Changes in human muscle spindle sensitivity during a proprioceptive attention task

Heart rate-related physiological changes induced by classical music-elicited emotions do not underlie alterations in healthy adults' ankle joint target-matching strategy

Emotions have the potential to modulate human voluntary movement by modifying muscle afferent discharge which in turn may affect kinesthetic acuity. We examined if heart rate (HR)-related physiological changes induced by music-elicited emotions would underlie alterations in healthy young adults' ankle joint target-matching strategy quantified by joint position sense (JPS). Participants (n = 40, 19 females, age = 25.9 ± 2.9 years) performed ipsilateral-, and contralateral ankle target-matching tasks with their dominant and non-dominant foot using a custom-made foot platform while listening to classical music pieces deemed to evoke happy, sad, or neutral emotions (each n = 10). Participants in the 4th group received no music during the task. Absolute (ABS), constant (CONST), and variable (VAR) target-matching errors and HR-related data were analyzed. Participants performed the contralateral target-matching task with smaller JPS errors when listening to sad vs. happy music (ABS: p < 0.001, d = 1.6; VAR: p = 0.010, d = 1.2) or neutral (ABS: p < 0.001, d = 1.6; VAR: p < 0.001, d = 1.4) music. The ABS (d = 0.8) and VAR (d = 0.3) JPS errors were lower when participants performed the task with their dominant vs. non-dominant foot. JPS errors were also smaller during the ipsilateral target-matching task when participants (1) listened to sad vs. neutral (ABS: p = 0.007, d = 1.2) music, and (2) performed the target-matching with their dominant vs. non-dominant foot (p < 0.001, d = 0.4). Although emotions also induced changes in some HR-related data during the matching conditions, i.e., participants who listened to happy music had lower HR-related values when matching with their non-dominant vs. dominant foot, these changes did not correlate with JPS errors (all p > 0.05). Overall, our results suggest that music-induced emotions have the potential to affect target-matching strategy and HR-related metrics but the changes in HR-metrics do not underlie the alteration of ankle joint target-matching strategy in response to classical music-elicited emotions.

Physiotherapy management focusing on proprioceptive impairment in a patient with gait and balance impairments following stroke: A case report

BACKGROUND

Proprioceptive impairment contributes to gait and balance impairments in patients with stroke. Diagnosis functional impairments and evaluation treatment efficacy require quantitative proprioception assessment. However, proprioception assessment has remained limited to ordinal scale measurement, with a lack of ratio scale measurements.

PURPOSE

This case report describes a physiotherapy management program focusing on proprioceptive impairment in patients with stroke using quantitative tests such as Threshold to Detect Passive Motion (TDPM) and Joint Position Sense (JPS).

CASE DESCRIPTION

A63-year-old male patient with an acute pontine lacunar infarction was admitted to our hospital. His muscle strength, selective movement, and trunk activity were preserved. However, the Berg Balance Scale (BBS) and Gait Assessment andIntervention Tool (GAIT) score were 42 and 9 points, observing balance impairment and the buckling knee pattern with hip ataxia during gait. Based on these, TDPM and JPS using image capture were performed. In physiotherapeuticdiagnosis, proprioceptive impairments in the hip and knee joints were the primary functional impairments related to balance and gait. To address these proprioceptive impairments, a 13-day treatment protocol incorporating transcutaneous electrical nerve stimulation (intensity: sensory threshold, frequency: 100 Hz) targeting the quadriceps femoris was performed.

OUTCOMES

The patient was discharged after achieving independent ambulation and improvement in BBS (56 points) and GAIT (2 points) scores, exceeding the minimum clinically important difference. Recovery of proprioceptive impairment corresponded withimproved balance and gait ability.

CONCLUSION

Quantitatively evaluating proprioceptive impairments may provide novel rehabilitation for patients with stroke who have proprioceptive impairments and contribute to clinical decision-making.

The Effect of Feedback Modality When Learning a Novel Wrist Sensorimotor Transformation Through a Body-Machine Interface

Body-Machine Interfaces (BoMIs) are promising assistive and rehabilitative tools for helping individuals with impaired motor abilities regain independence. When operating a BoMI, the user has to learn a novel sensorimotor transformation between the movement of certain body parts and the output of the device. In this study, we investigated how different feedback modalities impacted learning to operate a BoMI. Forty-seven able-bodied participants learned to control the velocity of a 1D cursor using the 3D rotation of their dominant wrist to reach as many targets as possible in a given amount of time. The map was designed to maximize cursor speed for movements around a predefined axis of wrist rotation. We compared the user's performance and control efficiency under three feedback modalities: i) visual feedback of the cursor position, ii) proprioceptive feedback of the cursor position delivered by a wrist manipulandum, iii) both i) and ii). We found that visual feedback led to a greater number of targets reached than proprioceptive feedback alone. Conversely, proprioceptive feedback yielded greater alignment between the axis of rotation of the wrist and the optimal axis represented by the map. These results suggest that proprioceptive feedback may be preferable over visual feedback when information about intrinsic task components, i.e. joint configurations, is of interest as in rehabilitative interventions aiming to promote more effective learning strategies.

Muscle spindles as pain receptors

Background

Muscle membranes have a sensation of pain, but within the muscle tissue, the origin of pain is unclear. We present a hypothesis that the pain receptors of the muscle tissue are situated principally in the muscle spindles. A recent report reintroduced that 'end plate spikes' in needle electromyography (EMG) are fusimotor unit potentials of the intrafusal muscle fibres, and thus represent a marker of muscle spindles.

Methods

We studied four relaxed muscles with 50 EMG needle insertions in each and mapped the appearance of pain and spontaneous EMG activity.

Results

Only 4.0% of the needle insertions in muscle tissue elicited pain. However, needle insertions in local active points showing 'end plate spikes' and, thus, fusimotor unit potentials of the muscle spindles elicited pain in 86% of the insertions, whereas needle insertions in points without 'end plate spikes' elicited pain in only 1.0% of the insertions (p<0.001).

Conclusions

Muscle spindles have pain receptors. The extrafusal muscle tissue is practically pain-free for the needle insertions. This demonstrates a scarcity of extrafusal pain receptors. How this observation is put into perspective with the muscle pain syndromes was discussed.

Effectiveness and safety of subthreshold vibration over suprathreshold vibration in treatment of muscle fatigue in elderly people

Muscle fatigue is common in many populations, particularly elderlies. Aging increases the incidence of muscle fatigue and delays its recovery. There is a huge debate about the current treatments for muscle fatigue, particularly in elderlies. Recently, it has been discovered that mechanoreceptors have an important role as a sensory system in sensing muscle fatigue which could enhance the body's response to muscle fatigue. The function of mechanoreceptors could be enhanced by applying either suprathreshold or subthreshold vibration. Although suprathreshold vibration improves muscle fatigue, it can cause desensitization of cutaneous receptors, discomfort, and paresthesia, which are barriers to clinical use. Subthreshold vibration has been approved as a safe and effective method of training for mechanoreceptors; however, its use and effectiveness in muscle fatigue have never been tested or explained. Possible physiological effects of subthreshold vibration in the treatment of muscle fatigue include: (1) Enhancing the function of mechanoreceptors themselves; (2) Increasing the firing rate and function of alpha motor neurons; (3) Increasing blood flow to fatigued muscles; (4) Decreasing the rate of muscle cell death in elderlies (sarcopenia); and (5) Driving motor commands and allow better performance of muscles to decrease fatigue incidence. In conclusion, the use of subthreshold vibration could be a safe and effective treatment for muscle fatigue in elderlies. It could enhance recovery from muscle fatigue. Finally, Subthreshold Vibration is safe and effective in treating muscle fatigue in comparison to suprathreshold vibration.

