Changes In Proprioception Research Articles

Biomechanical aspects of gait impairments after stroke: an analytical review

Restoring gait and balance functions after stroke constitutes a major problem in modern neurology. Post-stroke static and locomotor impairments are the most common disabling consequences that are critical for patients’ quality of life and basic functional independence. This analytical review attempts to comprehensively examine and assess the biomechanical aspects affecting the gait in patients with post-stroke static and locomotor impairments. The review outlines the multifaceted nature of such impairments, including muscle weakness, changes in neuromotor coordination, proprioception and stability, as well as compensatory mechanisms developing in patients. A particular focus is on biomechanical parameters, including kinematics and kinetics of movements, to provide a deeper understanding of the nature of impairments in order to develop more effective treatment strategies. The analysis highlights the importance of a personalized rehabilitation approach to be based on specific impairments of each patient. This review is intended to enhance the understanding of the biomechanical aspects of gait impairments for further research and development of innovative approaches in rehabilitation. The data presented are of great importance for the development and elaboration of personalized medical rehabilitation plans for post-stroke patients and may contribute to improving their functional independence and quality of life.

Aging Alters the Sense of Force but Not the Sense of Position in the Wrist and Ankle Joints

Introduction: The impact of aging on proprioceptive senses remains an open question. As the senses of position and force may rely on different neural substrates, we investigated the effect of aging on both senses to provide original and more comprehensive data on age-related changes in proprioception. Methods: The senses of position and force were assessed in several conditions using position- and force-reproduction tasks in young (20–40 years) and older (60–90 years) adults in the wrist (experiment 1, n = 41, 20 older adults) and ankle joints (experiment 2, n = 46, 24 older adults). Results: In both experiments, older adults exhibited larger force-reproduction errors than young adults at low (5% maximal force, p < 0.001) but not moderate forces (20% maximal force, p > 0.056). No age-related decline was observed for position-reproduction errors (p > 0.30), regardless of movement amplitude. Rare weak-to-moderate correlations were observed between position- and force-reproduction errors (r ≤ 0.53, p ≥ 0.009). Conclusion: In wrist and ankle joints, the age-related decline in proprioception is limited to the sense of force, especially for low forces. This nonuniform decline in proprioception across proprioceptive senses and testing conditions could reflect a decline in the central processing of proprioceptive information.

Relationship between reticulospinal system sensitization and proprioceptive pathways in the development of dynamic spasticity (ReProDS) post-spinal cord injury: protocol for a prospective, observational cohort study.

Dynamic spasticity (DS) is a common complication post-spinal cord injury (SCI), marked by intermittent increases in muscle tone during postural transitions or movement. Despite its prevalence, high-quality research on DS incidence, risk factors, and underlying mechanisms in SCI patients remains limited. With the growing application of spinal cord stimulation (SCS) for spasticity control, the role of proprioception in DS development has garnered attention. Additionally, advances in diffusion tensor imaging (DTI) allow for the analysis of the reticulospinal tract's (RST) role in postural control among SCI patients. However, the impact of microstructural changes in RST and proprioception on DS following SCI remains unclear. To investigate the relationship between microstructural changes in the RST and proprioceptive circuits in SCI patients, exploring their association with DS and potential predictive factors that influence recovery. This is a 12-month prospective cohort study. The neurophysiological and global functional status of the participants will be assessed. Primary outcomes include DTI indices of RST and proprioception, and spasticity assessment. Secondary outcomes include auditory startle reflex (ASR), H-reflex, shear wave velocity (SWV), overall functional status including spinal cord independence measure, gait analysis, modified Barthel Index, and the 36-item short form health survey. Data will be collected at 1, 3, 6, and 12 months after enrolment. Matched healthy controls will be measured during the same period after recruitment. This study is the first to explore the role of microstructural changes in the RST and proprioception in the assessment and prediction of DS following SCI. The findings aim to enhance theoretical understanding of SCS in spasticity management and to establish pre-treatment criteria for SCS interventions targeting motor function recovery in SCI. ChiCTR2400090724.

