of the trigeminal root motor fibers and correct electrode arrangement. A degree of asymmetry of the jaw jerk's amplitude between sides (ipJJ%), when the mandible was kept in the intercuspal position, was found in the TMD group (0.24% ± 0.14%) with a statistically significant difference in relation to the control group (0.61% ± 0.2%). This asymmetry seemed to be primarily due to a failure to facilitate the reflex on the painful side in intercuspal position. Conclusions In this 2 × 2 matrix diagnostic model, three different types of headache may be identified: 1) those due to organic pathologies directly and indirectly involving the trigeminal nervous system denoted as "Organic Damage"; 2) those in TMD patients; 3) other types of orofacial pain in subjects who could erroneously be considered healthy, denoted as Orofacial Pain "OP". This category of patient should be considered at risk, as organic neurological pathologies could be present and yet not directly affect the trigeminal system, at least in the early stages of the disease.
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The effect of inspiratory muscles fatigue on postural control in people with and without recurrent low back pain. Spine (Phila Pa 1976) 2010; 35:1088-94. [PMID: 20393397 DOI: 10.1097/brs.0b013e3181bee5c3] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A 2-group experimental design. OBJECTIVE To determine postural stability and proprioceptive postural control strategies of healthy subjects and subjects with recurrent low back pain (LBP) during acute inspiratory muscles fatigue (IMF). SUMMARY OF BACKGROUND DATA People with LBP use a more rigid proprioceptive postural control strategy than control subjects during postural perturbations. Recent evidence suggests that respiratory movements create postural instability in people with LBP. The role of the respiratory muscles in postural control strategies is unknown, but can be studied by inducing acute IMF. METHODS Postural control was evaluated in 16 people with LBP and 12 healthy controls, both before and after IMF. Center of pressure displacement was determined on a force plate to evaluate postural stability. Proprioceptive postural control strategies were examined during vibration of the triceps surae muscles or lumbar paraspinal muscles, while standing on both a stable and unstable support surface and without vision. Proprioceptive postural control strategies were determined by examining the ratio of mean center of pressure displacement measured during triceps surae muscles vibration to that measured during lumbar paraspinal muscles vibration. RESULTS.: After IMF, control subjects showed a significantly larger sway compared to the unfatigued condition while standing on an unstable support surface (P < 0.05). IMF induced an increased reliance on proprioceptive signals from the ankles, which resembled the postural control strategy used by people with LBP (P < 0.05). Subjects with LBP showed that same ankle steered postural control strategy in the unfatigued and IMF states (P > 0.05). CONCLUSION After IMF, control subjects use a rigid proprioceptive postural control strategy, rather than the normal "multisegmental" control, which is similar to people with LBP. This results in decreased postural stability. These results suggest that IMF might be a factor in the high recurrence rate of LBP.
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Mohammadi F, Roozdar A. Effects of fatigue due to contraction of evertor muscles on the ankle joint position sense in male soccer players. Am J Sports Med 2010; 38:824-8. [PMID: 20139329 DOI: 10.1177/0363546509354056] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The high incidence of ankle sprains that occur later in matches suggests that fatigue may contribute to altered neuromuscular control of the ankle. Moreover, deficits in ankle joint position sense (JPS) were seen in patients with a history of recurrent ankle sprains. It has been hypothesized that ankle sprains may be related to altered ankle JPS as a consequence of fatigue. PURPOSE To evaluate if fatiguing contractions of evertor muscles alter the ankle JPS. STUDY DESIGN Controlled laboratory study. METHODS Thirty-six soccer players (age, 24.7 +/- 1.3 years; height, 183.7 +/- 8.2 cm; weight, 78.9 +/- 7.9 kg) were recruited. Subjects were asked to recognize 2 positions (15 degrees of inversion and maximal active inversion minus 5 degrees ) for 2 conditions: normal and fatigue. Muscular fatigue was induced in evertor muscles of the dominant leg by using isometric contractions. The average of the absolute and variable errors of 3 trials were recorded for both fatigue and nonfatigue conditions. A matched control group of 36 soccer players (age, 23.9 +/- 0.9 years; height, 181.2 +/- 6.9 cm; weight, 77.8 +/- 6.5 kg) was asked to recognize the same positions, before a soccer match and after 45 minutes of playing, and their same scores were recorded. Finally, results of the 2 groups were compared. RESULTS There was significant decrease in subjects' ability to recognize passive and active repositioning of their ankle after a fatigue protocol (P <.001). Passive and active JPS were reduced after playing (P <.001). There was no significant difference between 2 groups in the results of JPS before and after the intervention (P > .1). CONCLUSION The acuity of the ankle JPS is reduced subsequent to a fatigue protocol and after a soccer match. CLINICAL RELEVANCE Evaluation of athletes' ankle JPS before returning to physical activity may prevent further injuries.