Dual-Task Interference Slows Down Proprioception

It is well-known that multitasking impairs the performance of one or both of the concomitant ongoing tasks. Previous studies have mainly focused on how a secondary task can compromise visual or auditory information processing. However, despite dual tasking being critical to motor performance, the effects of dual-task performance on proprioceptive information processing have not been studied yet. The purpose of the present study was, therefore, to investigate whether sensorimotor task performance would be affected by the dual task and if so, in which phase of the sensorimotor task performance would this negative effect occur. The kinematic variables of passive and active knee movements elicited by the leg drop test were analyzed. Thirteen young adults participated in the study. The dual task consisted of performing serial subtractions. The results showed that the dual task increased both the reaction time to counteract passive knee-joint movements in the leg drop test and the threshold to detect those movements. The dual task did not affect the speed and time during the active knee movement and the absolute angle error between the final and the target knee angles. Furthermore, the results showed that the time to complete the sensorimotor task was prolonged in dual tasking. Our findings suggest that dual tasking reduces motor performance due to slowing down proprioceptive information processing without affecting movement execution.

Effects of light finger touch on the regularity of center-of-pressure fluctuations during quiet bipedal and single-leg postural tasks

BACKGROUND

The use of extra sources of sensory information associated with light fingertip touch to enhance postural steadiness has been associated with increased attentional demands, whereas the regularity of center of pressure (COP) fluctuations has been interpreted as a marker of the amount of attention invested in posture control.

RESEARCH QUESTION

This study addressed whether increased attentional demands associated with postural tasks involving light finger touch might be reflected by measures of COP regularity.

METHODS

The experiments involved quiet bipedal stance (n = 8 participants) and single-legged stance (n = 14 participants). Each participant was instructed to stand as quietly as possible on a force plate, either touching an external rigid surface (applied force < 1 N, light touch condition), or not (no touch condition). Postural steadiness was assessed by traditional COP measurements (COP Area, RMS, and velocity), whereas the regularity of postural sway was based on estimates of the sample entropy (SaEn) of the COP time series.

RESULTS

Traditional parameters of postural sway and COP regularity (inversely related to SaEn COP measurements) were reduced during the touch conditions as compared to the no-touch conditions, for both bipedal quiet stance and single-legged stance. Decreased COP regularity with light touch was mainly reflected in the direction of the largest postural sway (i.e. in the sagittal plane for bipedal stance and in the frontal plane for single-legged stance).

SIGNIFICANCE

The present results suggest that actively touching an external surface with the fingertip, besides increasing postural steadiness, generated an externally oriented (presumably cognitive-dependent) focus of attention, so that participants invested less attention on the postural task per se (as suggested by increased SaEn), which might be associated with a more "automatic" control of posture.

Passive Proprioceptive Training Alters the Sensitivity of Muscle Spindles to Imposed Movements

Humans rely on precise proprioceptive feedback from our muscles, which is important in both the acquisition and execution of movements, to perform daily activities. Somatosensory input from the body shapes motor learning through central processes, as demonstrated for tasks using the arm, under active (self-generated) and passive conditions. Presently, we investigated whether passive movement training of the ankle increased proprioceptive acuity (psychophysical experiment) and whether it changed the peripheral proprioceptive afferent signal (microneurography experiment). In the psychophysical experiment, the ankle of 32 healthy human participants was moved passively using pairs of ramp-and-hold movements in different directions. In a pretraining test, participants made judgements about the movement direction in a two-alternative forced choice paradigm. Participants then underwent passive movement training, but only half were cued for learning, where a reference position was signaled by a sound and the participant had to learn to recognize this position; they then completed a post-training test. In a paradigm using the same setup, nine healthy participants underwent microneurography recordings of Ia muscle afferents from the peroneal nerve, where all were cued during training. In the psychophysical experiment, proprioceptive acuity improved with training only in the cued group. In the microneurography experiment, we found that muscle afferent firing was modulated, via an increase in the dynamic index, after training. We suggest that changes in muscle afferent input from the periphery can contribute to and support central perceptual and motor learning, as shown under passive conditions using ankle movements, which may be exploited for movement rehabilitation.

Delayed Onset Muscle Soreness (DOMS): The Repeated Bout Effect and Chemotherapy-Induced Axonopathy May Help Explain the Dying-Back Mechanism in Amyotrophic Lateral Sclerosis and Other Neurodegenerative Diseases

Delayed onset muscle soreness (DOMS) is hypothesized to be caused by glutamate excitotoxicity-induced acute compression axonopathy of the sensory afferents in the muscle spindle. Degeneration of the same sensory afferents is implicated in the disease onset and progression of amyotrophic lateral sclerosis (ALS). A series of “silent” acute compression proprioceptive axonopathies with underlying genetic/environmental factors, damaging eccentric contractions and the non-resolving neuroinflammatory process of aging could lead to ALS disease progression. Since the sensory terminals in the muscle spindle could not regenerate from the micro-damage in ALS, unlike in DOMS, the induced protective microcircuits and their long-term functional plasticity (the equivalent of the repeated bout effect in DOMS) will be dysfunctional. The acute stress invoking osteocalcin, bradykinin, COX1, COX2, GDNF, PGE2, NGF, glutamate and N-methyl-D-aspartate (NMDA) receptors are suggested to be the critical signalers of this theory. The repeated bout effect of DOMS and the dysfunctional microcircuits in ALS are suggested to involve several dimensions of memory and learning, like pain memory, inflammation, working and episodic memory. The spatial encoding of these memory dimensions is compromised in ALS due to blunt position sense from the degenerating proprioceptive axon terminals of the affected muscle spindles. Dysfunctional microcircuits progressively and irreversibly interfere with postural control, with motor command and locomotor circuits, deplete the neuroenergetic system, and ultimately interfere with life-sustaining central pattern generators in ALS. The activated NMDA receptor is suggested to serve the “gate control” function in DOMS and ALS in line with the gate control theory of pain. Circumvention of muscle spindle-loading could be a choice of exercise therapy in muscle spindle-affected neurodegenerative diseases.

Dynamic scapular recognition exercise improves scapular upward rotation and shoulder pain and disability in patients with adhesive capsulitis: a randomized controlled trial

BACKGROUND

Examine the ability of a dynamic scapular recognition exercise to improve scapular upward rotation and decrease shoulder pain and disability in patients with adhesive capsulitis of the shoulder.

METHODS

A test-retest randomized controlled study design was used. A total of sixty-six patients with unilateral adhesive capsulitis were equally divided into two groups. The study group received a dynamic scapular recognition exercise using a wireless biofeedback system, while the control group received placebo treatment in the form of active range-of-motion (ROM) exercises of the sound upper limb. A digital inclinometer was used to measure the scapular upward rotation and ROM of the shoulder joint, and the Shoulder Pain and Disability Index (SPADI) was used to measure the shoulder pain and disability.

RESULTS

Study results showed that after two weeks, there were statistically significant differences between the study and control groups in scapular upward rotation and shoulder flexion and abduction (P < .05) and nonsignificant differences in shoulder external rotation and SPADI (P > .05). After two and six months, there were statistically significant differences between study and control groups in scapular upward rotation; shoulder flexion, abduction and external rotation; and SPADI scores (P < .05).