The Relationships Among Proprioception, Balance, and Cognitive Perception of Body Awareness in College Students: A Pilot Study

Introduction: This pilot study examined the relationships among lower extremity proprioception, balance ability, and perception of body awareness. Researchers also evaluated the influence of sex, sport participation, leg dominance, and previous ankle injury. Methods: Eighteen participants (F = 11, M = 7) completed the initial testing, with eight (F = 4, M = 4) repeating the mLEPT one week later. Participant characteristics and mBARQ data were collected using an online survey. Measures included proprioception errors on the mLEPT, utilizing distances of 12 and 22 cm, and the Biodex Balance SystemÔ Limits of Stability Test. Results: For the mLEPT, good reliability was noted for the dominant leg 22 cm distance between trials 1 and 2 for all 18 participants (ICC = 0.83). Moderate test-retest reliability was observed when comparing the averages of day 1 to day 2 for the dominant leg 22 cm distance (ICC = 0.53), and for the overall error when collapsing across conditions (ICC = 0.63). Moderate reliability was also observed for the mBARQ (α = 0.76). Strong inverse relationships between proprioception error and directional control scores were observed, indicating an association between dynamic balance and lower extremity proprioception (r = -0.55-0.54, p = 0.02). Sex, sports participation, leg dominance, and previous ankle injury also influenced proprioception performance. Females displayed better lower extremity proprioception and balance control than males. In addition, participants without previous ankle injury scored higher on the mBARQ, and had better directional control and time to completion, indicating that those without ankle injury had a higher perception of body awareness and better dynamic balance. Conclusions: Both the mLEPT and mBARQ appear to have moderate reliability. mLEPT performance was strongly associated with dynamic balance measures. In addition, lower mBARQ scale scores in those with previous ankle injury were strongly associated with poorer proprioception. While preliminary findings are promising, a larger follow-up study is needed to determine if the mLEPT and mBARQ are potential quick and inexpensive tools to monitor changes in proprioception during rehabilitation post-injury.

The Effect of Total Knee Replacement on Dual-Task Gait Performance in Older Adults.

Total knee replacement (TKR) is a common solution for patients with advanced knee osteoarthritis (OA). Still, fall rates remain relatively high after surgery. TKR may alter pain and knee function, balance control, and proprioception. However, given the role of complex (dual-task) walking in fall prediction for older adults, it is unknown how TKR alters the attentional demand of walking in older adults. The goal of this study was to examine the effect of TKR on dual-task walking among older adults. Participants were evaluated 1month before surgery and 4.5months after surgery. Participants walked along an instrumented 7-meter path for 1minute with and without a cognitive task (serial-3 subtraction). Pain and knee function, knee proprioception, dynamic balance, and balance confidence, as well as dual-task costs (DTC) were compared before and after the surgery and factors associated with change in gait DTCs were assessed. Thirty-eight participants completed the study (age 72.6years, SD = 4.9; 11 men). A significant decrease in pain was found following TKR, with no change in balance, balance confidence, or proprioception. There were no differences in gait DTCs before and after the surgery. However, change in dynamic balance, specifically reactive postural control and dynamic gait, predicted changes in gait speed and stride time DTCs. The absence of an effect of TKR on gait DTCs can potentially underlie increased fall risk after TKR. Results from this study emphasize the significance of balance as a measure and focal point for rehabilitation after TKR. This study contributes to our understanding of the attentional cost of walking in people before and after TKR, as well as to factors associated with it. Results from this work can assist formulation of rehabilitation programs for people with knee OA.

Biometric Image-Analysis Techniques for Monitoring Chronic Neck Pain

The term “mechanical neck pain” is a generic term used to define neck pain in people with neck injuries, neck dysfunction, or shoulder and neck pain. Several factors must be considered during the physical-therapy evaluation of cervical disorders, including changes in the visual systems and postural and proprioceptive balance. Currently, the Cervicocephalic Relocation Test (CRT) is used by physiotherapists to detect changes in cervical proprioception. This procedure requires precise equipment, customized installation in a dedicated area and, above all, a significant amount of time post-treatment for the doctor to make the diagnosis. An innovative system composed of Google’s MediaPipe library combined with a personal laptop and camera is proposed and evaluated. The system architecture was developed, and a user interface was designed with the goal of allowing the system to be used more easily, more quickly, and more effectively by the healthcare practitioner. The tool is presented in this paper and tested in a use case, and the results are presented. The final user report, containing the visualization of the results of the CRT, which are ready for analysis by the physical therapist, can be exported from the developed tool.

Perceptual error based on Bayesian cue combination drives implicit motor adaptation.