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Affiliation(s)
- Farshid Mohammadi
- Physiotherapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Abstract
STUDY DESIGN Intervention study on healthy human subjects. OBJECTIVE To determine whether reflex activation of the back muscles is influenced by muscle fatigue or soft tissue creep in the spine. SUMMARY OF BACKGROUND DATA Reflex contraction of the back muscles normally acts to limit spinal flexion, and hence protect the underlying spine from injury. However, repeated flexion allows bending moments on the spine to increase. Impaired reflexes as a result of fatigue or soft tissue creep may be contributing factors. METHODS A total of 15 healthy volunteers (8 females/7 males aged 23-55 years) underwent 2 interventions, on separate days: (a) sitting flexed for 1 hour to induce creep and (b) performing the Biering-Sorensen test to induce back muscle fatigue. Before and after each intervention, reflex activation of the erector spinae in response to sudden trunk flexion (initiated by a Kin-Com dynamometer) was monitored bilaterally at T10 and L3 using surface electromyography (EMG) electrodes. These recordings indicated the onset latency of reflex activation, the peak EMG, and time to peak, at each site. Measurements before and after each intervention and between muscle sites were compared using a 2-way repeated measures Analysis of Variance. RESULTS Spinal creep was confirmed by an increase in maximum flexion of 2.3 degrees +/- 2.5 degrees (P = 0.003), and fatigue by a significant fall in median frequency at one or more sites. Following creep, onset latency increased from 60 +/- 12 milliseconds to 96 +/- 26 milliseconds (P < 0.001) but there was no change in peak EMG or time to peak EMG. Differences between sites (P = 0.004) indicated greater latencies in lumbar compared to thoracic regions, especially after creep. Muscle fatigue had no significant effects on any of the measured parameters. CONCLUSION Prolonged spinal flexion can impair sensorimotor control mechanisms and reduce back muscle protection of the underlying spine. The effect is due to time-dependent "creep" in soft tissues rather than muscle fatigue.
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Abstract
STUDY DESIGN Before and after intervention trials. OBJECTIVE To investigate the effect of cervical muscular fatigue on joint position sense. SUMMARY OF BACKGROUND DATA Although fatigue-related degradation of proprioceptive acuity at lower and upper limbs is well documented, to date no study has investigated whether muscular fatigue induced at the neck could modify joint position sense. METHODS A total of 9 young healthy adults were asked to perform the cervicocephalic relocation test to the neutral head position, that is, to relocate the head on the trunk, as accurately as possible, after full active cervical rotation to the left and right sides. This experimental task was executed in 2 conditions of No fatigue and Fatigue of the scapula elevator muscles. Absolute and variable errors were used to assess the cervical joint repositioning accuracy and consistency, respectively. RESULTS Less accurate and less consistent repositioning performances were observed in Fatigue relative to No fatigue condition, as indicated by increased absolute and variable errors, respectively. CONCLUSION Results of the present experiment evidence that cervical joint position sense, assessed through the cervicocephalic relocation test to the neutral head position, is degraded by muscular fatigue.
