Dissertationen zum Thema „Proprioceptive stimulations“

Un séjour en réanimation a des conséquences délétères sur l'organisme, tant sur le plan physique que psychique. Évidemment indispensable pour écarter le risque vital, la réanimation entraîne, en plus de l'effort de l'organisme pour se défendre de la pathologie initiale, un alitement prolongé obligatoire. Ces deux impératifs, effort métabolique et alitement prolongé, sont à l'origine de séquelles parfois très lourdes, parfois irréversibles. Pour les patients neurolésés, ces effets délétères s'ajoutent à ceux de la lésion neurologique initiale. Alors qu'une rééducation précoce est maintenant recommandée à la fois pour les patients de réanimation et pour les patients neurolésés, les modalités les plus efficaces pour l'entreprendre restent encore floues.Cette thèse a pour objectif d'évaluer la faisabilité, la sécurité et l'efficacité de l'administration précoce, dès que possible en réanimation, de stimulations proprioceptives fonctionnelles sur des patients neurolésés. Ce moyen de rééducation s'appuie sur l'utilisation de vibrations tendineuses périphériques capables de stimuler les circuits neuronaux du système nerveux central, aux niveaux médullaire et cérébral. Deux études cliniques contrôlées randomisées ont été menées dans le cadre de cette thèse sur trois populations neurolésées de réanimation : les patients blessés médullaires, les patients traumatisés crâniens sévères et les patients neuro-vasculaires aigus. Ces travaux ont permis de montrer que l'administration précoce des stimulations proprioceptives fonctionnelles est sûre et faisable dès les premiers stades du séjour dans toutes les situations graves de réanimation. Si elles semblent ne pas éviter la fonte musculaire, ces stimulations apparaissent avoir un effet favorable sur la spasticité à court terme qui devra être confirmé par d'autres études
A stay in intensive care has harmful consequences for the body, both physically and psychologically. While essential to avert the risk of death, intensive care entails, in addition to the body's efforts to defend itself from the initial pathology, compulsory prolonged bed rest. These two imperatives - metabolic effort and prolonged bed rest - are at the root of sequelae that are sometimes very serious and sometimes irreversible. For neuro-injured patients, these harmful effects compound those of the initial neurological injury. While early rehabilitation is now recommended for both intensive care and neuro-injured patients, the most effective modalities for undertaking it remain unclear.This thesis aims to evaluate the feasibility, safety, and effectiveness of the early administration of functional proprioceptive stimulation to neuro-injured patients as soon as possible in intensive care. This rehabilitation method is based on peripheral tendon vibrations, which stimulate neural circuits of the central nervous system at the spinal and cerebral levels. Two randomized controlled clinical trials were conducted as part of this thesis on three neuro-injured critically ill populations: spinal cord injury patients, severe traumatic brain injured patients, and acute stroke patients. This work has demonstrated that early administration of functional proprioceptive stimulation is safe and feasible from the earliest stages of severe intensive care situations. Although they do not seem to prevent muscle wasting, these stimuli appear to have a favorable short-term effect on spasticity, which needs to be confirmed by further studies