CONCLUSION

This study showed that a dynamic scapular recognition exercise significantly improves scapular upward rotation and the ROM of shoulder flexion and abduction after two weeks. At two and six months, this exercise improves scapular upward rotation; ROM of shoulder flexion, abduction, and external rotation; and SPADI scores. These improvements persisted for six months after the performance of this exercise.

Can Proprioceptive Training Enhance Fatigability and Decrease Progression Rate of Sarcopenia in Seniors? A Novel Approach

Sarcopenia is a common condition in older adults, which causes the frequent occurrence of muscle fatigue. Muscle fatigue commonly develops among seniors. Muscle fatigue is a type of physical fatigue that occurs due to either motor or sensory dysfunctions. Current interventions developed to decrease the occurrence of muscle fatigue, which include either increasing rest periods or subdividing large tasks into small ones. The effectiveness of these interventions is highly contradicted. Recently, researchers discovered that mechanoreceptors are the main receptors of muscle fatigue, however, no clinical study investigated the effect of performing proprioceptive training to enhance the mechanoreceptors and decrease the occurrence of muscle fatigue. Performing proprioceptive training could improve muscle fatigue by improving its sensory part. The function of mechanoreceptors might consequently enhance fatigue and decrease the progression rate of sarcopenia. Thus, this review was conducted to suggest a novel approach of treatment to enhance fatigue and decrease Sarcopenia in seniors. This might be accomplished through increasing the firing rate of α- motor neurons, increasing the amount of Ca²⁺ ions in the neuromuscular junction, slowing the progression rate of Sarcopenia, and correcting movement deviations, which commonly occur with muscle fatigue in seniors. In conclusion, proprioceptive training could play an effective role in decreasing the progression rate of sarcopenia and enhancing the fatigability among seniors.

Have We Looked in the Wrong Direction for More Than 100 Years? Delayed Onset Muscle Soreness Is, in Fact, Neural Microdamage Rather Than Muscle Damage

According to our hypothesis, delayed onset muscle soreness (DOMS) is an acute compression axonopathy of the nerve endings in the muscle spindle. It is caused by the superposition of compression when repetitive eccentric contractions are executed under cognitive demand. The acute compression axonopathy could coincide with microinjury of the surrounding tissues and is enhanced by immune-mediated inflammation. DOMS is masked by sympathetic nervous system activity at initiation, but once it subsides, a safety mode comes into play to prevent further injury. DOMS becomes manifest when the microinjured non-nociceptive sensory fibers of the muscle spindle stop inhibiting the effects of the microinjured, hyperexcited nociceptive sensory fibers, therefore providing the ‘open gate’ in the dorsal horn to hyperalgesia. Reactive oxygen species and nitric oxide play a cross-talking role in the parallel, interlinked degeneration–regeneration mechanisms of these injured tissues. We propose that the mitochondrial electron transport chain generated free radical involvement in the acute compression axonopathy. ‘Closed gate exercises’ could be of nonpharmacological therapeutic importance, because they reduce neuropathic pain in addition to having an anti-inflammatory effect. Finally, DOMS could have an important ontogenetical role by not just enhancing ability to escape danger to survive in the wild, but also triggering muscle growth.

Sensory inflow manipulation induces learning-like phenomena in motor behavior

PURPOSE

Perceptual and goal-directed behaviors may be improved by repetitive sensory stimulations without practice-based training. Focal muscle vibration (f-MV) modulating the spatiotemporal properties of proprioceptive inflow is well-suited to investigate the effectiveness of sensory stimulation in influencing motor outcomes. Thus, in this study, we verified whether optimized f-MV stimulation patterns might affect motor control of upper limb movements.

METHODS

To answer this question, we vibrated the slightly tonically contracted anterior deltoid (AD), posterior deltoid (PD), and pectoralis major muscles in different combinations in forty healthy subjects at a frequency of 100 Hz for 10 min in single or repetitive administrations. We evaluated the vibration effect immediately after f-MV application on upper limb targeted movements tasks, and one week later. We assessed target accuracy, movement mean and peak speed, and normalized Jerk using a 3D optoelectronic motion capture system. Besides, we evaluated AD and PD activity during the tasks using wireless electromyography.

RESULTS

We found that f-MV may induce increases (p < 0.05) in movement accuracy, mean speed and smoothness, and changes (p < 0.05) in the electromyographic activity. The main effects of f-MV occurred overtime after repetitive vibration of the AD and PD muscles.

CONCLUSION

Thus, in healthy subjects, optimized f-MV stimulation patterns might over time affect the motor control of the upper limb movement. This finding implies that f-MV may improve the individual's ability to produce expected motor outcomes and suggests that it may be used to boost motor skills and learning during training and to support functional recovery in rehabilitation.

Can Proprioceptive Training Reduce Muscle Fatigue in Patients With Motor Neuron Diseases? A New Direction of Treatment

Muscle fatigue is a serious problem in patients with motor neuron diseases (MNDs). It commonly disturbs both daily life activity and rehabilitation tolerance. A particular concern should be taken when MNDs occur in older ages. Older patients with MNDs usually have a worse clinical presentation and a lower survival rate. This could increase the occurrence of muscle fatigue. Muscle fatigue occurs due to a dysfunction in either motor or sensory systems. Current exercise interventions performed to decrease the occurrence of muscle fatigue focused only on treating motor causes of muscle fatigue. It has been demonstrated that these interventions have a high debate in their effectiveness on decreasing the occurrence of muscle fatigue. Also, these exercise interventions ignored training the affected sensory part of muscle fatigue, however, the important role of the sensory system in driving the motor system. Thus, this review aimed to develop a novel exercise intervention by using proprioceptive training as an intervention to decrease the occurrence of muscle fatigue in patients with MNDs particularly, older ones. The physiological effects of proprioceptive training to decrease the occurrence of muscle fatigue could include two effects. The first effect includes the ability of the proprioceptive training to increase the sensitivity of muscle spindles as an attempt to normalize the firing rate of α-motoneurons, which their abnormalities have major roles in the occurrence of muscle fatigue. The second effect includes its ability to correct the abnormal movement-compensations, which develop due to the biomechanical constraints imposed on patients with MNDs.

Fingertip-Coupled Spindle Signaling Does Not Contribute to Reduce Postural Sway Under Light Touch

The details of how light touch (LT) of a stable surface reduces postural sway are still not well known. We hypothesized that removal of feedback provided by muscle afferents of the touching fingertip would increase postural sway in standing subjects. Eleven participants stood upright on a force plate with eyes closed and on an unstable surface. The experimental conditions involved two different finger positions: with partial muscle afferents (PMA), which includes sensory information from the fingertip flexor muscles, and no muscle afferents (NMA), without information from either fingertip flexor or extensor muscles. In the control condition, the participants kept the same posture, but with no finger touch (NT). Postural sway in both anteroposterior (AP) and mediolateral (ML) axes were recorded. Results showed that LT decreased all sway quantifiers as compared with the NT condition. The withdrawal of information from the touch finger muscle afferents (NMA condition) did not increase postural sway. Actually, there was a small, albeit statistically significant, decrease in the variability of center of pressure displacement in the AP direction. These results indicate that in some cases, muscle afferent input may either not contribute or even worsen the overall quality of sensory feedback from a given body segment, leading to no improvement or even a slightly decreased performance of the motor control system (evaluated by means of levels of postural sway in the present investigation). The results suggest that non-spindle fingertip afferents provide the bulk of the sensory feedback associated with the fingertip that is touching a ground-referenced object during quiet standing under LT.