The sensorimotor system can recalibrate itself without our conscious awareness, a type of procedural learning whose computational mechanism remains undefined. Recent findings on implicit motor adaptation, such as over-learning from small perturbations and fast saturation for increasing perturbation size, challenge existing theories based on sensory errors. We argue that perceptual error, arising from the optimal combination of movement-related cues, is the primary driver of implicit adaptation. Central to our theory is the increasing sensory uncertainty of visual cues with increasing perturbations, which was validated through perceptual psychophysics (Experiment 1). Our theory predicts the learning dynamics of implicit adaptation across a spectrum of perturbation sizes on a trial-by-trial basis (Experiment 2). It explains proprioception changes and their relation to visual perturbation (Experiment 3). By modulating visual uncertainty in perturbation, we induced unique adaptation responses in line with our model predictions (Experiment 4). Overall, our perceptual error framework outperforms existing models based on sensory errors, suggesting that perceptual error in locating one's effector, supported by Bayesian cue integration, underpins the sensorimotor system's implicit adaptation.

Responsiveness of the cervical joint position error test to detect changes in neck proprioception following four weeks of home-based proprioceptive training.

People with chronic neck pain (CNP) commonly exhibit a range of physical impairments including cervical proprioceptive deficits. Assessing proprioception using a head mounted laser to assess joint position error (JPE) is a reliable and valid measure. However, the responsiveness of this measure has not been assessed. To assess the responsiveness of the measure of cervical JPE after a 4-week home-based neck proprioceptive training intervention in people with CNP. An observational study to assess the responsiveness of the measure of cervical JPE. The JPE test was assessed in people with CNP before and after 4 weeks of neck proprioception training. JPE was assessed as participants performed neck joint position sense tests for flexion, extension, right rotation, and left rotation in sitting and standing which were performed in a random order. Both the absolute and constant JPE were assessed. The intervention consisted of neck repositioning exercises as well as movement sense exercises. Cohen's d effect size was used to assess the internal responsiveness of the JPE test. The Pearson's correlation was used to assess the change of scores of the laser pointer and measures from inertial measurement units (IMUs) (external responsiveness). After 4 weeks of proprioception training, JPE assessed in sitting reduced from 2.69◦-3.57◦ to 1.88◦-1.98◦ for flexion, extension, and right rotation with large effect sizes (Cohen's d range: 1.25-2.00). For left rotation, JPE reduced from 3.23◦ to 1.9◦, and the effect size was close to being large (Cohen's d: 0.79). When assessed in standing, JPE reduced from 3.49◦-4.52◦ to 1.5◦-2.33◦ with large effect sizes (Cohen's d range: 0.89-1.25) for flexion, extension, right rotation, and left rotation. Large effect sizes were not observed for the constant JPE when assessed in either sitting or standing. The assessment of the external responsiveness revealed weak correlations between the change of scores obtained from the laser pointer and the IMUs for all movements, apart from the constant JPE in sitting for left rotation, which showed a strong correlation (r = 0.7). The results of this study showed that the measure of the JPE has sufficient internal responsiveness, however, the external responsiveness was inadequate. Further research is advised.

Effects of Nontraditional Division III Lacrosse Participation on Movement Pattern Quality and Dynamic Postural Control.

No studies have observed the effects of a collegiate lacrosse season on movement pattern quality, dynamic postural control, or the accuracy of athletes' perceived movement pattern quality. The purpose was to examine the effects of a nontraditional fall season on movement pattern quality, perceived movement pattern quality, and dynamic postural control in collegiate lacrosse athletes. Cross-sectional laboratory study. Fifty men's (age=19.38±1.24 years, height=182.63±6.16 cm, mass=82.37±8.46 kg) and 22 women's (age=19.68±1.17 years, height=165.10±6.88 cm, mass=64.09±8.72 kg) lacrosse players were recruited. Outcome measures included individual Functional Movement Screen™ (FMS™) scores, self-reported perceived movement pattern quality scores, lower and upper extremity Y-Balance Test (YBT) measurements, and active dorsiflexion range of motion (ROM) before the start and again at the end of the fall lacrosse season. Pre- and post-season measurements were assessed using paired t-tests and chi-squared analyses. FMS™ composite scores did not significantly change from preseason to postseason for males (p=0.74) or females (p=0.07). Male perceived movement pattern quality was significantly higher than measured for 10 of 12 movements (p<0.05). Female perceived movement pattern quality was significantly higher than measured for four of 12 movements (p<0.05). Asymmetry frequency significantly increased in males in the hurdle step from two individuals to nine (1=25.52, p<0.01), inline lunge from 10 to 20 (1=12.50, p<0.01), and shoulder mobility from 4 to 21 (1=78.53, p<0.01). Asymmetries in male athletes significantly decreased in the active straight leg raise from 26 to 8 (1=25.96, p<0.01). YBT composite scores increased in males for the right leg (p=0.001) and left leg (p<0.03). Right dorsiflexion ROM (p<0.001) and left dorsiflexion ROM (p<0.001) significantly decreased in males from preseason to postseason. YBT scores for the right leg significantly increased in females from preseason to postseason (p=0.01). YBT scores for females for the right arm significantly increased from preseason to postseason (p=0.045). A 5-week season may not change overall movement pattern quality of men's or women's lacrosse players, but some individual movement scores diminished. Athletes may overestimate self-reported movement pattern quality and are therefore unlikely to individually address movement deficits. Male dynamic postural control may change throughout a season, resulting in a potential increased risk of injury later in the season due to compensatory patterns or changes in mobility, proprioception, or balance. 3b.