La proprioception permet de fournir des informations spatio-temporelles pour calibrer un espace moteur, ajuster la trajectoire des mouvements, l'équilibre, la direction des mouvements, et la coordination intermembres et multiarticulaires. Nous prenons à partir des récepteurs sensoriels une information liée à la vitesse du geste, à sa direction, à son amplitude et à son orientation. Bien que les muscles soient définis comme étant les récepteurs sensoriels contribuant principalement à fournir une information proprioceptive, les récepteurs cutanés avec l'étirement de la peau au cours du mouvement montrent des capacités à fournir une information redondante aux récepteurs musculaires. Cependant au regard de la contribution des récepteurs musculaires, le poids attribué aux informations cutanées est relativement faible hormis dans des situations précises où la contribution des récepteurs musculaires est altérée comme en situation de fatigue musculaire ou minimisée comme lors de l'évaluation du sens de la position articulaire. Le champ de la médecine sportive suggère que les différents supports de prévention des traumatismes améliorent l'acuité proprioceptive par une stimulation des récepteurs cutanés. Il reste néanmoins quelques points à éclaircir, en particulier comment pouvons nous stimuler la peau ? Au cours de trois expérimentations, nous avons testé deux moyens, la pression et les forces de cisaillement pour améliorer l'acuité proprioceptive. Dans l'ensemble nos résultats montrent une amélioration de la pertinence des informations cutanées par une diminution de l'incertitude dans le choix de la position articulaire ce traduisant par une amélioration de la précision de nos mouvements. Cette amélioration est indépendante du niveau de pression et serait en lien avec la création de force de cisaillement là où la peau s'étire le plus avec le mouvement
Proprioception can provide spatiotemporal information for calibrating a motor space, adjust the trajectory of movement, balance, direction of movement, and coordination and Inter multiarticulaires. We take from the sensory receptors of information related to the speed of movement, its leadership, its amplitude and its direction. Although the muscles are defined as sensory receptors contributing primarily to provide information proprioceptive receptors in the skin of the tethering of the skin during movement show a capacity to provide redundant information to muscle receptors. However, in view of the contribution of muscle receptors, the weight given to information skin is relatively low except in specific situations where the contribution of muscle receptors is altered as experiencing muscle fatigue or minimized as in the evaluation of the meaning of joint position. The field of sports medicine suggests that different media Injury Prevention im prove proprioceptive acuity by stimulation of cutaneous receptors. It remains to clarify some points, especially how can we stimulate the skin? In three experiments, we tested two methods, pressure and shear forces to improve proprioceptive acuity. Overall our results show an improvement in the adequacy of the information skin by reducing the uncertainty in the choice of this joint position resulting in improved accuracy of our movements. This improvement is independent of pressure level and be linked with the creation of shear force where the skin stretches over with the movement

Thesis (M.S.)--University of North Carolina at Chapel Hill, 2007.
Title from electronic title page (viewed Apr. 25, 2008). "... in partial fulfillment of the requirements of the degree of Masters of Science in the Department of Biomedical Engineering." Discipline: Biomedical Engineering; Department/School: Medicine.

Thesis (Ph. D.)--University of Oregon, 2002.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 195-205). Also available for download via the World Wide Web; free to University of Oregon users.