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Brerro-Saby C, Delliaux S, Steinberg JG, Jammes Y. The changes in neuromuscular excitability with normobaric hyperoxia in humans. Exp Physiol 2009; 95:153-9. [DOI: 10.1113/expphysiol.2009.049460] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Partanen JV, Ojala TA, Arokoski JPA. Myofascial syndrome and pain: A neurophysiological approach. ACTA ACUST UNITED AC 2009; 17:19-28. [PMID: 19500953 DOI: 10.1016/j.pathophys.2009.05.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2008] [Revised: 03/26/2009] [Accepted: 05/07/2009] [Indexed: 12/15/2022]
Abstract
It has been debated whether muscle spindles have a role in myofascial pain or not. We present a number of arguments for the former hypothesis. It was hypothesized that firing of intrafusal muscle fibres, i.e. fusimotor activity can be observed as "end plate spikes" (EPSs) in electromyography (EMG). The EPSs may be found in local active spots of muscle, often associated with miniature end plate potentials (MEPPs). Insertion of EMG needle electrodes into an active spot is painful, indicating nociception in the muscle spindle. Myofascial syndrome patients have taut bands with active trigger points (TrPs) in painful muscles. End plate activity (EPSs and MEPPs) is a significantly more common finding in TrPs of myofascial pain than in control points of the muscle, indicating the presence of muscle spindles. However, some control sites may show EPSs of normal muscle spindles. Increased amount of inflammatory metabolites have been observed in active TrPs. Muscle spindle is a capsulated gel-filled container, where inflammatory and contraction metabolites may be heavily concentrated during sustained fusimotor activation. Thus the intrafusal chemosensitive pain mediating III- and IV-afferents are sensitized and activated. Intrafusal inflammation causes further reflex activation of the fusimotor and skeletofusimotor systems via sensitized III- and IV-afferents. The taut band itself may be a contracture (rigor) of local skeletofusimotor (beta) units caused by sustained reflex drive by the given muscle spindles. In EMG this may be seen as complex repetitive discharges. We conclude that TrPs of myofascial pain are related to painful muscle spindles in taut bands.
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Affiliation(s)
- Juhani V Partanen
- University and University Hospital of Helsinki, Department of Clinical Neurophysiology, Jorvi Hospital, P.O. Box 800, FIN-00029 HUS, Finland
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Bottas R, Nicol C, Komi PV, Linnamo V. Adaptive changes in motor control of rhythmic movement after maximal eccentric actions. J Electromyogr Kinesiol 2009; 19:347-56. [DOI: 10.1016/j.jelekin.2007.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2007] [Revised: 08/31/2007] [Accepted: 09/04/2007] [Indexed: 11/16/2022] Open
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Brerro-Saby C, Delliaux S, Steinberg JG, Jammes Y. Fatigue-induced changes in tonic vibration response (TVR) in humans: Relationships between electromyographic and biochemical events. Muscle Nerve 2008; 38:1481-1489. [DOI: 10.1002/mus.21117] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Regueme SC, Barthèlemy J, Gauthier GM, Blin O, Nicol C. Delayed influence of stretch-shortening cycle fatigue on large ankle joint position coded with static positional signals. Scand J Med Sci Sports 2008; 18:373-82. [DOI: 10.1111/j.1600-0838.2007.00693.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Zampagni ML, Corazza I, Molgora AP, Marcacci M. Can ankle imbalance be a risk factor for tensor fascia lata muscle weakness? J Electromyogr Kinesiol 2008; 19:651-9. [PMID: 18455436 DOI: 10.1016/j.jelekin.2008.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Revised: 03/11/2008] [Accepted: 03/11/2008] [Indexed: 10/22/2022] Open
Abstract
Risk factors that can determine knee and ankle injuries have been investigated and causes are probably multifactorial. A possible explanation could be related by the temporary inhibition of muscular control following an alteration of proprioceptive regulation due to the ankle imbalance pathology. The purpose of our study was to validate a new experimental set up to quantify two kinesiologic procedures (Shock Absorber Test (SAT) and Kendall and Kendall's Procedure (KKP)) to verify if a subtalus stimulus in an ankle with imbalance can induce a non-appropriate response of controlateral tensor fascia lata muscle (TFL). Fifteen male soccer players with ankle imbalance (AIG) and 14 healthy (CG) were tested after (TEST) before (NO-TEST) a manual percussion in subtalus joint (SAT). A new tailor-made device equipped with a load cell was used to quantify TFL's strength activation in standardized positions. Two trials for each subject were performed, separated by at least one 4-min resting interval. In NO-TEST conditions both AIG and CG showed a progressive adaptation of the subject to the force imposed by operator. No reduction in mean force, mean peak force, and muscle force duration (p>0.5). AIG presented significant differences (mean difference 0.92+/-0.46 s; p=0.000) in muscle force duration in TEST conditions. Our results indicated that "wrong" proprioceptive stimuli coming from the subtalus joint in AIG might induce inhibition in terms of duration of TFL muscle altering the knee stability. This kinesiological evaluation might be useful to prevent ankle and knee injuries.