INFLUENCE OF THE ERGON TECHNIQUE ON THE PROPRIOCEPTION OF A PATIENT WITH A BIMALLEOLAR FRACTURE

Purpose: The aim of the study was to follow the influence of the Ergon Technique on proprioception in patients after surgical treatment of bimalleolar ankle fracture. Material/Methods: 30 patients with a bimalleolar fracture in the subacute postoperative period were studied, divided as follows: control group (CG) - 15 patients and experimental group (EG) - 15 patients. In CG, a traditional model of kinesitherapy is applied, and in EG, an experimental model is applied, which includes twice a week and Ergon Technique. To monitor changes in proprioception, a test was conducted: a balanced stance on the injured leg on a hard and flat surface was performed, and the time the patient maintained balance (in seconds) was recorded. Results: The mean values (±SD) after one month of kinesitherapy application are as follows: in the control group 0,9333+0,88 sec. and 3,0 sec. in the experimental group. After three months of treatment, the results are as follows: in the control group, 3,93+2,49 sec. And 9,2+4,19 sec. in the experimental group. The values of P show that the established difference in the mean values ​​of the indicator in the two groups after three months of kinesitherapy is statistically significant and proves a higher efficiency of the experimental model compared to the traditional one applied in the control group at P&lt;0.05. Conclusion: In the conducted study, we found that there were statistically significant differences in both groups. In EG, we found that Ergon Tehnique has a better effect on proprioception in patients with bimalleolar fracture of the ankle joint compared to the applied traditional model of kinesitherapy in CG.

Reference value of knee position sense in weight-bearing and non-weight-bearing conditions

BackgroundOur study aimed to identify age-related changes in knee proprioception to provide reference values for weight-bearing (WB) and non-weight-bearing (NWB) conditions and to identify factors (age, WB condition, dominance, and sex) that can affect knee proprioception.MethodsA total of 84 healthy adult men and women were recruited. Active knee joint position sense (JPS) was measured using a digital inclinometer for knee proprioception. The participants performed the required movements actively, with verbal feedback from the examiner, slowly moving to the target angles (30° and 50°) and maintaining them for 5 s before returning to the starting position. Afterward, without assistance from the examiner, the participants actively moved back to the same angle, and the examiner confirmed the angles. This procedure was repeated twice for each target angle, and the average values were used as the data. The participants were barefoot, wearing shorts, and closed their eyes while the measurements were obtained. The measurements were first obtained on the dominant side under the NWB conditions. When a change in posture was needed during the measurement, the participants sat in a resting position for 2 min.ResultsExcept for age, all other factors (WB condition, dominance, sex) were not statistically significant. Age showed a significant difference in knee JPS, except for the non-dominant side at 30° and the dominant side at 50° in the NWB condition.ConclusionThis study indicates that the WB condition, dominant side, and sex need not be considered when measuring and assessing knee JPS. Age shows a negative correlation with knee joint position sense, and the reference values presented in this study can be used as objective target values during the rehabilitation process.

Proprioception and Mechanoreceptors in Osteoarthritis: A Systematic Literature Review.