Orientador: Antonio Augusto Fasolo Quevedo
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Eletrica e de Computação
Made available in DSpace on 2018-08-05T20:28:39Z (GMT). No. of bitstreams: 1 Magdalon_ElianeCristina_M.pdf: 5057993 bytes, checksum: 8b91572f38174d37b3e61c9e1b6d54f7 (MD5) Previous issue date: 2004
Resumo: Objetivo: verificar o efeito da adição da Estimulação Elétrica Neuromuscular (NMES) ao treinamento do padrão de Facilitação Neuromuscular Proprioceptiva (FNP) em membro superior de pacientes hemiparéticos pós-AVC. Metodologia: foram selecionados 10 pacientes, divididos igualmente em dois grupos. Ambos receberam o treinamento com os padrões de FNP, entretanto o grupo 2 recebeu a adição da NMES. As avaliações dos membros superiores foram realizadas pré-tratamento (iniciais), pós-tratamento (finais) e após 7 a 8 semanas do término das sessões de tratamento (tardias). Para a avaliação utilizou-se a Escala de Fugl-Meyer, o índice de Barthel Modificado (IBM) e Escala de Ashworth. Resultados: Análises não-paramétricas revelaram aumentos estatisticamente significativos na pontuação motora total do MS em todos os estágios da avaliação de Fugl-Meyer para o grupo 1. O grupo 2 somente mostrou aumento estatisticamente significativo para o estágio I x F (p-valor=O,O30), sendo para os demais estágios o p-valor>O,O5. Na escala de Ashworth encontrou-se diferença significativa somente entre a comparação dedo I dedo F do grupo 1 (p-valor=O,O30). No grupo 1, encontraram-se diferenças significativas (pvalor=O,O30) na goniometria ativa e passiva da flexão de ombro e de cotovelo I x F e I x T, e também houve diferença significativa na flexão de punho passiva F x T e extensão de punho passiva I x T. Não houve diferença estatisticamente significativa no IBM para ambos os grupos. Conclusões: analisando-se isoladamente cada grupo, o protocolo utilizado para o grupo de FNP foi suficiente para aumentar a pontuação motora do MS na Escala de Fugl-Meyer, apresentando retenção do tratamento. Entretanto a adição da NMES não foi suficiente para garantir a retenção do tratamento e alterar o IBM e Escala de Ashworth
Abstract: Objectives: The aim of this study was to evaluate the efficacy of Neuromuscular Electrical stimulation (NMES) added to Proprioceptive Neuromuscular Facilitation (PNF) patterns in upper limbs of hemiparetic patients after stroke. Methods: Ten hemiparetic subjects were divided into two groups, both receiving PNF patterns. Group 2 received, in addition, NMES. Upper limb was evaluated pre-treatment (initial - I), post-treatment (final - F) and after 7 or 8 weeks after the end of the sessions (Iate - L). Motor function was assessed with the upper extremity motor subscore of the Fugl-Meyer Assessment (FMA), the Modified Barthel lndex (MBI), and Ashworth Scale for muscular tonus. Results: Non-parametric analyses revealed statistically significant gains in Fugl-Meyer Scores between I x F, I x L and F x L (p=O,O30) in group 1. Group 2 only showed statistically significant gains for I x F, for the other combinations p>O,O5. Ashworth Score presented significant differences only for fingers I x F in group 1 (p=O,OO3). For group 1, there were significant differences (p=O,OO3) in active and passive goniometry for shoulder flexion I x F and I x L, elbow flexion I x F and Initial x L, and there were also significant differences in passive wrist flexion F x L and passive wrist extension I x L. There were not statistically significant differences in MBI for both groups. Conclusion: The methodology was able to increase the motor score of upper extremity by Fugl-Meyer Score and increasing amplitude of the passive and active movement. Meanwhile, the addition of FES was not enough to change with statistical significance the data of the Fugl-Meyer Assessment, MBI and Ashworth Scale
Mestrado
Engenharia Biomedica
Mestre em Engenharia Elétrica

