The sensorimotor effects of a lower limb proprioception training intervention in individuals with a spinal cord injury

Qaiser, Taha; Eginyan, Gevorg; Chan, Franco; Lam, Tania

doi:10.1152/jn.00842.2018

Cited by 13 publications

(8 citation statements)

References 37 publications

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“…Following a training robotic-based proprioception training protocol in people with chronic incomplete SCI, significant improvements in endpoint and knee joint position sense and in a precision stepping task performance were shown. These results suggest altering proprioceptive sense is possible in people with incomplete SCI using a passive proprioception training [90].…”

Section: Robotic Exoskeletonsmentioning

confidence: 75%

The Role of Supraspinal Structures for Recovery after SCI: From Motor Dysfunction to Mental Health

Torre-Valdovinos¹,

Osuna-Carrasco²,

Ramos³

2021

Paraplegia

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Neural circuitry controlling limbed locomotion is located in the spinal cord, known as Central Pattern Generators (CPGs). After a traumatic Spinal Cord Injury (SCI), ascending and descending tracts are damaged, interrupting the communication between CPGs and supraspinal structures that are fundamental to initiate, control and adapt movement to the environment. Although low vertebrates and some mammals regain some physiological functions after a spinal insult, the capacity to recover in hominids is rather limited. The consequences after SCI include physiological (sensory, autonomic and motor) and mental dysfunctions, which causes a profound impact in social and economic aspects of patients and their relatives Despite the recent progress in the development of therapeutic strategies for SCI, there is no satisfactory agreement for choosing the best treatment that restores the affected functions of people suffering the devastating consequences after SCI. Studies have described that patients with chronic SCI can achieve some degree of neurorestoration with strategies that include physical rehabilitation, neuroprosthesis, electrical stimulation or cell therapies. Particularly in the human, the contribution of supraspinal structures to the clinical manifestations of gait deficits in people with SCI and its potential role as therapeutic targets is not well known. Additionally, mental health is considered fundamental as it represents the first step to overcome daily adversities and to face progression of this unfortunate condition. This chapter focuses on the consequences of spinal cord disconnection from supraspinal structures, from motor dysfunction to mental health. Recent advancements on the study of supraspinal structures and combination of different approaches to promote recovery after SCI are discussed. Promising strategies are used alone or in combination and include drugs, physical exercise, robotic devices, and electrical stimulation.

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Section: Robotic Exoskeletonsmentioning

confidence: 75%

The Role of Supraspinal Structures for Recovery after SCI: From Motor Dysfunction to Mental Health

Torre-Valdovinos¹,

Osuna-Carrasco²,

Ramos³

2021

Paraplegia

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“…In addition, recent studies show that (a) proprioceptive impairment affects the rate of learning a precision walking task (Chisholm, Qaiser, Williams, Eginyan, & Lam, 2019) and (b) the magnitude of improvement after gait training is related to pretraining proprioceptive sense (Qaiser, Eginyan, Chan, & Lam, 2019). The protocol developed in the present study could therefore also be used as a baseline assessment tool to potentially predict therapy outcome and help in patient screening.…”

Section: Discussionmentioning

confidence: 88%

Ankle proprioception during gait in individuals with incomplete spinal cord injury