One session of motor control exercise improves joint position sense assessed by an iPhone application: a randomized controlled trial

[Purpose] To establish the test-retest reliability of an iPhone application and determine the immediate effect of motor control exercise (MCE) on lumbar position sense. [Participants and Methods] This study used a two-arm, randomized controlled trial design with a blinded assessor. Sixty healthy participants were randomized into the exercise or control group. The exercise group underwent 30-min MCE, whereas the control group rested for 15 min. Lumbar motion measured by two iPhones with goniometer application was used to determine the test-retest reliability. Absolute repositioning errors (pre- and post-test) from the control and exercise groups were used to determine the immediate effect of MCE on lumbar position sense. [Results] The test-retest reliability was 0.67–0.95. A significant interaction effect was found for Angle*Time, main effect of Angle, and main effect of Time. Post-hoc comparison showed a significant improvement in position sense at 45° and 60° in the exercise group. [Conclusion] The findings suggest that a mobile phone application has the ability to detect changes in lumbar position sense between sessions that exceed measurement error following MCE. One session of specific MCE can improve lumbar position sense at high lumbar flexion.

Seeing Your Foot Move Changes Muscle Proprioceptive Feedback

Multisensory effects are found when the input from single senses combines, and this has been well researched in the brain. Presently, we examined in humans the potential impact of visuo-proprioceptive interactions at the peripheral level, using microneurography, and compared it with a similar behavioral task. We used a paradigm where participants had either proprioceptive information only (no vision) or combined visual and proprioceptive signals (vision). We moved the foot to measure changes in the sensitivity of single muscle afferents, which can be altered by the descending fusimotor drive. Visual information interacted with proprioceptive information, where we found that for the same passive movement, the response of muscle afferents increased when the proprioceptive channel was the only source of information, as compared with when visual cues were added, regardless of the attentional level. Behaviorally, when participants looked at their foot moving, they more accurately judged differences between movement amplitudes, than in the absence of visual cues. These results impact our understanding of multisensory interactions throughout the nervous system, where the information from different senses can modify the sensitivity of peripheral receptors. This has clinical implications, where future strategies may modulate such visual signals during sensorimotor rehabilitation.

Emotions can alter kinesthetic acuity

Kinesthesia, the perception of our own body movements, relies on the integration of proprioceptive information arising mostly from muscle spindles, which are sensory receptors in skeletal muscles. We recently showed that emotions alter the proprioceptive messages from such muscle afferents, making them more sensitive to muscle lengthening when participants were listening sad music. Presently, we investigated whether these changes in proprioceptive feedback relating to emotional state may affect the perception of limb movements. Kinesthetic acuity was tested in 20 healthy, young adults by imposing ramp-and-hold movements that consisted of either plantar flexion or dorsiflexion movements of the ankle at 0.04°/s, or no movement. These were imposed during four emotional conditions (listening to neutral, sad, or happy music, or no music). The participants were asked to relax and focus on music (or nothing), and then they shifted their focus to the direction of an incoming movement. Once this had finished, they were asked its direction. Muscle activity, heart rate, and electrodermal activity were recorded during each trial, and after each music condition the participants rated the emotion felt on a visual analog scale. The rating of the emotional content of the music corroborated with changes in physiological measures. Kinesthetic acuity was also affected by the emotional state and found to be larger during the sad condition, as compared to the no music or neutral conditions. We conclude that emotion can shape our perception of movements, which we show here where feeling sadness significantly increase our kinesthetic acuity, this may be functionally relevant for the preparation of appropriate behavioral responses.

Sensory trick efficacy in cervical dystonia is linked to processing of neck proprioception

BACKGROUND

Muscle vibration activates muscle spindles and when applied over posterior neck muscles during stance modulates global body orientation. This is characterised by a tonic forward sway response that is reportedly diminished or absent in patients with idiopathic cervical dystonia.

OBJECTIVE

To investigating the impact of the sensory trick on vibration-induced postural responses.

METHODS

20 patients with idiopathic cervical dystonia and a sensory trick, 15 patients without a trick, and 16 healthy controls were recruited. Neck muscle vibration was applied bilaterally over the upper trapezius under three different conditions: 1) Quiet standing; 2) standing while performing the trick (or trick-like movement in non-responders); 3) standing while elevating the flexed arm without touching any part of the body. Centre of pressure position and whole-body orientation in the sagittal plane were analysed.

RESULTS

Patients with a sensory trick responded similarly to healthy controls: neck muscle vibration led to an initial forward sway of the body that slowly increased during the prolonged vibration for all three conditions. This response was mainly mediated by ankle flexion. In patients without a trick, the initial sagittal sway was significantly reduced in all three conditions and the later slow increase was absent. Performance of the trick did not have an effect on any aspect of the response in either cervical dystonia group.

CONCLUSIONS

The whole-body response to neck vibration in cervical dystonia differs depending on the effectiveness of the sensory trick to alleviate the dystonic neck posture. Variable pathophysiology of proprioceptive processing may be the common factor.

Task-dependent responses to muscle vibration during reaching

Feedback corrections in reaching have been shown to be task-dependent for proprioceptive, visual and vestibular perturbations, in line with predictions from optimal feedback control theory. Mechanical perturbations have been used to elicit proprioceptive errors, but have the drawback to actively alter the limb's trajectory, making it nontrivial to dissociate the subject's compensatory response from the perturbation itself. In contrast, muscle vibration provides an alternative tool to perturb the muscle afferents without changing the hands trajectory, inducing only changes in the estimated, but not the actual, limb position and velocity. Here, we investigate whether upper-arm muscle vibration is sufficient to evoke task-dependent feedback corrections during goal-directed reaching to a narrow versus a wide target. Our main result is that for vibration of biceps and triceps, compensatory responses were down-regulated for the wide compared to the narrow target. The earliest detectable difference between these target-specific corrections is at about 100 ms, likely reflecting a task-dependent feedback control policy rather than a voluntary response.

Increased human stretch reflex dynamic sensitivity with height-induced postural threat

KEY POINTS

Threats to standing balance (postural threat) are known to facilitate soleus tendon-tap reflexes, yet the mechanisms driving reflex changes are unknown. Scaling of ramp-and-hold dorsiflexion stretch reflexes to stretch velocity and amplitude were examined as indirect measures of changes to muscle spindle dynamic and static function with height-induced postural threat. Overall, stretch reflexes were larger with threat. Furthermore, the slope (gain) of the stretch-velocity vs. short-latency reflex amplitude relationship was increased with threat. These findings are interpreted as indirect evidence for increased muscle spindle dynamic sensitivity, independent of changes in background muscle activity levels, with a threat to standing balance. We argue that context-dependent scaling of stretch reflexes forms part of a multisensory tuning process where acquisition and/or processing of balance-relevant sensory information is continuously primed to facilitate feedback control of standing balance in challenging balance scenarios.