A literatura tem mostrado que as deteriorações proprioceptivas relacionadas ao envelhecimento podem ter consequências funcionais graves na realização de tarefas sensório-motoras como postura e marcha. A avaliação do limiar de percepção cinestésica é uma forma de avaliação da acuidade proprioceptiva e representa uma tarefa sensório-motora, com envolvimento de receptores e vias periféricas bem como de níveis superiores do sistema nervoso central. O presente estudo teve como objetivo avançar no método de quantificação proprioceptiva do tornozelo em jovens e idosos e foi dividida em dois capítulos. O primeiro capítulo investigou aspectos eletrofisiológicos corticais associados à percepção cinestésica do tornozelo. O protocolo experimental consistiu de aquisição de sinais eletrencefalográficos durante a avaliação do tempo de resposta à percepção de movimento passivo de tornozelo em velocidades baixa (0,5º/s) e alta (22º/s). Foram realizadas análises de potencial relacionado a evento (ERP do inglês Event-Related Potential) e de dessincronização e sincronização relacionados a evento (ERD/ERS do inglês Event-Related Desynchronization/Synchronization) na faixa beta (14 a 37 Hz). Os resultados mostraram atrasos nos tempos de resposta à percepção cinestésica dos idosos correlacionados aos atrasos de ativação cortical. O componente inicial do ERP (N1) foi menor e mais tardio em idosos e pode indicar uma chegada de influxo aferente proprioceptivo atrasada e de menor magnitude ao córtex. Os idosos também apresentaram maior ativação cerebral (maior ERD), o que pode representar um maior esforço cognitivo para processar as informações proprioceptivas. Além disso, após finalizada a tarefa sensório-motora na condição de velocidade alta de movimentação passiva, a inibição cortical (ERS) esteve atenuada em idosos em comparação aos jovens. Na condição de velocidade baixa, ERS foi observada em idosos, mas não em jovens, o que indica diferenças em níveis corticais entre os grupos etários na preparação para o movimento seguinte. O segundo capítulo deste trabalho foi motivado por estudos que mostraram que níveis ótimos de ruído elétrico podem melhorar a detecção e transmissão de sinais neurais, melhorando o desempenho de tarefas sensório-motoras. O presente estudo investigou se a aplicação de estímulo elétrico (EE) na região posterior das pernas melhora a percepção cinestésica e o controle postural de jovens e idosos. O limiar cinestésico foi avaliado pelo tempo de resposta à percepção de movimento passivo de tornozelo na velocidade de 0,5º/s. O controle postural foi avaliado durante a manutenção da postura ereta em três condições: olhos fechados, olhos abertos com movimentação periódica ou não-periódica do cenário visual (paradigma da sala móvel). Os resultados indicaram que a aplicação de EE na perna levou a uma redução do tempo de resposta à percepção cinestésica em adultos jovens e idosos. A amplitude de oscilação corporal também foi reduzida em ambos os grupos etários com a aplicação de EE, porém somente na condição de movimentação não-periódica da sala móvel. A partir destes resultados, conclui-se que a aplicação de EE promove melhoras no desempenho sensório-motor, que estão possivelmente relacionadas com uma melhor sinalização de receptores periféricos. Estes achados podem ter implicações clínicas importantes para indivíduos idosos, cujas alterações proprioceptivas e posturais os tornam mais suscetíveis a quedas
The literature has shown that age-related proprioceptive impairments may have serious functional consequences in performing sensorimotor tasks such as posture and gait. The evaluation of threshold for kinesthetic perception is a way to assess the proprioceptive accuracy and represents a sensorimotor task involving receptors and peripheral pathways as well as processing in upper levels of the central nervous system. The present study aimed to advance the method for quantifying ankle joint proprioception in older and young adults, and was divided into two chapters. The first chapter investigated the cortical electrophysiological aspects of evaluation of the threshold for ankle kinesthetic perception. The experimental protocol consisted of acquisition of electroencephalographic signals during the evaluation of the response time to the perception of passive ankle movement at low (0.5 °/s) and high (22°/s) velocities. Event-related potentials (ERP) and event-related desynchronization and synchronization (ERD/ERS) in the beta band (14-37 Hz) were analyzed. The results showed delayed response times to the kinesthetic perception in older adults with correlated delay in cortical activation. The initial ERP component (N1) had lower amplitude and was delayed in the older group and may indicate delayed and deficient arrival of afferent inputs to the cortex. Older adults also showed larger cerebral activation (larger ERD), which may represent higher cognitive efforts to process the proprioceptive information. In addition, after completing the sensorimotor task in the high velocity condition of passive foot movement, cortical inhibition (ERS) was attenuated in older adults when compared to young adults. In the low velocity condition, ERS was observed in older but not in young adults, which indicates differences at cortical levels between age groups during the preparation for the next movement. The second chapter of this study was motivated by results from studies that have shown that optimal levels of electrical noise can enhance the detection and transmission of neural signals, thereby improving the performance of sensorimotor tasks. The present study investigated whether the application of electrical stimulation (ES) in the posterior region of the legs improves kinesthetic perception and postural control in young and elderly. The kinesthetic threshold was assessed by the response time to the perception of passive ankle movement at 0.5º/s. Postural control was assessed during the upright stance in three conditions: eyes closed and with periodic and non-periodic movement of the visual scenario by means of a moving room paradigm. The results indicated ES applied over the legs led to a reduction in the response time to kinesthetic perception in young and older adults. The body sway amplitude was also reduced in both age groups with application of ES, but only in the condition with non-periodic room movement. From these results, it is concluded that the application of ES promotes improvements in sensorimotor performance and it is possibly related to improvements of receptor signaling. These findings may have important clinical implications for older adults, whose proprioceptive and postural changes make them more susceptible to falls