Osteoarthritis (OA) is one of the most common chronic diseases in the world. It is frequently accompanied by high levels of persistent pain, as well as substantial impairments in function and functional capacity. This review aims to systematically analyze the changes in proprioception and related mechanoreceptors in OA patients. Studies from September 2013 to September 2023 were identified by conducting searches on the PubMed, Web of Science, and Scopus electronic databases following the PRISMA statement. One reviewer independently assessed and screened the literature, extracted the data, and graded the studies. The body of evidence underwent an evaluation and grading process using the ROBINS-I tool, which was specifically designed to assess the risk of bias in non-randomized studies of interventions. Results were summarized using descriptive methods. A search through 37 studies yielded 14 clinical studies that were ultimately included. The primary focus of the studies was on the knee joint, particularly the posterior cruciate ligament (PCL). The studies found that PCL in OA patients had impaired proprioceptive accuracy, possibly due to changes in mechanoreceptors (Ruffini, Pacini, and Golgi Mazzoni corpuscles). This suggests that dysfunctional articular mechanoreceptors, especially in severe cases of OA, may contribute to reduced proprioception. Dynamic stabilometry also identified significant proprioceptive deficits in patients with knee articular cartilage lesions, underscoring the impact of such lesions on knee proprioception. Literature data have shown that proprioceptive accuracy may play an important role in OA, particularly in the knee PCL and cartilage. However, the role of proprioception and related mechanoreceptors needs to be further clarified. Future studies focusing on the relationship between proprioception, OA disease, and symptoms, considering age and gender differences, and exploring OA joints other than the knee should be conducted to improve clinical and surgical outcomes in cases where proprioception and mechanoreceptors are impaired in OA patients.

Changes in proprioception at different time points following anterior cruciate ligament injury or reconstruction

PurposeTo investigate the changes in 30° and 60° position sense in patients with anterior cruciate ligament (ACL) injury at different time points after injury and reconstruction.MethodsPatients were divided into six groups according to time after ACL injury and reconstruction: group A (ACL injury 1.5–6 months), group B (ACL injury 6–12 months), group C (ACL injury > 12 months), group D (postoperative ACL reconstruction 1–6 months), group E (postoperative ACL reconstruction > 6 months), and group F consisting of 14 healthy adults (control group). The ability of the affected leg to reproduce the same joint position during knee flexion was tested using active joint position sense assays to assess proprioception in both the lower extremities of the patient or between groups.ResultsProprioception decreased rapidly during the early stages of ACL injury. Significant difference in the affected side at 30° compared to the healthy side (Group A: 4.70 (4.78, 9.00) vs 4.15 (3.35, 6.13), P = 0.03; Group B: 2.90 (0.48, 4.56) vs 8.30 (4.18, 10.43), P = 0.001; Group E: 6.25 (2.55, 11.60) vs 9.60 (3.90, 12.73), P = 0.009). However, no significant differences were detected for a double lower limb contrast of 60° (Group A: 5.1 (1.00, 8.00) vs 3.00 (0.75, 3.55), P = 0.044). Finally, the affected side of patients in groups C, D and E had significant differences in position perception at 30° compared with healthy subjects (P < 0.01), and the affected side of patients in groups C and E had significant differences in position sense at 60° compared with healthy subjects (P < 0.01).ConclusionACL injury had a greater impact on the patient's 30° position sense, with only a small impact for 60°. Further, the early and middle proprioception recovery stages after ACL injury were the best before surgery. Finally, proprioception recovery training should be performed soon after injury.

Age-Related Changes in Plantar Sensation and Ankle Proprioception in Adolescents to Older Adults.

Plantar sensation and ankle proprioception occur in a stage-like variance across the life span. However, changes in adolescents, young adults, middle-aged adults, and older adults remain unclear. The aim of this study was to investigate the differences of plantar sensation and ankle proprioception in adolescents to older adults. A total of 212 participants were recruited in the study and were divided into four groups, including adolescents (n = 46), young adults (n = 55), middle-aged adults (n = 47), and older adults (n = 54). Plantar tactile sensitivity/tactile acuity/vibration threshold and ankle movement threshold/joint position sense/force sense were assessed in all groups. The Kruskal-Wallis H test was used to analyze the differences in Semmes-Weinstein monofilaments between different age groups in different plantar positions. One-way analysis of variance was used to determine differences in foot vibration threshold, two-point discrimination, and ankle proprioception between different age groups. Significant differences were found in the Semmes-Weinstein monofilament test (p < .001), the two-point discrimination test (p < .05), and the vibration threshold test (p < .05) in the six tested plantar positions among adolescents, young adults, middle-aged adults, and older adults. For ankle proprioception, significant differences were found in movement thresholds in ankle plantar flexion (p = .01), ankle dorsiflexion (p < .001), ankle inversion (p < .001), and ankle eversion (p < .001), as well as relative absolute errors in the ankle force senses of ankle plantar flexion (p = .02) and ankle dorsiflexion (p = .02) across the four age groups. Plantar sensation and ankle proprioception were sensitive in adolescents and young adults than in middle-aged adults and older adults.

