Limb Proprioception Research Articles

Joint position and force senses in young female tennis players and untrained adolescents.

The aim of the study was to determine the differences between tennis players and untrained peers in the development of upper limb proprioception in 10-15-year-olds. A group of 67 girls (12.75 ± 1.46 years old), including 33 tennis players and 34 age-matched untrained controls, was divided into three age groups: A1, 10-11-years-old; A2, 12-13-years-old; and A3, 14-15-years-old. Joint position sense (JPS) and force sense (FS) were assessed by reproducing memorized target angle or torque value of three joints: glenohumeral, elbow, and radiocarpal. The JPS error for the elbow joint in group A1 was 71% and 80% higher (p < 0.01) than that in groups A2 and A3, respectively, and the performance of all tennis players was 27.5% (p = 0.01) better than that of untrained controls. For FS, proprioception of only the more demanding task tested (reproduction of 50% maximal voluntary contraction) and specific function (elbow and radiocarpal extension, and glenohumeral internal rotation) showed development with age. The error values for elbow extension (A1, A2) and the glenohumeral joint (A3) of tennis players were lower than those of age-matched controls. We conclude that the development of FS in the upper limb varied and was related to the specific functions and joints. The 10-13-year-old tennis players showed elbow extensor FS performance at the level of the older participants, while the 14-15-year-old tennis players were characterized with superior FS internal rotation performance in the glenohumeral joint.

Assessment of lower limb proprioception after fibula free flap harvest: A pilot study.

After undergoing fibula-free flap harvest, patients may experience complications such as ankle instability. It remains unclear whether these patients have deficits of proprioception, and the recovery process is also uncertain. This study aimed to objectively evaluate proprioception on the donor and normal side of surgical patients during long-term follow-up using the Pro-kin system. This study enrolled 36 patients who underwent reconstruction of the head and neck using osseous free flaps harvested from the fibula. Each patient underwent pre-operative evaluations and was subsequently evaluated at postoperative months 1, 3, 6, and 12. The study assessed the proprioceptive evaluation of the lower limbs, muscle function, range of motion of the ankle, and donor side complications. On the donor side, the average trace error (ATE) at postoperative month 1 was significantly higher than pre-operation, postoperative months 6 and 12 (P< 0.05). The test execution time (TTE) at postoperative month 1 was significantly increased by 9.875s compared to the pre-operative levels (P= 0.012, 95% confidence interval [CI] 4: 1.877-17.873) and by 11.583s compared to postoperative month 12 (P= 0.007, 95% CI: 2.858-20.309). The reduction in range of motion of ankle dorsiflexion was most pronounced at postoperative month 1, exhibiting an 11.25∘ decrease compared to pre-operative levels (P< 0.001, 95% CI: 6.304-16.16). Although the range of motion of ankle dorsiflexion gradually improved over time at postoperative months 3, 6, and 12, it remained lower than pre-operative levels (P< 0.05). The study revealed that the patients exhibited proprioceptive disturbances in both lower limbs at postoperative month 1. The proprioceptive function gradually improved over time, with a gradual decrease in donor site complications.

Acoustic cues of keyboard mechanics enable auditory localization of upright piano tones.

Piano tone localization at the performer's listening point is a multisensory process involving audition, vision, and upper limb proprioception. The consequent representation of the auditory scene, especially in experienced pianists, is likely also influenced by their memory about the instrument keyboard. Disambiguating such components is not obvious, and first requires an analysis of the acoustic tone localization process to assess the role of auditory feedback in forming this scene. This analysis is complicated by the acoustic behavior of the piano, which does not guarantee the activation of the auditory precedence effect during a tone attack, nor can it provide robust interaural differences during the subsequent free evolution of the sound. In a tone localization task using a Disklavier upright piano (which can be operated remotely and configured to have its hammers hit a damper instead of producing a tone), twenty-three expert musicians, including pianists, successfully recognized the angular position of seven evenly distributed notes across the keyboard. The experiment involved listening to either full piano tones or just the key mechanical noise, with no additional feedback from other senses. This result suggests that the key mechanical noise alone activated the localization process without support from vision and/or limb proprioception. Since the same noise is present in the onset of the full tones, the key mechanics of our piano created a touch precursor in such tones that may be responsible of their correct angular localization by means of the auditory precedence effect. However, the significance of pitch cues arriving at a listener after the touch precursor was not measured when full tones were presented. As these cues characterize a note and, hence, the corresponding key position comprehensively, an open question remains regarding the contribution of pianists' spatial memory of the instrument keyboard to tone localization.