abstract: Previously accomplished research examined sensory integration between upper limb proprioception and tactile sensation. The active proprioceptive-tactile relationship points towards an opportunity to examine neuromodulation effects on sensory integration with respect to proprioceptive error magnitude and direction. Efforts to improve focus and attention during upper limb proprioceptive tasks results in a decrease of proprioceptive error magnitudes and greater endpoint accuracy. Increased focus and attention can also be correlated to neurophysiological activity in the Locus Coeruleus (LC) during a variety of mental tasks. Through non-invasive trigeminal nerve stimulation, it may be possible to affect the activity of the LC and induce improvements in arousal and attention that would assist in proprioceptive estimation. The trigeminal nerve projects to the LC through the mesencephalic nucleus of the trigeminal complex, providing a pathway similar to the effects seen from vagus nerve stimulation. In this experiment, the effect of trigeminal nerve stimulation (TNS) on proprioceptive ability is evaluated by the proprioceptive estimation error magnitude and direction, while LC activation via autonomic pathways is indirectly measured using pupil diameter, pupil recovery time, and pupil velocity. TNS decreases proprioceptive error magnitude in 59% of subjects, while having no measurable impact on proprioceptive strategy. Autonomic nervous system changes were observed in 88% of subjects, with mostly parasympathetic activation and a mixed sympathetic effect.
Dissertation/Thesis
Masters Thesis Biomedical Engineering 2019

碩士
長庚大學
復健科學研究所
96
Background: Proprioception is the perception of joint and body movements, as well as body or body segments positions, in space. It is provided primarily by joint mechanoreceptors, superficial receptors, and muscle afferents. Proprioception may be affected by many factors such as age, gender, disease, exercise, and fatigue. Up today, the mechanisms or pathways by which fatigue influences proprioception have not been elucidated. Generally, it is well accepted that local muscular effects occur during fatigue may negatively affect proprioception. It has been proposed that in addition to the metabolic acidosis resulting from actively muscle works, stretching and laxity of the joint resulted from the repetitive joint movements might also reduce proprioception. So far, little direct evidence or research supports this hypothesis. Purpose: This study aimed to examine the effects of fatigue exercise and repetitive passive motions (RMP) on knee proprioception. Method: We employed a pretest-posttest control group design and used two active repositioning methods to measure knee proprioception before and following a fatigue exercise and a repetitive passive motion intervention. Result: Study results showed a statistically significant increase in absolute repositioning error following the fatigue exercise, and a decrease following the RPM intervention. Conclusion: This study demonstrated that a RPM protocol (120°/s over a 10°~100° range, 60 rep) was capable of improving knee joint position sense. Meanwhile, the negative effect form the muscle receptors following the fatigue exercise overwhelmed the positive effect from the RPM intervention. Clinical relevance: This study supports the clinical utilization of RPM to promote proprioception. In addition, this study suggests routines of dynamic joint movements before exercise and sports to better enhance the warm-up effects, than merely using heat pack or hot bath.

碩士
國立陽明大學
物理治療暨輔助科技學系
107
英文摘要 Background: The application of mechanical and electrical noise stimulation has been shown to improve the proprioception task in lower limbs. However, little did we know the application of stimulation to the upper limbs. Besides, there is no consistent result in the stimulation intensity. Method: We applied four different levels of stochastic resonance (no-stimulation, 70%, 90%, and 100% of their sensory threshold ST) on median nerve. The proprioception tests consist of a force task and a join position task. In the force task, subjects maintained steady grip force at 30% maximal voluntary contraction (MVC) for 1s and repeat 5 time without visual feedback. In the join angle task, subjects reproduce 30 degree of wrist extension with eye closed, and repeat 5 time for each trial. The stimulation intensity of the best performance in proprioception test was the optimal stimulation (OS). Next, Subjects perform a steady hold 30%MVC task for 30 seconds and simultaneously collect EEG and EMG tested before, during, and after 30-min stochastic resonance stimulation. Results: 70% ST has the best force task performance; 100%ST has the best join position task performance. CMC show no significant result in both beta and gamma band. The power spectrum of EEG decreases 17% in channel FC1 at the gamma band during the stimulation but show little change in beta band. After 30minutes stimulation it increase 25% in channel C3 at the gamma band but show little change in beta band. Our preliminary results indicate that stochastic resonance stimulation improves sensorimotor function and it induces brain plasticity, which can be detected using EEG and EMG.