Reducing Lumbar Flexion in a Repetitive Lifting Task: Comparison of Leukotape and Kinesio Tape and Their Effect on Lumbar Proprioception

Rigid leukotape applied to the skin of the trunk dorsum, superficial to the lumbar paraspinals, has been shown to reduce lumbar flexion in repetitive lifting, with the potential to reduce the risk of injury in jobs requiring the handling of material. It is unclear which mechanism underpins this reduction, and whether a tape with more elastic properties (i.e., kinesio tape) can yield similar results. In this study, twelve participants were randomly allocated into two groups, and practiced a repetitive lifting task with either leukotape or kinesio tape applied to the skin of their trunk dorsum. The participants also performed a sagittal plane repositioning task to assess changes in lumbar proprioception. The results showed a small reduction in lumbar flexion in the kinesio tape group and a moderate reduction in the leukotape group, and suggested a reduction in repositioning errors in the kinesio tape group only. We suggest that leukotape may correct the movement and improve performance during a flexion-based task, while kinesio tape may improve lumbar proprioception and promote learning. These results have implications for the choice and use of wearable textiles aiming to reduce injury risks in the manual handling industry.

Does Taping Have an Immediate Effect on Shooting the Target?

In overhead shooting athletes may have increased activity of the upper trapezius and inhibition of other shoulder muscles active during upper extremity elevation. In this study, we aimed to increase target retention and shoulder proprioception sense accuracy by taping in a way that would activate the lower trapezius muscle in elite adolescent archers. Our participants were 43 elite young athletes, aged 11-14 years, from the Archers Foundation Sports Club. We gathered athletes' sociodemographic information (age, height, weight, gender, the time they were engaged in archery, and other sports they were involved in), and we assessed their posture via the New York Posture Scale (NYPS) before taping. We evaluated them for the presence of scapular asymmetry using the Lateral Scapular Slide Test (LSST) and assessed their proprioception with the active displacement test and their target-reaching performances with the Archery Shooting Score (ASS). Since testing and scoring with the ASS is different for 11-12 and 13-14 age groups, we divided this sample into two different age groups for all analyses. There were significant changes in ASS and proprioception in both age groups, with medium to large effect sizes. There were between intragroup pre- and post-taping changes in classification according to the presence of scapular asymmetry, and there were significant changes in the archery shooting score and proprioception in both groups, with medium to large effect sizes (p < 0.05). Thus, taping applied to the lower part of the trapezius had a large to medium effect on proprioception and shooting accuracy improvement in these young archers.

Effects of neck proprioceptive modulation on pallidal network connectivity in dystonia.

Cervical dystonia (CD) is the third most common movement disorder affecting 1 million people worldwide. Proprioceptive modulation is the hallmark of contemporary therapies for dystonia, but the mechanism for this intervention is unclear. We studied proprioceptive influence on CD by measuring the spontaneous single-neuron responses and local field potentials (LFP) from the globus pallidus interna (GPi) in 17 CD patients (9 isolated CD and 8 with CD as a feature of generalized dystonia). The goal was to examine how high-frequency neck vibration, a putative modulator of neck proprioception changes pallidal physiology. We found that the neck vibration instantaneously alters the pallidal single neuron activity. We also found that neck vibration modulates pallido-cerebellar connectivity by changing alpha band in LFP recordings. The effects were more robust in those with isolated CD. The vibration also affects pallido-hippocampal connectivity by modulating theta-band power. These effects were more robust in CD with generalized dystonia. Vibration changed LFP only in select pallidal regions. Regions where LFP power was substantially modulated had a prominent proportion of burst subtypes of neurons, compared to pause or tonic subtypes. Such disparity in subtype was absent in regions where the LFP power was not modulated or subtly reduced with neck vibration. When changes in the theta, alpha and beta bands of the LFP recordings were compared against each other in response to vibration, high correlation was observed.