et al. 2019

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IntroductionProprioception is known to be affected after a spinal cord injury (SCI). However, it is currently assessed during simple tasks that do not reflect activities of daily living. To better understand how proprioception affects movement, assessing it during a functional sensorimotor task such as walking is therefore of primary importance.Therefore, the objectives of this study were as follows: (a) measure the protocol reliability of a new robotic test in nondisabled controls; (b) evaluate the effect nonlesion‐related factors such as sex, age, pain, and gait speed on ankle proprioception; and (c) assess ankle proprioception during walking in individuals with SCI.MethodsIn the current study, ankle proprioception was assessed during gait in individuals with an incomplete spinal cord injury (iSCI; n = 15) using an electrohydraulic robotized ankle–foot orthosis (rAFO). Ankle proprioceptive threshold was quantified as the participants’ ability to detect torque perturbations of varied amplitude applied during swing by the rAFO. In addition, test–retest reliability and the potential effect of nonlesion‐related factors (sex, age, pain, and gait speed) were evaluated in nondisabled (ND; n = 65) participants.ResultsDuring gait, individuals with iSCI had a 53% poorer proprioceptive threshold than ND controls (p < .05). Test–retest reliability was good (ICC = 0.78), and only gait speed affected proprioceptive threshold (p = .018).ConclusionThis study is the first to show that ankle proprioception assessed during gait is impaired in individuals with an iSCI. The developed test can now be used to better characterize proprioception in population with other neurological conditions and has potential to maximize functional recovery during gait training in those populations.

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“…Only one study used passive movement training as the primary intervention. Qaiser et al ( 60 ) investigated the effects of passive leg movements on proprioception and a spatial precision stepping task in 15 individuals with spinal cord injury and ten healthy controls. There was a 23% reduction in passive JPSE post-training (5.22° to 4.03°) across participants and a 20% reduction of precision error in the stepping task in the eight participants with spinal cord injury who were able to perform the task.…”

Section: Resultsmentioning

confidence: 99%

The Effectiveness of Proprioceptive Training for Improving Motor Performance and Motor Dysfunction: A Systematic Review

Winter

Huang

Sertic

et al. 2022

Front. Rehabilit. Sci.

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ObjectiveProprioceptive training is any intervention aiming to improve proprioceptive function with the ultimate goal to enhance motor function and performance. It has been promoted as an approach to enhance athletic performance and as a tool for sensorimotor rehabilitation. Numerous studies sought to provide evidence on the effectiveness of the approach. However, many different training regimes claiming to train proprioception report a variety of sensorimotor measures that are not directly comparable. This, in turn, makes it difficult to assess effectiveness across approaches. It is the objective of this study to systematically review recent empirical evidence to gain an understanding of which outcome measures are most sensitive, which populations may benefit most from proprioceptive training, and what are the effects on proprioceptive and motor systems.MethodsFour major databases were searched. The following inclusion criteria were applied: (1) A quantified pre- and post-treatment measure of proprioceptive function. (2) An intervention or training program believed to influence or enhance proprioceptive function. (3) Contained at least one form of treatment or outcome measure that is indicative of somatosensory function and not confounded by information from other sensory modalities. 4) The study reported of at least one quantified measure of motor performance.ResultsOf the 3,297 articles identified by the database search, 70 studies met the inclusion criteria and were included for further review. Across studies, proprioceptive training led to comparable gains in both proprioceptive (+46%) and motor performance (+45%). The majority of studies (50/70) applied active movement interventions. Interventions applying somatosensory stimulation were most successful in clinical populations. Joint position sense error (JPSE) was the most commonly used proprioceptive measure and presents a reliable and feasible measure for clinical use.ConclusionProprioceptive training can lead to significant improvements in proprioceptive and motor function across a range healthy and clinical populations. Regimens requiring active movement of the trainee tended to be most successful in improving sensorimotor performance. Conclusive evidence on how long training gains are retained is still lacking. There is no solid evidence about the underlying long-term neuroplastic changes associated proprioceptive training.

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The sensorimotor effects of a lower limb proprioception training intervention in individuals with a spinal cord injury

Cited by 13 publications

References 37 publications

The Role of Supraspinal Structures for Recovery after SCI: From Motor Dysfunction to Mental Health

The Role of Supraspinal Structures for Recovery after SCI: From Motor Dysfunction to Mental Health

Ankle proprioception during gait in individuals with incomplete spinal cord injury

The Effectiveness of Proprioceptive Training for Improving Motor Performance and Motor Dysfunction: A Systematic Review

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