ABSTRACT

Postural threat increases soleus tendon-tap (t-) reflexes. However, it is not known whether t-reflex changes are a result of central modulation, altered muscle spindle dynamic sensitivity or combined spindle static and dynamic sensitization. Ramp-and-hold dorsiflexion stretches of varying velocities and amplitudes were used to examine velocity- and amplitude-dependent scaling of short- (SLR) and medium-latency (MLR) stretch reflexes as an indirect indicator of spindle sensitivity. t-reflexes were also performed to replicate previous work. In the present study, we examined the effects of postural threat on SLR, MLR and t-reflex amplitude, as well as SLR-stretch velocity scaling. Forty young-healthy adults stood with one foot on a servo-controlled tilting platform and the other on a stable surface. The platform was positioned on a hydraulic lift. Threat was manipulated by having participants stand in low (height 1.1 m; away from edge) then high (height 3.5 m; at the edge) threat conditions. Soleus stretch reflexes were recorded with surface electromyography and SLRs and MLRs were probed with fixed-amplitude variable-velocity stretches. t-reflexes were evoked with Achilles tendon taps using a linear motor. SLR, MLR and t-reflexes were 11%, 9.5% and 16.9% larger, respectively, in the high compared to low threat condition. In 22 out of 40 participants, SLR amplitude was correlated to stretch velocity at both threat levels. In these participants, the gain of the SLR-velocity relationship was increased by 36.1% with high postural threat. These findings provide new supportive evidence for increased muscle spindle dynamic sensitivity with postural threat and provide further support for the context-dependent modulation of human somatosensory pathways.

Proprioceptive identification of joint position versus kinaesthetic movement reproduction

Regarding our voluntary control of movement, if identification of joint position, that is independent of the starting condition, is stronger than kinaesthetic movement reproduction, that implies knowledge of the starting position and movement's length for accuracy, is still a matter of debate in motor control theories and neuroscience. In the present study, we examined the mechanisms that individuals seem to prefer/adopt when they locate spatial positions and code the amplitude of movements. We implemented a joint position matching task on a wrist robotic device: this task consists in replicating (i.e. matching) a reference joint angle in the absence of vision and the proprioceptive acuity is given by the goodness of such matching. Two experiments were carried out by implementing two different versions of the task and performed by two groups of 15 healthy participants. In the first experiment, blindfolded subjects were asked to perform matching movements towards a fixed target position, experienced with passive movements that started from different positions and had different lengths. In the second experiment, blindfolded subjects were requested to accurately match target positions that had a different location in space but were passively shown through movements of the same length. We found a clear evidence for higher performances in terms of accuracy (0.42±0.011/°) and precision (0.43±0.011/°) in the first experiment, therefore in case of matching positions, rather than in the second where accuracy and precision were lower (0.36±0.011/° and 0.35±0.011/° respectively). These results suggested a preference for proprioceptive identification of joint position rather than kinaesthetic movement reproduction.

Functional properties of human muscle spindles

Muscle spindles are ubiquitous encapsulated mechanoreceptors found in most mammalian muscles. There are two types of endings, primary and secondary, and both are sensitive to changes in muscle length and velocity, with the primary endings having a greater dynamic sensitivity. Unlike other mechanoreceptors in the somatosensory system, muscle spindles are unique in possessing motor innervation, via γ-motoneurons (fusimotor neurons), that control their sensitivity to stretch. Much of what we know about human muscles spindles comes from studying the behavior of their afferents via intraneural microelectrodes (microneurography) inserted into accessible peripheral nerves. We review the functional properties of human muscle spindles, comparing and contrasting with what we know about the functions of muscle spindles studied in experimental animals. As in the cat, many human muscle spindles possess a background discharge that is related to the degree of muscle stretch, but mean firing rates are much lower (~10 Hz). They can faithfully encode changes in muscle fascicle length in passive conditions, but higher level extraction of information is required by the central nervous system to measure changes in muscle length during muscle contraction. Moreover, although there is some evidence supporting independent control of human muscle spindles via fusimotor neurons, any effects are modest compared with the clearly independent control of fusimotor neurons observed in the cat.

Kinesthetic Senses

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

Effect of noise stimulation below and above sensory threshold on postural sway during a mildly challenging balance task

BACKGROUND

Mechanical and electrical sub-sensory noise stimulation applied to the sensory receptors has been shown to improve performance during postural balance tasks. This improvement has been linked with the Stochastic Resonance (SR) phenomenon. It is not clear if noise levels above sensory threshold can also lead to a reduction in postural sway.

RESEARCH QUESTION

The aim of this study was to investigate the different effects of sub- and super-sensory electrical noise stimulation applied to the Tibialis Anterior muscle during several repetitions of a mildly challenging single-leg postural balance task.

METHODS

Fifteen healthy individuals participated in this study. Participants performed 25 repetitions of a balance tasks where they leaned forward and maintained a pre-determined position for 20 s. Each participant experienced 5 different stimulation levels (no-stimulation, 70%, 90%, 110% and 130% of their sensory threshold ST) for 5 times in a randomized order. Optimal stimulation (OS) was defined as the stimulation intensity minimizing the standard deviation of postural sway in the anteroposterior direction.

RESULTS

∼57% of the participants presented levels of OS below ST. We did not observe a clear SR-effect, characterized by a U-shaped relationship between the performance metric and the stimulation intensity. OS led to a selective improvement in all the anteroposterior posturographic parameters analyzed. Stimulation below ST led to an improvement in most of the balance features, while stimulation above ST led to an increase in postural sway.

SIGNIFICANCE

Our results suggest that OS can be found both below and above ST although stimulation below ST appears to be more effective in reducing postural sway.

Effects of White Noise Achilles Tendon Vibration on Quiet Standing and Active Postural Positioning

Applying white noise vibration to the ankle tendons has previously been used to improve passive movement detection and alter postural control, likely by enhancing proprioceptive feedback. The aim of the present study was to determine if similar methods focused on the ankle plantarflexors affect the performance of both quiet standing and an active postural positioning task, in which participants may be more reliant on proprioceptive feedback from actively contracting muscles. Twenty young, healthy participants performed quiet standing trials and active postural positioning trials designed to encourage reliance on plantarflexor proprioception. Performance under normal conditions with no vibration was compared to performance with 8 levels of vibration amplitude applied to the bilateral Achilles tendons. Vibration amplitude was set either as a percentage of sensory threshold (n = 10) or by root-mean-square (RMS) amplitude (n = 10). No vibration amplitude had a significant effect on quiet standing. In contrast, accuracy of the active postural positioning task was significantly (P = .001) improved by vibration with an RMS amplitude of 30 μm. Setting vibration amplitude based on sensory threshold did not significantly affect postural positioning accuracy. The present results demonstrate that appropriate amplitude tendon vibration may hold promise for enhancing the use of proprioceptive feedback during functional active movement.

Codification mechanisms of wrist position sense

Proprioceptive signals from cutaneous, joint, tendon and muscle receptors create the basis for bodily perception and are known to be essential for motor control. However, which are the mechanisms underlying the proprioceptive signals and which are the variables that affect them is still a matter of debate. In particular, what is worth to investigate is, namely, the codification of proprioceptive information related to pointing movements of the wrist towards kinesthetic targets. In this work we asked 10 healthy adults to perform with their wrist a robot-aided proprioceptive matching task, in which the starting position of the matching movements was shifted forward or backward, in order to ascertain to which extent such shifts cause target over/under estimation and how important is movement's length on task performance. Results indicate that accuracy and precision of performance are highly correlated with the starting position and targets tended to be undershot when the active matching movements were longer. Moreover, further analysis revealed a consistent decrement of movement speed for shorter movements and conversely, faster displacement in case of backward of starting position.