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Affiliation(s)
- Maria L Zampagni
- Biomechanics Laboratory-Rizzoli Orthopaedics Institute, Bologna, Italy; Center of Bioengineering and Motor Sciences, Trento University, Italy
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Regueme S, Barthèlemy J, Gauthier G, Nicol C. Changes in illusory ankle movements induced by tendon vibrations during the delayed recovery phase of stretch-shortening cycle fatigue: An indirect study of muscle spindle sensitivity modifications. Brain Res 2007; 1185:129-35. [DOI: 10.1016/j.brainres.2007.09.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2007] [Revised: 09/11/2007] [Accepted: 09/12/2007] [Indexed: 10/22/2022]
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Juul-Kristensen B, Lund H, Hansen K, Christensen H, Danneskiold-Samsøe B, Bliddal H. Poorer elbow proprioception in patients with lateral epicondylitis than in healthy controls: a cross-sectional study. J Shoulder Elbow Surg 2007; 17:72S-81S. [PMID: 18036844 DOI: 10.1016/j.jse.2007.07.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Accepted: 07/06/2007] [Indexed: 02/01/2023]
Abstract
Two groups of women, 15 patients with lateral epicondylitis and 21 healthy controls, were studied to compare proprioception in the elbows and knees between the groups. Outcome measures were absolute error and variable error for joint position sense and for threshold to detection of a passive movement. Both absolute error and variable error of threshold to detection of a passive movement were greater in the lateral epicondylitis-diagnosed elbows than in the controls' elbows (lateral epicondylitis, 1.8 degrees vs controls 1.1 degrees, P = .026; lateral epicondylitis, 0.8 degrees vs controls 0.3 degrees, P = .015), and there was a tendency toward a greater absolute error of joint position sense compared with the control elbows (lateral epicondylitis, 8.2 degrees vs controls, 5.6 degrees; P = .078). Absolute error of joint position sense was greater in the elbows than in the knees of the lateral epicondylitis patients, but no group differences were found for knees. Proprioception seems, therefore, to be poorer in elbows with lateral epicondylitis elbows than in the controls' elbows. This needs to be taken into consideration in the management of lateral epicondylitis.
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Affiliation(s)
- Birgit Juul-Kristensen
- Department of Orthopaedic Medicine and Rehabilitation, University Hospital of Copenhagen, Copenhagen, Denmark.
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Hospod V, Aimonetti JM, Roll JP, Ribot-Ciscar E. Changes in human muscle spindle sensitivity during a proprioceptive attention task. J Neurosci 2007; 27:5172-8. [PMID: 17494703 PMCID: PMC6672388 DOI: 10.1523/jneurosci.0572-07.2007] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The aim of the present study was to test whether fusimotor control of human muscle spindle sensitivity changed when attention was selectively directed to the recognition of an imposed two-dimensional movement in the form of a written symbol. The unitary activities of 32 muscle spindle afferents (26 Ia, 6 II) were recorded by microneurography at the level of the common peroneal nerve. The patterns of firing rate in response to passive movements of the ankle, forming different letters or numbers, were compared in two conditions: control and recognition. No visual cues were given in either condition, but subjects had to recognize and name the character in one condition compared with not paying attention in the control condition. The results showed that 58% of the tested Ia afferents presented modified responses to movements when these had to be recognized. Changes in Ia afferent responses included decreased depth of modulation, increased variability of discharge, and changes in spontaneous activity. Not all changes were evident in the same afferent. Furthermore, the percentage of correctly recognized movements amounted to 63% when changes were observed, but it was only 48% when the primary ending sensitivity was unaltered. The responses of group II afferents were only weakly changed or unchanged. It is suggested that the altered muscle spindle sensitivity is because of selective changes in fusimotor control, the consequence of which might be to feed the brain movement trajectory information that is more accurate.