How does a motor or cognitive dual-task affect our sense of upper limb proprioception?

Daily upper limb activities require multitasking and our division of attention. How we allocate our attention can be studied using dual-task interference (DTi). Given the vital role proprioception plays in movement planning and motor control, it is important to investigate how conscious upper limb proprioception is impacted by DTi through cognitive and motor interference. To examine how dual-task interference impacts conscious upper limb proprioception during active joint repositioning tasks (AJRT). Forty-two healthy participants, aged between 18 and 35, took part in this cross-sectional study. Participants completed two AJRT during three conditions: baseline (single task), dual-cognitive task (serial subtractions), and dual-motor task (non-dominant hand movements). The proprioceptive error (PE; difference between their estimation and targeted position) was measured using an AJRT of 75% and 90% of maximum internal rotation using the Biodex System IIITM and the Upper Limb Proprioception Reaching Test (PRO-Reach). To determine if PEs differed during dual-task interference, interference change scores from baseline were used with one sample t-tests and analyses of variance. The overall mean PE with the Biodex was 4.1° ± 1.9 at baseline. Mean change scores from baseline reflect a mean improvement of 1.5° ± 1.0 (p < .001) during dual-cognitive task and of 1.5° ± 1.2 (p < .001) during dual-motor task. The overall mean PE with the PRO-Reach was 4.4cm ± 1.1 at baseline. Mean change scores from baseline reflect a mean worsening of 1.0cm ± 1.1 (p < .001) during dual-cognitive task and improvement of 0.8cm ± 0.6 (p < .001) during dual-motor task. Analysis of variance with the Biodex PEs revealed an interference effect (p < .001), with the cognitive condition causing greater PEs compared to the motor condition and a criterion position effect (p = .006), where 75% of maximum IR produced larger PEs during both interference conditions. An interference effect (p = .022) with the PRO-Reach PEs was found highlighting a difference between the cognitive and motor conditions, with decreased PEs during the contralateral motor task. Interference tasks did impact proprioception. Cognitive interference produced mixed results, whereas improved proprioception was seen during motor interference. Individual task prioritization strategies are possible, where each person may choose their own attention strategy when faced with dual-task interference.

Knee osteoarthritis patients assessed during walking for ankle inversion movement discrimination sensitivity.

Background: Knee osteoarthritis (KOA) is a common musculoskeletal condition that affects dynamic balance control and increases the risk of falling during walking. However, the mechanisms underlying this are still unclear. Diminished ankle proprioception during walking has been found to be related to fear of falling in older adults, with a gender difference in incidence of falling. This study aimed to determine 1) whether ankle inversion proprioceptive acuity during walking is impaired in patients with KOA; and 2) whether there is any difference between genders. Methods: Thirty-two patients with KOA (F:M = 17:15, Median age = 52.5, BMI = 22.3 ± 3.0) and 34 healthy controls without KOA (HC) (F:M = 17:17; median age = 49.0, BMI = 22.5 ± 2.7) were recruited. In patients with KOA, ankle inversion proprioceptive acuity was measured on the affected side using the ankle inversion discrimination apparatus for walking (AIDAW), whilst HC were assessed on a randomly selected side. Two-way (2*2) analysis of variance (ANOVA) was performed to determine the main effects and interaction between gender and KOA condition. Results: Two-way ANOVA showed a significant KOA main effect (F = 26.6, p < 0.001, ƞp 2 = 0.3) whereby AIDAW scores during walking for individuals with KOA were significantly lower than those without KOA (KOA vs. HC: 0.746 ± 0.057 vs. 0.807 ± 0.035). There was neither a gender main effect nor interaction (both p > 0.05). Conclusion: Individuals with KOA demonstrated lower ankle proprioception scores during walking compared to their healthy counterparts, with a similar level of impairment in ankle proprioceptive acuity between male and female patients. A low score may contribute to an increased risk of falling in the KOA population. The current findings suggest the need for global concern about lower limb proprioception in the clinical management of KOA.

Assessment of inter-rater and intra-rater reliability of the Luna EMG robot as a tool for assessing upper limb proprioception in patients with stroke-a prospective observational study.