Escape from homeostasis: spinal microcircuits and progression of amyotrophic lateral sclerosis

In amyotrophic lateral sclerosis (ALS), loss of motoneuron function leads to weakness and, ultimately, respiratory failure and death. Regardless of the initial pathogenic factors, motoneuron loss follows a specific pattern: the largest α-motoneurons die before smaller α-motoneurons, and γ-motoneurons are spared. In this article, we examine how homeostatic responses to this orderly progression could lead to local microcircuit dysfunction that in turn propagates motoneuron dysfunction and death. We first review motoneuron diversity and the principle of α-γ coactivation and then discuss two specific spinal motoneuron microcircuits: those involving proprioceptive afferents and those involving Renshaw cells. Next, we propose that the overall homeostatic response of the nervous system is aimed at maintaining force output. Thus motoneuron degeneration would lead to an increase in inputs to motoneurons, and, because of the pattern of neuronal degeneration, would result in an imbalance in local microcircuit activity that would overwhelm initial homeostatic responses. We suggest that this activity would ultimately lead to excitotoxicity of motoneurons, which would hasten the progression of disease. Finally, we propose that should this be the case, new therapies targeted toward microcircuit dysfunction could slow the course of ALS.

Cardinal features of involuntary force variability can arise from the closed-loop control of viscoelastic afferented muscles

Involuntary force variability below 15 Hz arises from, and is influenced by, many factors including descending neural drive, proprioceptive feedback, and mechanical properties of muscles and tendons. However, their potential interactions that give rise to the well-structured spectrum of involuntary force variability are not well understood due to a lack of experimental techniques. Here, we investigated the generation, modulation, and interactions among different sources of force variability using a physiologically-grounded closed-loop simulation of an afferented muscle model. The closed-loop simulation included a musculotendon model, muscle spindle, Golgi tendon organ (GTO), and a tracking controller which enabled target-guided force tracking. We demonstrate that closed-loop control of an afferented musculotendon suffices to replicate and explain surprisingly many cardinal features of involuntary force variability. Specifically, we present 1) a potential origin of low-frequency force variability associated with co-modulation of motor unit firing rates (i.e.,‘common drive’), 2) an in-depth characterization of how proprioceptive feedback pathways suffice to generate 5-12 Hz physiological tremor, and 3) evidence that modulation of those feedback pathways (i.e., presynaptic inhibition of Ia and Ib afferents, and spindle sensitivity via fusimotor drive) influence the full spectrum of force variability. These results highlight the previously underestimated importance of closed-loop neuromechanical interactions in explaining involuntary force variability during voluntary ‘isometric’ force control. Furthermore, these results provide the basis for a unifying theory that relates spinal circuitry to various manifestations of altered involuntary force variability in fatigue, aging and neurological disease.

Involuntary fluctuations in muscle force are an unavoidable consequence of human motor control and underlie movement execution errors. Amplification and distortion of involuntary force variability are common phenomena found in various neurological conditions and in fatigue. However, the underlying mechanisms for this are often unclear. We investigated the generation and modulation of involuntary force variability arising from different sources, as well as their interactions. We used a closed-loop simulation which included a physiologically-grounded model of an afferented musculotendon and an error-controller. We show that interactions among neural noise, musculotendon mechanics, proprioceptive feedback, and error correction are critical components of force control, and by taking these into account, our model was able to both replicate and explain many cardinal features of involuntary force variability previously reported experimentally. Also, our results suggest previously unrecognized pathways through which force variability may be altered in fatigue and in certain neurological diseases. Finally, we emphasize the potential for important clinical and scientific information to be extracted from relatively simple, non-invasive measurements of force.

Age-Related Decline of Wrist Position Sense and its Relationship to Specific Physical Training

Perception of limb and body positions is known as proprioception. Sensory feedback, especially from proprioceptive receptors, is essential for motor control. Aging is associated with a decline in position sense at proximal joints, but there is inconclusive evidence of distal joints being equally affected by aging. In addition, there is initial evidence that physical activity attenuates age-related decline in proprioception. Our objectives were, first, to establish wrist proprioceptive acuity in a large group of seniors and compare their perception to young adults, and second, to determine if specific types of training or regular physical activity are associated with preserved wrist proprioception. We recruited community-dwelling seniors (n = 107, mean age, 70 ± 5 years, range, 65–84 years) without cognitive decline (Mini Mental State Examination-brief version ≥13/16) and young adult students (n = 51, mean age, 20 ± 1 years, range, 19–26 years). Participants performed contralateral and ipsilateral wrist position sense matching tasks with a bimanual wrist manipulandum to a 15° flexion reference position. Systematic error or proprioceptive bias was computed as the mean difference between matched and reference position. The respective standard deviation over five trials constituted a measure of random error or proprioceptive precision. Current levels of physical activity and previous sport, musical, or dance training were obtained through a questionnaire. We employed longitudinal mixed effects linear models to calculate the effects of trial number, sex, type of matching task and age on wrist proprioceptive bias and precision. The main results were that relative proprioceptive bias was greater in older when compared to young adults (mean difference: 36% ipsilateral, 88% contralateral, p < 0.01). Proprioceptive precision for contralateral but not for ipsilateral matching was smaller in older than in young adults (mean difference: 38% contralateral, p < 0.01). Longer years of dance training were associated with smaller bias during ipsilateral matching (p < 0.01). Other types of training or physical activity levels did not affect bias or precision. Our findings demonstrate that aging is associated with a decline in proprioceptive bias in distal arm joints, but age does not negatively affect proprioceptive precision. Further, specific types of long-term dance related training may attenuate age-related decline in proprioceptive bias.

Sensory training with vibration-induced kinesthetic illusions improves proprioceptive integration in patients with Parkinson's disease

The present study investigates whether proprioceptive training, based on kinesthetic illusions, can help in re-educating the processing of muscle proprioceptive input, which is impaired in patients with Parkinson's disease (PD). The processing of proprioceptive input before and after training was evaluated by determining the error in the amplitude of voluntary dorsiflexion ankle movement (20°), induced by applying a vibration on the tendon of the gastrocnemius-soleus muscle (a vibration-induced movement error). The training consisted of the subjects focusing their attention upon a series of illusory movements of the ankle. Eleven PD patients and eleven age-matched control subjects were tested. Before training, vibration reduced dorsiflexion amplitude in controls by 4.3° (P<0.001); conversely, vibration was inefficient in PD's movement amplitude (reduction of 2.1°, P=0.20). After training, vibration significantly reduced the estimated movement amplitude in PD patients by 5.3° (P=0.01). This re-emergence of a vibration-induced error leads us to conclude that proprioceptive training, based on kinesthetic illusions, is a simple means for re-educating the processing of muscle proprioceptive input in PD patients. Such complementary training should be included in rehabilitation programs that presently focus on improving balance and motor performance.