abstract: Proprioception is the sense of body position, movement, force, and effort. Loss of proprioception can affect planning and control of limb and body movements, negatively impacting activities of daily living and quality of life. Assessments employing planar robots have shown that proprioceptive sensitivity is directionally dependent within the horizontal plane however, few studies have looked at proprioceptive sensitivity in 3d space. In addition, the extent to which proprioceptive sensitivity is modifiable by factors such as exogenous neuromodulation is unclear. To investigate proprioceptive sensitivity in 3d we developed a novel experimental paradigm employing a 7-DoF robot arm, which enables reliable testing of arm proprioception along arbitrary paths in 3d space, including vertical motion which has previously been neglected. A participant’s right arm was coupled to a trough held by the robot that stabilized the wrist and forearm, allowing for changes in configuration only at the elbow and shoulder. Sensitivity to imposed displacements of the endpoint of the arm were evaluated using a “same/different” task, where participant’s hands were moved 1-4 cm from a previously visited reference position. A measure of sensitivity (d’) was compared across 6 movement directions and between 2 postures. For all directions, sensitivity increased monotonically as the distance from the reference location increased. Sensitivity was also shown to be anisotropic (directionally dependent) which has implications for our understanding of the planning and control of reaching movements in 3d space. The effect of neuromodulation on proprioceptive sensitivity was assessed using transcutaneous electrical nerve stimulation (TENS), which has been shown to have beneficial effects on human cognitive and sensorimotor performance in other contexts. In this pilot study the effects of two frequencies (30hz and 300hz) and three electrode configurations were examined. No effect of electrode configuration was found, however sensitivity with 30hz stimulation was significantly lower than with 300hz stimulation (which was similar to sensitivity without stimulation). Although TENS was shown to modulate proprioceptive sensitivity, additional experiments are required to determine if TENS can produce enhancement rather than depression of sensitivity which would have positive implications for rehabilitation of proprioceptive deficits arising from stroke and other disorders.
Dissertation/Thesis
Doctoral Dissertation Neuroscience 2018

Title: Therapeutic intervention of low back pain - comparing of two therapeutic approaches Objectives: The main objective of this experimental study was to compare two therapeutic approaches: Sensorimotor stimulation by Janda Vávrová and Proprioceptive neuromuscular facilitation in patients with low back pain. Methods: Experimental comparative study aimed at comparing the effect of Proprioceptive neuromuscular facilitation method of Kabat and Sensorimotor stimulation by Jandy and Vávrová in patients with chronic low back pain. The probands were selected from among patients of private healthcare facilities Medi-centre Skalka s.r.o. The assessment of pain, we used a standardized questionnaire Oswestry. The data will be processed using statistical method Mann-Whitney U test. Results: The study showed no significant difference in treatment effect low back pain between Sensorimotor stimulation method by Janda and Vávrová and Proprioceptive neuromuscular facilitation. Keywords: Proprioceptive neuromuscular facilitation, Sensorimotor stimulation by Janda Vávrová, low back pain.

A dissertation submitted to the Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science in Occupational Therapy. 21 November 2016
The oculomotor system plays an important role in reading skills. A sensory stimulation oculomotor-vestibular-proprioceptive intervention programme was provided to primary school children who were based at a remedial school and were identified as poor readers. A sample of 30 children ranging between 8 years and 12 years 11 months formed the final participants for the study. Learners were divided into two groups and the programme was presented in an alternate group design with groups acting as a control when not receiving intervention. The intervention sessions were carried out twice weekly for three weeks. The assessments included the Neale Analysis of Reading, the Developmental Eye Movement test and an informal eye movement test. The change in oculomotor function and reading over the intervention and control periods for both groups was determined. The results of this study were used to explore the impact of sensory stimulation on oculomotor function and reading skills. Significant positive changes were recorded for both groups but for different components of oculomotor function and reading. Group A had significant change for eye movements across the midline, DEM horizontal scores and rate of reading. Group A continued to improve after the intervention was withdrawn. Group B had significant change for quick localisation, DEM errors scores and reading accuracy and comprehension. Moderate correlations were found between vertical and horizontal scores, accuracy, and rate of reading.
MT2017