The aim of the study was to assess the inter-rater and intra-rater agreement of measurements performed with the Luna EMG (electromyography) multifunctional robot, a tool for evaluation of upper limb proprioception in individuals with stroke. The study was conducted in a group of patients with chronic stroke. A total of 126 patients participated in the study, including 78 women and 48 men, on average aged nearly 60 years (mean = 59.9). Proprioception measurements were performed using the Luna EMG diagnostic and rehabilitation robot to assess the left and right upper limbs. The examinations were conducted by two raters, twice, two weeks apart. The results were compared between the raters and the examinations. High consistency of the measurements performed for the right and the left hand was reflected by the interclass correlation coefficients (0.996-0.998 and 0.994-0.999, respectively) and by Pearson's linear correlation which was very high (r = 1.00) in all the cases for the right and the left hand in both the inter-rater and intra-rater agreement analyses. Measurements performed by the Luna EMG diagnostic and rehabilitation robot demonstrate high inter-rater and intra-rater agreement in the assessment of upper limb proprioception in patients with chronic stroke. The findings show that Luna EMG is a reliable tool enabling effective evaluation of upper limb proprioception post-stroke.

Evaluation of Reliability of the Luna EMG Rehabilitation Robot to Assess Proprioception in the Upper Limbs in 102 Healthy Young Adults.

BACKGROUND Proprioception, the body's ability to perceive its own position and movement, is fundamental for motor control and coordination. Reliable assessment tools are essential, particularly for conditions affecting proprioceptive function. This study aimed to evaluate the external and internal compliance of the Luna EMG -multifunction robotic device in assessing proprioception. MATERIAL AND METHODS The study involved 102 healthy students (31 men and 71 women; mean age 22.2±1.46 years), assessing proprioception using the Luna EMG for the upper limbs. Two investigators conducted measurements, which were repeated after 2 weeks under identical conditions. RESULTS Based on the identified values of the interclass correlation coefficient (ICC) (ICC=0.969-0.997), which is a key measure of agreement between 2 assessments, the study shows a high agreement of measurements both between investigators (for right hand: P=0.3484 [Exam 1]; P=1.0000 [Exam 2]; for left hand: P=0.1092 [Exam 1]; P=0.7706 [Exam 2]) and between the examinations (for right hand: 0.1127 [Investigator 1]; 0.2113 [Investigator 2]; for left hand: P=0.0087 [Investigator 1]; P=0.1466 [Investigator 2]). The Bland-Altman analysis showed very small inter-rater deviations, approximately 0.05° in the first examination for the left side and 0.04° for the right side. The highest deviation between the examinations, amounting to 0.08°, was identified for the left side. CONCLUSIONS The study shows that the Luna EMG multifunction robotic device enables a reliable evaluation of upper limb proprioception. Measurements performed using this device show high internal and external consistency in the assessment of the proprioceptive senses of the upper limb in 102 healthy young adults.

Effects of proprioceptive training on gait and plantar pressure after anterior cruciate ligament reconstruction: study protocol for a randomized controlled trial

BackgroundPeople who have undergone anterior cruciate ligament reconstruction have an increased risk of osteoarthritis. Abnormality of lower limb kinematics will occur after the operation. This may be related to lower limb muscle strength, the co-excitation of hamstrings and quadriceps femoris, and the weakness of proprioception. Proprioceptive training can improve the proprioception of lower limbs and promote the recovery of lower limb kinematics. Our research objective is to observe whether proprioceptive training can improve the proprioception of lower limbs within 3 months after surgery and whether the recovery of proprioception can correct the abnormal lower limb kinematics. The secondary objective is to explore the underlying mechanism of postoperative lower limb gait abnormalities.Methods/designThis study is a prospective single-center randomized clinical trial to be conducted in the Sports Medicine and Orthopedics of Zhongda Hospital Southeast University. Forty participants aged 18–50, preparing to undergo anterior cruciate ligament reconstruction, and initial anterior cruciate ligament reconstruction using hamstring tendons as grafts will be randomly assigned to the intervention or comparator group. People in the intervention group will add proprioceptive training three times a week, 20 min each time. The intervention will be conducted on the first day after surgery. The researcher mainly collects the data of joint of sense, gait, and plantar pressure. The assessment will be divided into three stages: after signing the informed consent form (within 2 weeks before surgery), 6 weeks after surgery, and 12 weeks after surgery.DiscussionThe main purpose of our study is to explore whether the proprioception of patients after anterior cruciate ligament reconstruction is weakened, whether the lower limb kinematics is abnormal and whether the lower limb kinematics can be corrected through proprioceptive training.Trial registrationChinese Clinical Trial Registry ChiCTR2200065808. Registered on 15 November 2022; Version 1.