Emotions alter muscle proprioceptive coding of movements in humans

Emotions can evoke strong reactions that have profound influences, from gross changes in our internal environment to small fluctuations in facial muscles, and reveal our feelings overtly. Muscles contain proprioceptive afferents, informing us about our movements and regulating motor activities. Their firing reflects changes in muscle length, yet their sensitivity can be modified by the fusimotor system, as found in animals. In humans, the sensitivity of muscle afferents is modulated by cognitive processes, such as attention; however, it is unknown if emotional processes can modulate muscle feedback. Presently, we explored whether muscle afferent sensitivity adapts to the emotional situation. We recorded from single muscle afferents in the leg, using microneurography, and moved the ankle joint of participants, while they listened to evocative classical music to induce sad, neutral, or happy emotions, or sat passively (no music). We further monitored their physiological responses using skin conductance, heart rate, and electromyography measures. We found that muscle afferent firing was modified by the emotional context, especially for sad emotions, where the muscle spindle dynamic response increased. We suggest that this allows us to prime movements, where the emotional state prepares the body for consequent behaviour-appropriate reactions.

Altered visual strategies and attention are related to increased force fluctuations during a pinch grip task in older adults

The purpose of the study was to determine the visual strategies used by older adults during a pinch grip task and to assess the relations between visual strategy, deficits in attention, and increased force fluctuations in older adults. Eye movements of 23 older adults (>65 yr) were monitored during a low-force pinch grip task while subjects viewed three common visual feedback displays. Performance on the Grooved Pegboard test and an attention task (which required no concurrent hand movements) was also measured. Visual strategies varied across subjects and depended on the type of visual feedback provided to the subjects. First, while viewing a high-gain compensatory feedback display (horizontal bar moving up and down with force), 9 of 23 older subjects adopted a strategy of performing saccades during the task, which resulted in 2.5 times greater force fluctuations in those that exhibited saccades compared with those who maintained fixation near the target line. Second, during pursuit feedback displays (force trace moving left to right across screen and up and down with force), all subjects exhibited multiple saccades, and increased force fluctuations were associated (r_s = 0.6; P = 0.002) with fewer saccades during the pursuit task. Also, decreased low-frequency (<4 Hz) force fluctuations and Grooved Pegboard times were significantly related (P = 0.033 and P = 0.005, respectively) with higher (i.e., better) attention z scores. Comparison of these results with our previously published results in young subjects indicates that saccadic eye movements and attention are related to force control in older adults.NEW & NOTEWORTHY The significant contributions of the study are the addition of eye movement data and an attention task to explain differences in hand motor control across different visual displays in older adults. Older participants used different visual strategies across varying feedback displays, and saccadic eye movements were related with motor performance. In addition, those older individuals with deficits in attention had impaired motor performance on two different hand motor control tasks, including the Grooved Pegboard test.

Improved proprioceptive function by application of subsensory electrical noise: Effects of aging and task-demand

The application of subsensory noise stimulation over the lower limbs has been shown to improve proprioception and postural control under certain conditions. Whereas the effect specificity seems to depend on several factors, studies are still needed to determine the appropriate method for training and rehabilitation purposes. In the current study, we investigated whether the application of subsensory electrical noise over the legs improves proprioceptive function in young and older adults. We aimed to provide evidence that stronger and age-related differential effects occur in more demanding tasks. Proprioceptive function was initially assessed by testing the detection of passive ankle movement (kinesthetic perception) in twenty-eight subjects (14 young and 14 older adults). Thereafter, postural control was assessed during tasks with different sensory challenges: i) by removing visual information (eyes closed) and; ii) by moving the visual scene (moving room paradigm). Tests performed with the application of electrical noise stimulation were compared to those performed without noise. The results showed that electrical noise applied over the legs led to a reduction in the response time to kinesthetic perception in both young and older adults. On the other hand, the magnitude of postural sway was reduced by noise stimulation only during a more challenging task, namely, when the optical flow was changing in an unpredictable (nonperiodic) manner. No differential effects of stimulation between groups were observed. These findings suggest that the relevance of proprioceptive inputs in tasks with different challenges, but not the subjects' age, is a determining factor for sensorimotor improvements due to electrical noise stimulation.

Precise coding of ankle angle and velocity by human calf muscle spindles

Human standing balance control requires the integration of sensory feedback to produce anticipatory, stabilizing ankle torques. However, the ability of human triceps surae muscle spindles to provide reliable sensory feedback regarding the small, slow ankle movements that occur during upright standing has recently come under question. We performed microneurography to directly record axon potentials from single muscle spindle afferents in the human triceps surae during servo-controlled movement of the ankle joint. To simulate movements of the ankle while standing, we delivered random 90-s dorsiflexion/plantar flexion oscillations of the ankle joint, with a peak-to-peak amplitude of 0.7° and frequency content below 0.5Hz. In roughly half of the trials (46%), participants held a low-level, near-isometric contraction of the triceps surae muscles. We demonstrate that afferent activity in a population of muscle spindles closely reflects ankle movements at frequencies and amplitudes characteristic of human standing. Four out of five soleus spindles, and three out of seven gastrocnemius spindles coded for at least a single frequency component of anteroposterior ankle rotation. Concatenating within muscles, coherence was significantly greater for soleus spindles at all stimulus frequencies. Voluntary contraction of the parent muscle reduced spindle sensitivity, but only significantly near the mean power frequency of the stimulus (∼0.3Hz). In conclusion, these results provide direct evidence that triceps surae muscle spindles are potentially capable of providing important sensory feedback for the control of human standing balance.

The Dynamics of Voluntary Force Production in Afferented Muscle Influence Involuntary Tremor

Voluntary control of force is always marked by some degree of error and unsteadiness. Both neural and mechanical factors contribute to these fluctuations, but how they interact to produce them is poorly understood. In this study, we identify and characterize a previously undescribed neuromechanical interaction where the dynamics of voluntary force production suffice to generate involuntary tremor. Specifically, participants were asked to produce isometric force with the index finger and use visual feedback to track a sinusoidal target spanning 5-9% of each individual's maximal voluntary force level. Force fluctuations and EMG activity over the flexor digitorum superficialis (FDS) muscle were recorded and their frequency content was analyzed as a function of target phase. Force variability in either the 1-5 or 6-15 Hz frequency ranges tended to be largest at the peaks and valleys of the target sinusoid. In those same periods, FDS EMG activity was synchronized with force fluctuations. We then constructed a physiologically-realistic computer simulation in which a muscle-tendon complex was set inside of a feedback-driven control loop. Surprisingly, the model sufficed to produce phase-dependent modulation of tremor similar to that observed in humans. Further, the gain of afferent feedback from muscle spindles was critical for appropriately amplifying and shaping this tremor. We suggest that the experimentally-induced tremor may represent the response of a viscoelastic muscle-tendon system to dynamic drive, and therefore does not fall into known categories of tremor generation, such as tremorogenic descending drive, stretch-reflex loop oscillations, motor unit behavior, or mechanical resonance. Our findings motivate future efforts to understand tremor from a perspective that considers neuromechanical coupling within the context of closed-loop control. The strategy of combining experimental recordings with physiologically-sound simulations will enable thorough exploration of neural and mechanical contributions to force control in health and disease.

