Systematic changes in position sense accompany normal aging across adulthood

Abstract

BackgroundDevelopment of clinical neurological assessments aimed at separating normal from abnormal capabilities requires a comprehensive understanding of how basic neurological functions change (or do not change) with increasing age across adulthood. In the case of proprioception, the research literature has failed to conclusively determine whether or not position sense in the upper limb deteriorates in elderly individuals. The present study was conducted a) to quantify whether upper limb position sense deteriorates with increasing age, and b) to generate a set of normative data that can be used for future comparisons with clinical populations.MethodsWe examined position sense in 209 healthy males and females between the ages of 18 and 90 using a robotic arm position-matching task that is both objective and reliable. In this task, the robot moved an arm to one of nine positions and subjects attempted to mirror-match that position with the opposite limb. Measures of position sense were recorded by the robotic apparatus in hand-and joint-based coordinates, and linear regressions were used to quantify age-related changes and percentile boundaries of normal behaviour. For clinical comparisons, we also examined influences of sex (male versus female) and test-hand (dominant versus non-dominant) on all measures of position sense.ResultsAnalyses of hand-based parameters identified several measures of position sense (Variability, Shift, Spatial Contraction, Absolute Error) with significant effects of age, sex, and test-hand. Joint-based parameters at the shoulder (Absolute Error) and elbow (Variability, Shift, Absolute Error) also exhibited significant effects of age and test-hand.ConclusionsThe present study provides strong evidence that several measures of upper extremity position sense exhibit declines with age. Furthermore, this data provides a basis for quantifying when changes in position sense are related to normal aging or alternatively, pathology.

Manual aiming in healthy aging: does proprioceptive acuity make the difference?

“…Overall, these results are strongly in line with the current field of knowledge on proprioceptive acuity in older age. Specifically, several other investigators have reported an age-related decline in motion (Kokmen et al 1978;Wright et al 2011) and position sense of the upper limbs (Adamo et al 2007;Adamo et al 2009;Herter et al 2014). These deteriorations may partially be caused by physiological changes in the structure and function of muscle spindles throughout late adulthood (Herter et al 2014;Kalisch et al 2012;Proske and Gandevia 2012).…”

“…Specifically, there was no evidence to show that the withdrawal of visual feedback increased aiming errors in the non-active older adults more than in the other three groups, even though the proprioceptive ability of this group was, generally, inferior (negating hypothesis 3). Those seemingly contradicting outcomes require further attention because main body of findings from both experiments are consisted with a vast body of literature on effects of physical activity and aging on manual aiming (e.g., Chaput and Proteau 1996;Lyons et al 1996;Seidler-Dobrin and Stelmach 1998;Van Halewyck et al 2014) and proprioception (e.g., Adamo et al 2007;Adamo et al 2009;Herter et al 2014;Wright et al 2011). The specific effects of age and physical activity level on manual aiming and proprioception as emerged in findings of experiment 1 and experiment 2 are discussed in more details next.…”

“…This outcome is considered to reflect an increased dependence on limb-target control (Lyons et al 1996;Seidler-Dobrin and Stelmach 1998) which possibly allows older adults to achieve the same level of endpoint accuracy as young adults (Boisseau et al 2002;Ketcham et al 2002;Lyons et al 1996;Welsh et al 2007). The increased dependence on limb-target control in older adults may perhaps be explained by a decline in proprioceptive acuity (Adamo et al 2007;Adamo et al 2009;Herter et al 2014;Kokmen et al 1978;Wright et al 2011;see Goble et al 2009, for a review), impaired efficiency of feedback processing (Rand and Stelmach 2011;Stelmach et al 1988;Temprado et al 2013;Van Halewyck et al 2015b), or both. Indeed, well-documented evidence show that agerelated declines in proprioceptive acuity has led many to suggest that visual feedback becomes increasingly important during accurate aiming in older age (e.g., Coats and Wann 2011;Rand and Stelmach 2011;Terrier et al 2011).…”

“…These competing hypotheses were addressed in experiment 1. As proprioception traditionally consists of motion (i.e., the ability to perceive limb movements) and position sense (i.e., the ability to identify a static limb position) (Herter et al 2014;Proske and Gandevia 2012;Sherrington 1907), we anticipated that participants with poorer proprioceptive acuity (experiment 2) would also demonstrate poorer endpoint accuracy in the absence of visual feedback (experiment 1). Given the beneficial effect of physical activity on brain functions such as sensory processing, motor planning, and sensorimotor integration (Jacobs et al 2011;Nagamatsu et al 2012;Smith et al 2011;Voelcker-Rehage et al 2011; for a review, see Voelcker-Rehage and Niemann 2013), the association between declines in proprioceptive acuity and lower endpoint accuracy was expected to be more pronounced in non-active than active older adults (hypothesis 3).…”

Differential Impact of Acute Lesions Versus White Matter Hyperintensities on Stroke Recovery

“…Visually guided reaching (VGR) assesses visuomotor abilities by having participants perform center‐out reaching 28. Position matching (PM) is a test of proprioception (position sense), in which the robot moves the stroke‐affected arm to 1 of 9 locations, and the subject is instructed to move their other arm to the mirror‐image location with vision occluded 29, 30. Object hit (OH) is a test of bimanual sensorimotor control in which participants use virtual paddles at their fingertips to hit away balls that move toward them at increasing speed and frequency 31.…”