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Affiliation(s)
- Valérie Hospod
- Neurobiologie Intégrative et Adaptative, Aix-Marseille Université, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 6149, 13331 Marseille Cedex 03, France
| | - Jean-Marc Aimonetti
- Neurobiologie Intégrative et Adaptative, Aix-Marseille Université, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 6149, 13331 Marseille Cedex 03, France
| | - Jean-Pierre Roll
- Neurobiologie Intégrative et Adaptative, Aix-Marseille Université, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 6149, 13331 Marseille Cedex 03, France
| | - Edith Ribot-Ciscar
- Neurobiologie Intégrative et Adaptative, Aix-Marseille Université, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 6149, 13331 Marseille Cedex 03, France
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Bayramoglu M, Toprak R, Sozay S. Effects of Osteoarthritis and Fatigue on Proprioception of the Knee Joint. Arch Phys Med Rehabil 2007; 88:346-50. [PMID: 17321828 DOI: 10.1016/j.apmr.2006.12.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the impact of knee osteoarthritis (OA) and periarticular muscular fatigue on knee joint kinesthesia. DESIGN Cross-sectional study. SETTING A physical medicine and rehabilitation outpatient clinic. PARTICIPANTS Fifty patients with bilateral OA of the knee, and a control group of 30 age-matched healthy volunteers. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The Kellgren-Lawrence grading system was used to determine the radiographic severity of knee OA. The Lequesne index of severity for knee osteoarthritis was used for assessment of pain, kinesthesia was measured by determining angle reposition error at the knee joint using isokinetic dynamometry, and muscle strength was measured by isokinetic dynamometry. RESULTS Reposition errors did not differ between the patient and the control groups, nor did they differ between pre- and postexercise. CONCLUSIONS Mild-to-moderate OA of the knees does not affect reposition error. Fatigue produced by mild-to-moderate exercise also has no effect on reposition error.
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Affiliation(s)
- Meral Bayramoglu
- Department of Physical Medicine and Rehabilitation, Baskent University Faculty of Medicine, Ankara, Turkey.
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Sjölander P, Michaelson P, Jaric S, Djupsjöbacka M. Sensorimotor disturbances in chronic neck pain--range of motion, peak velocity, smoothness of movement, and repositioning acuity. ACTA ACUST UNITED AC 2007; 13:122-31. [PMID: 17197230 DOI: 10.1016/j.math.2006.10.002] [Citation(s) in RCA: 181] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2004] [Revised: 06/22/2006] [Accepted: 10/20/2006] [Indexed: 01/11/2023]
Abstract
The purpose of this pilot study was to evaluate sensorimotor functions in patients with chronic neck pain with objective and quantitative methods. A group of 16 patients with chronic idiopathic neck pain of insidious onset or whiplash associated disorders (WAD) was compared to an equally sized group of healthy subjects. Kinematics were investigated during voluntary head rotations by measuring range of motion, variability of range of motion (ROM-Variability), peak velocity, and smoothness of movement (jerk index). Repositioning acuity after cervical rotations was evaluated by analysing constant and variable error (VE). In comparison to the healthy subjects, the patients showed significantly larger jerk index, ROM-Variability and VE. No statistically significant differences were found between insidious neck pain and WAD. It is concluded that jerky and irregular cervical movements and poor position sense acuity are characteristic sensorimotor symptoms in chronic neck pain. The observed individuality in sensorimotor disturbances emphasizes the importance of developing specific rehabilitation programs for specific dysfunctions, and of using objective and quantitative methods for evaluation of rehabilitation.
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Affiliation(s)
- Per Sjölander
- Southern Lapland Research Department, Postgatan 7, SE-912 32 Vilhelmina, Sweden.
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Haavik Taylor H, Murphy BA. Altered cortical integration of dual somatosensory input following the cessation of a 20 min period of repetitive muscle activity. Exp Brain Res 2006; 178:488-98. [PMID: 17136532 DOI: 10.1007/s00221-006-0755-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2006] [Accepted: 10/08/2006] [Indexed: 11/30/2022]
Abstract
The adult human central nervous system (CNS) retains its ability to reorganize itself in response to altered afferent input. Intracortical inhibition is thought to play an important role in central motor reorganization. However, the mechanisms responsible for altered cortical sensory maps remain more elusive. The aim of the current study was to investigate changes in the intrinsic inhibitory interactions within the somatosensory system subsequent to a period of repetitive contractions. To achieve this, the dual peripheral nerve stimulation somatosensory evoked potential (SEP) ratio technique was utilized in 14 subjects. SEPs were recorded following median and ulnar nerve stimulation at the wrist (1 ms square wave pulse, 2.47 Hz, 1x motor threshold). SEP ratios were calculated for the N9, N11, N13, P14-18, N20-P25 and P22-N30 peak complexes from SEP amplitudes obtained from simultaneous median and ulnar (MU) stimulation divided by the arithmetic sum of SEPs obtained from individual stimulation of the median (M) and ulnar (U) nerves. There was a significant increase in the MU/M + U ratio for both cortical SEP components following the 20 min repetitive contraction task, i.e. the N20-P25 complex, and the P22-N30 SEP complex. These cortical ratio changes appear to be due to a reduced ability to suppress the dual input, as there was also a significant increase in the amplitude of the MU recordings for the same two cortical SEP peaks (N20-P25 and P22-N30) following the typing task. No changes were observed following a control intervention. The N20 (S1) changes may reflect the mechanism responsible for altering the boundaries of cortical sensory maps, changing the way the CNS perceives and processes information from adjacent body parts. The N30 changes may be related to the intracortical inhibitory changes shown previously with both single and paired pulse TMS. These findings may have implications for understanding the role of the cortex in the initiation of overuse injuries.