Боль в спине у пожилых — современное состояние проблемы

The article discusses various aspects of chronic pain syndrome in general and chronic back pain in elderly patients. The frequency of chronic pain occurrence in the elderly, according to different authors, is up to 83.8%, chronic back pain ranges from 27 to 86%. The negative impact of chronic back pain on the life quality of elderly patients was shown. Correlations were found between chronic back pain and such conditions as an increased risk of falls, fractures, and the development of dementia. Chronic pain syndrome in people over 60 y. o. contributes to a risk of mortality increase by 57%. The reasons for the chronic back pain development are not only degenerative-dystrophic changes in the spine, but also changes in proprioception and locomotor function. The analysis of the literature substantiates the need for further research on chronic back pain in the elderly.

Distorted body schema after mastectomy with immediate breast reconstruction: a 4-month follow up study.

BackgroundAfter breast cancer, some patients report residual pain-related upper limb disability without physical impairment. Although pain and altered proprioception are known to affect the working body schema (WBS), there is little available evidence investigating the WBS of breast cancer survivors (BrCS). WBS—body representations in the brain—affect the “neuromatrix” that modulates pain sensitivity and the threshold for threatening stimuli. The aim of this study was to investigate whether WBS was disrupted after mastectomy with immediate breast reconstruction (IBR) for breast cancer and whether pain and proprioceptive changes affected WBS.MethodsThirty-five BrCS participated in the 4-month follow-up study. They were observed at 1 and 4 months postoperatively. The main outcome measures were the left right judgement test (LRJT) results, absolute angle error, pectoralis minor length index (PMI), pain, and Quick-Disabilities of the Arm, Shoulder, and Hand (Q-DASH) score. They were measured at each observation, and parametric tests were performed to identify the nature of WBS.ResultsBoth the reaction time and accuracy of the hand LRJT were poorer than those of the foot and back LRJT (p < 0.001). The hand LRJT reaction time and accuracy were unchanged over the total follow-up period (p = 0.77 and p = 0.47, respectively). There was a weak correlation between the LRJT reaction time and PMI (r = −0.26, p = 0.07), pain severity (r = 0.37, p = 0.02), and Q-DASH score (r = 0.37, p = 0.02). There was also a weak correlation between LRJT accuracy and Q-DASH score (r = −0.31, p = 0.04). The LRJT accuracy of BrCS who underwent surgery on their dominant side was higher than that of BrCS who underwent surgery on their non-dominant side (p = 0.002). Regression analysis found a weak but significant relationship between the early hand LRJT results and late pain severity (adjusted R2 = 0.179, p = 0.007). A similar relationship was found between early hand LRJT results and Q-DASH score (adjusted R2 = 0.099, p = 0.039).ConclusionTo the best of our knowledge, this is the first study providing the nature of WBS after mastectomy with IBR. In this population, it is necessary to postoperatively preserve WBS integrity for pain and upper limb disability.

Prospective comparative study between knee alignment-oriented static and dynamic balance exercise in patellofemoral pain syndrome patients with dynamic knee valgus.

Exercise therapy has been reported as an effective treatment method for patellofemoral pain syndrome (PFPS). However, there is a lack of studies regarding the effectiveness of balance exercise in the treatment of patients with PFPS. This study aimed to prospectively compare changes in proprioception, neuromuscular control, knee muscle strength, and patient-reported outcomes between patients with PFPS treated with knee alignment-oriented static balance exercise (SBE) and dynamic balance exercise (DBE). The participants were divided into 2 groups: 17 knee alignment-oriented SBE group and 19 knee alignment-oriented DBE group. Proprioception was assessed by dynamic postural stability using postural stabilometry. Neuromuscular control and knee muscle strength were measured for acceleration time and peak torque in quadriceps muscle using an isokinetic device. Patient-reported outcomes were evaluated using a visual analog scale for pain and the Kujala Anterior Knee Pain Scale. There was greater improvement in dynamic postural stability (0.9 ± 0.3 vs 1.2 ± 0.5; 95% confidence interval [CI]: 0, 0.6; Effect size: 0.72; P = .021) and quadriceps AT (40.5 ± 14.3 vs 54.1 ± 16.9; 95% CI: 2.9, 24.2; Effect size: 0.86; P = .014) in the DBE group compared to the SBE group. Knee alignment-oriented DBE can be more effective in improving dynamic postural stability and quadriceps muscle reaction time compared with the knee alignment-oriented SBE in PFPS patients with dynamic knee valgus.