Robot-Aided Mapping of Wrist Proprioceptive Acuity across a 3D Workspace

Proprioceptive signals from peripheral mechanoreceptors form the basis for bodily perception and are known to be essential for motor control. However we still have an incomplete understanding of how proprioception differs between joints, whether it differs among the various degrees-of-freedom (DoFs) within a particular joint, and how such differences affect motor control and learning. We here introduce a robot-aided method to objectively measure proprioceptive function: specifically, we systematically mapped wrist proprioceptive acuity across the three DoFs of the wrist/hand complex with the aim to characterize the wrist position sense. Thirty healthy young adults performed an ipsilateral active joint position matching task with their dominant wrist using a haptic robotic exoskeleton. Our results indicate that the active wrist position sense acuity is anisotropic across the joint, with the abduction/adduction DoF having the highest acuity (the error of acuity for flexion/extension is 4.64 ± 0.24°; abduction/adduction: 3.68 ± 0.32°; supination/pronation: 5.15 ± 0.37°) and they also revealed that proprioceptive acuity decreases for smaller joint displacements. We believe this knowledge is imperative in a clinical scenario when assessing proprioceptive deficits and for understanding how such sensory deficits relate to observable motor impairments.

Improving proprioceptive deficits after stroke through robot-assisted training of the upper limb: a pilot case report study

The purpose of this study was to determine whether a conventional robot-assisted therapy of the upper limb was able to improve proprioception and motor recovery of an individual after stroke who exhibited proprioceptive deficits. After robotic sensorimotor training, significant changes were observed in kinematic performance variables. Two quantitative parameters evaluating position sense improved after training. Range of motion during shoulder and wrist flexion improved, but only wrist flexion remained improved at 3-month follow-up. These preliminary results suggest that intensive robot-aided rehabilitation may play an important role in the recovery of sensory function. However, further studies are required to confirm these data.

Evaluation of upper limb sense of position in healthy individuals and patients after stroke

The aims of this study were to develop and evaluate reliability of a quantitative assessment tool for upper limb sense of position on the horizontal plane. We evaluated 15 healthy individuals (controls) and 9 stroke patients. A robotic device passively moved one arm of the blindfolded participant who had to actively move his/her opposite hand to the mirror location in the workspace. Upper-limb's position was evaluated by a digital camera. The position of the passive hand was compared with the active hand's 'mirror' position. Performance metrics were then computed to measure the mean absolute errors, error variability, spatial contraction/expansion, and systematic shifts. No significant differences were observed between dominant and non-dominant active arms of controls. All performance parameters of the post-stroke group differed significantly from those of controls. This tool can provide a quantitative measure of upper limb sense of position, therefore allowing detection of changes due to rehabilitation.

Task-related changes in sensorimotor integration influence the common synaptic input to motor neurones

AIM

The purpose of this investigation was to understand how visual information, when used to guide muscle activity, influences the frequency content of the neural drive to muscles and the gain of afferent feedback.

METHODS

Subjects maintained static, isometric contractions of the tibialis anterior muscle by matching a visual display of their ankle dorsiflexion force to a target set at 10% of their maximum voluntary contraction level. Two visual feedback conditions were studied. The first was a high-sensitivity feedback, in which small changes in force were of large on-screen visual magnitude. The second was a low-sensitivity feedback, in which the on-screen scaling of feedback was reduced by a factor of 10, making small force fluctuations difficult to perceive. Force tremor and Hoffmann reflex (H-reflex) amplitudes were compared between the two conditions, as well as coherence among single motor unit spike trains derived from high-density EMG recordings.

RESULTS

The high-sensitivity feedback condition was associated with lower error, larger force tremor (4-12 Hz) and larger H-reflex amplitudes relative to the low-sensitivity feedback condition. In addition, the use of high-sensitivity feedback was associated with lower 1-5 Hz coherence among pairs of motor units, but larger coherence at high frequencies (6-12, approx. 20, >30 Hz).

CONCLUSION

Alteration of visual feedback influences nearly the entire frequency spectrum of common input to motor neurones, as well the gain of afferent feedback. We speculate that task-related modulation of afferent feedback could be the origin of many of the observed changes in the neural drive to muscles.

Sensory systems in the control of movement

Animal movement is immensely varied, from the simplest reflexive responses to the most complex, dexterous voluntary tasks. Here, we focus on the control of movement in mammals, including humans. First, the sensory inputs most closely implicated in controlling movement are reviewed, with a focus on somatosensory receptors. The response properties of the large muscle receptors are examined in detail. The role of sensory input in the control of movement is then discussed, with an emphasis on the control of locomotion. The interaction between central pattern generators and sensory input, in particular in relation to stretch reflexes, timing, and pattern forming neuronal networks is examined. It is proposed that neural signals related to bodily velocity form the basic descending command that controls locomotion through specific and well-characterized relationships between muscle activation, step cycle phase durations, and biomechanical outcomes. Sensory input is crucial in modulating both the timing and pattern forming parts of this mechanism.

Neural correlates of task-related changes in physiological tremor

Appropriate control of muscle contraction requires integration of command signals with sensory feedback. Sensorimotor integration is often studied under conditions in which muscle force is controlled with visual feedback. While it is known that alteration of visual feedback can influence task performance, the underlying changes in neural drive to the muscles are not well understood. In this study, we characterize the frequency content of force fluctuations and neural drive when production of muscle force is target guided versus self guided. In the self-guided condition, subjects performed isometric contractions of the first dorsal interosseous (FDI) muscle while slowly and randomly varying their force level. Subjects received visual feedback of their own force in order to keep contractions between 6% and 10% of maximum voluntary contraction (MVC). In the target-guided condition, subjects used a display of their previously generated force as a target to track over time. During target tracking, force tremor increased significantly in the 3–5 and 7–9 Hz ranges, compared with self-guided contractions. The underlying changes in neural drive were assessed by coherence analysis of FDI motor unit activity. During target-guided force production, pairs of simultaneously recorded motor units showed less coherent activity in the 3–5 Hz frequency range but greater coherence in the 7–9 Hz range than in the self-guided contractions. These results show that the frequency content of common synaptic input to motoneurons is altered when force production is visually guided. We propose that a change in stretch-reflex gain could provide a potential mechanism for the observed changes in force tremor and motor unit coherence.

Enhanced proprioceptive acuity at the knee in the competitive athlete

STUDY DESIGN

Controlled laboratory study: cross-sectional.

OBJECTIVE

To determine if proprioception, measured by the threshold to detection of passive motion (TDPM), differed in individuals who regularly participate in moderate-intensity exercise for fitness as compared to individuals involved in high-intensity skilled exercise.

BACKGROUND

Previous research has been equivocal as to whether exercise training is associated with superior proprioceptive acuity, in particular, exercise that includes dynamic postural challenges such as cutting and pivoting.

METHODS

Two groups of 25 healthy individuals (18-32 years old) were recruited. One group consisted of individuals who performed moderate-activity level exercises for 5 to 10 hours per week. Participants in the other group performed high-activity level exercises, including high-speed cutting and pivoting activities, at least 10 hours per week. Proprioception was determined using TDPM, in which the knee was slowly extended or flexed at an angular velocity of 0.5°/s or less from a starting position of 40° of knee flexion.

RESULTS

Individuals participating in competitive, high-intensity skilled exercise demonstrated better acuity (average of both limbs) of TDPM (mean ± SD, 0.81° ± 0.38°; P<.001) than those participating in moderate-intensity exercise for fitness (1.53° ± 0.58°). A low but statistically significant association (r = -0.38, P = .006) was found between weekly duration of exercise and proprioceptive threshold as measured by TDPM.

CONCLUSION

These results suggest that perceptual thresholds of passive movement may be enhanced, depending on activity level and associated postural challenge, and that higher level and increased amount of exercise may promote enhanced neurosensory processing in these individuals. Consequently, high-intensity skilled training may deserve further emphasis in orthopaedic rehabilitation.