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Affiliation(s)
- Heidi Haavik Taylor
- Human Neurophysiology and Rehabilitation Laboratory, Department of Sport and Exercise Science, Tamaki Campus, University of Auckland, Auckland, New Zealand.
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Kavanagh JJ, Morrison S, Barrett RS. Lumbar and cervical erector spinae fatigue elicit compensatory postural responses to assist in maintaining head stability during walking. J Appl Physiol (1985) 2006; 101:1118-26. [PMID: 16763109 DOI: 10.1152/japplphysiol.00165.2006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The purpose of this study was to examine how inducing fatigue of the 1) lumbar erector spinae and 2) cervical erector spinae (CES) muscles affected the ability to maintain head stability during walking. Triaxial accelerometers were attached to the head, upper trunk, and lower trunk to measure accelerations in the vertical, anterior-posterior, and mediolateral directions during walking. Using three accelerometers enabled two adjacent upper body segments to be defined: the neck segment and trunk segment. A transfer function was applied to root mean square acceleration, peak power, and harmonic data derived from spectral analysis of accelerations to quantify segmental gain. The structure of upper body accelerations were examined using measures of signal regularity and smoothness. The main findings were that head stability was only affected in the anterior-posterior direction, as accelerations of the head were less regular following CES fatigue. Furthermore, following CES fatigue, the central nervous system altered the attenuation properties of the trunk segment in the anterior-posterior direction, presumably to enhance head stability. Following lumbar erector spinae fatigue, the trunk segment had greater gain and increased regularity and smoothness of accelerations in the mediolateral direction. Overall, the results of this study suggest that erector spinae fatigue differentially altered segmental attenuation during walking, according to the level of the upper body that was fatigued and the direction that oscillations were attenuated. A compensatory postural response was not only elicited in the sagittal plane, where greater segmental attenuation occurred, but also in the frontal plane, where greater segmental gain occurred.
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Affiliation(s)
- Justin J Kavanagh
- School of Physiotherapy and Exercise Science, Griffith University, PMB 50, Gold Coast Mail Centre, Queensland, Australia 9726.
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Effect of muscle fatigue on target positioning of the human forearm under conditions of restriction of visual control. NEUROPHYSIOLOGY+ 2006. [DOI: 10.1007/s11062-006-0073-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Stapley PJ, Beretta MV, Dalla Toffola E, Schieppati M. Neck muscle fatigue and postural control in patients with whiplash injury. Clin Neurophysiol 2006; 117:610-22. [PMID: 16427356 DOI: 10.1016/j.clinph.2005.11.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2003] [Revised: 11/08/2005] [Accepted: 11/12/2005] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To examine if patients with whiplash injury show identifiable increases in neck muscle fatigability and associated increase in postural body sway after contractions of dorsal neck muscles, and if physiotherapy treatment reduces these effects. METHODS Sway was measured during stance in 13 patients before and after 5 min of isometric dorsal neck muscle contractions and after recovery, pre- and post-physiotherapy, using a force platform. Amplitude and median frequency of neck muscle EMG were calculated during the contracting period. After each stance trial, patients gave a subjective score of sway. RESULTS Pre-treatment, seven patients showed EMG signs of fatigue (increases in amplitude, decreases in median frequency) and increases in sway (eyes closed) after contractions. The other patients showed neither fatigue nor increased sway. Post-treatment, no signs of fatigue or imbalance were recorded in all patients, for the same levels of muscle contraction. CONCLUSIONS As in normal human subjects, increases in sway are associated with signs of neck muscle fatigue in some whiplash injury patients. Physiotherapy decreases the susceptibility to fatigue of neck muscles and is an effective choice of treatment of subjective instability and sway. SIGNIFICANCE This study demonstrates a pathophysiological link between neck muscle fatigue and impaired postural control, and also that physiotherapy can relieve symptoms and signs of impaired neck muscle function by reducing muscle fatigability.
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Affiliation(s)
- Paul J Stapley
- Centro Studi Attività Motorie, Fondazione Salvatore Maugeri (IRCCS), Istituto Scientifico di Pavia, Via Ferrata 8, 27100 Pavia, Italy
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Masri R, Ro JY, Capra N. The effect of experimental muscle pain on the amplitude and velocity sensitivity of jaw closing muscle spindle afferents. Brain Res 2005; 1050:138-47. [PMID: 15982645 DOI: 10.1016/j.brainres.2005.05.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2005] [Revised: 05/12/2005] [Accepted: 05/14/2005] [Indexed: 10/25/2022]
Abstract
The effect of experimental muscle pain on the amplitude and velocity sensitivity of muscle spindle primary afferent neurons in the trigeminal mesencephalic nucleus (Vmes) was examined. Extracellular recordings were made from 45 neurons designated as spindle primary- or secondary-like on the basis of their response to ramp-and-hold jaw movements. Velocity sensitivity was assessed in spindle primary-like afferents by calculating the mean dynamic index of each unit in response to three different velocities of jaw opening before and after intramuscular injection with hypertonic saline (HS, 5%, 100 microl). The amplitude sensitivity of all jaw muscle spindle afferents was assessed by calculating the mean firing rate of each unit in response to three different amplitudes of jaw openings during both the open and hold phases of the movement and with best-fit lines obtained, using linear regression analysis, before and after HS injection. The variance of the two regression lines obtained for each unit before and after the injection was compared using the coincidence test, and changes in intercept and slope were determined. Seventy-five percent of the primary-like units and 80% of the secondary-like units presented with changes in static behavior after HS injection. Thirty-six percent of the primary-like units showed changes in dynamic behavior. Injection of isotonic saline (control) did not alter the responses of the spindle afferent to jaw opening. Thus, our results demonstrate that the predominant effect of noxious stimulation was a shift in the amplitude sensitivity of both spindle primary-like and secondary-like afferents and, to a lesser extent, the velocity sensitivity of the spindle primary-like unit. In accordance with earlier studies in the cat hindlimb and neck muscles, these results suggest that the activation of masseter muscle nociceptor alters spindle afferent responses to stretch acting primarily through static gamma motor neurons.
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Affiliation(s)
- Radi Masri
- Department of Biomedical Sciences, School of Dentistry, University of Maryland Baltimore, 666 W Baltimore St. # 5-E-24, Baltimore, MD 21201, USA
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Visser B, van Dieën JH. Pathophysiology of upper extremity muscle disorders. J Electromyogr Kinesiol 2005; 16:1-16. [PMID: 16099676 DOI: 10.1016/j.jelekin.2005.06.005] [Citation(s) in RCA: 201] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2004] [Revised: 05/11/2005] [Accepted: 06/09/2005] [Indexed: 12/26/2022] Open
Abstract
A review of the literature on the pathophysiology of upper extremity muscle disorders (UEMDs) was performed. An overview is given of clinical findings and hypotheses on the pathogenesis of UEMDs. The literature indicates that disorders of muscle cells and limitations of the local circulation underlie UEMDs. However, these disorders identified do not necessarily lead to symptoms. The following mechanisms have been proposed in the literature: (1) selective recruitment and overloading of type I (Cinderella) motor units; (2) intra-cellular Ca(2+) accumulation; (3) impaired blood flow; (3b) reperfusion injury; (3.3c) blood vessel-nociceptor interaction; (4a) myofascial force transmission; (4b) intramuscular shear forces; (5) trigger points; (6) impaired heat shock response. The results of the review indicate that there are multiple possible mechanisms, but none of the hypotheses forms a complete explanation and is sufficiently supported by empirical data. Overall, the literature indicates that: (1) sustained muscle activity, especially of type I motor units, may be a primary cause of UEMDs; (2) in UEMDs skeletal muscle may show changes in morphology, blood flow, and muscle activity; (3) accumulation of Ca(2+) in the sarcoplasm may be the cause of muscle cell damage; (4) it seems plausible that suboptimal blood flow plays a role in pathogenesis of UEMDs; (5) since the presence of fiber disorders is not a sufficient condition for the development of UEMSDs additional mechanisms, such as sensitization, are assumed to play a role.
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Affiliation(s)
- Bart Visser
- Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, Vrije Universiteit Amsterdam, The Netherlands
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