The effect of compression and combined compression-tactile stimulation on lower limb somatosensory acuity

BackgroundLower limb somatosensation and proprioception are important for maintaining balance. Research has shown that compression garments or exposure to textured surfaces, can enhance somatosensation however, little is known about the effect of combined compression and texture on somatosensory acuity in the lower limb. This study aimed to assess the effects of combined compression socks with a plantar textured sole, on lower limb somatosensory acuity.MethodsThirty participants completed a somatosensory acuity task (active movement extent discrimination apparatus; AMEDA) under three conditions: barefoot (control condition), standard knee-high compression sock (compression sock), and knee-high compression sock with internal rubber nodules situated on the sole (textured-compression sock). Somatosensory acuity was assessed between the different sock conditions for the (i) entire group, (ii) high performers, and (iii) low performers. It was hypothesized that low performers would see gains wearing either sock, but the greatest improvement would be in the textured-compression sock condition.ResultsAMEDA scores were not significantly different between conditions when the entire group was analyzed (p = 0.078). The low performers showed an improvement in somatosensory acuity when wearing the compression sock (p = 0.037) and the textured compression sock (p = 0.024), when compared to barefoot, but there was no difference between the two sock conditions (p &amp;gt; 0.05). The high performers did not show any improvement (p &amp;gt; 0.05 for all).ConclusionThese findings demonstrate that additional sensory feedback may be beneficial to individuals with lower baseline somatosensory acuity but is unlikely to provide benefit for those with higher somatosensory acuity.

Chronic Low Back Pain Has a Globally Negative Effect on Lower Limb Proprioception

Chronic Low Back Pain Has a Globally Negative Effect on Lower Limb Proprioception

Proprioceptive Acuity Assessment in Multiple Directions Across Multiple Joints in the Upper Limb.

Proprioception is essential for precise movement as it helps the body transmit important data about its surroundings to the central nervous system for maintaining body posture and position. This study aimed to investigate the effect of direction and joint angle on upper limb proprioception. Thirty individuals (all males) completed a position reproduction activity in 13 directions and three joint angles. It was discovered that upper limb proprioception is dependent on joint angle, direction, and range of motion. The position reproduction error was found to be dependent on the direction, which had a significantly lower accuracy in the direction with a larger range of motion. In addition, upper limb repositioning errors increased at greater limb elevation angles. Our findings also showed that the joint angle did not significantly affect the absolute error of elbow flexion. With an increase in the elbow flexion, the increase of the gravitational moment of the upper arm and hand coupled with the increase of the muscle arm of the biceps brachii possibly causes slight changes in muscle length perceived by spindles or muscular force perceived by Golgi tendon organs.

Sensorimotor function and standing balance in older adults with transtibial limb loss

BackgroundLimited research has focused on older prosthesis users despite the expected compounded effects of age and amputation on sensorimotor function, balance, and falls. This study compared sensorimotor factors and standing balance between older individuals with and without transtibial amputation, hypothesizing that prosthesis users would demonstrate worse sensorimotor function. Secondarily we assessed the relationship between standing balance and somatosensation in prosthesis users. MethodsThirteen persons with unilateral transtibial amputation (71.7 years) and 10 able-bodied controls (71.7 years) participated in this cross-sectional observational study. Passive joint range-of-motion, muscle strength, proprioception (joint position sense), tactile sensitivity, and standing balance (center-of-pressure sway) were compared between groups. A multiple linear regression analysis assessed the relationship between proprioception and balance (without vision) in prosthesis users. FindingsOur hypotheses were generally not supported, with the only differences being reduced joint range-of-motion and strength in prosthesis users (with large effect sizes), but comparable sensation and balance. Notably, prosthesis users demonstrated better proprioception than controls as reflected through better joint position sense when the limb was non-weight bearing. Worse amputated limb proprioception was associated with better standing balance in prosthesis users. InterpretationOlder prosthesis users have impaired passive joint motion and muscle strength compared to controls that could challenge their ability to position and control the amputated limb to avoid falls during daily activities. However, their better amputated limb proprioception might help counteract those limitations by leveraging sensory feedback from the suspended limb. The relationship between amputated limb proprioception and standing balance suggests a nuanced relationship that warrants further study.

The differential effect of age on upper limb sensory processing, proprioception and motor function.

Sensory processing consists in the integration and interpretation of somatosensory information. It builds upon proprioception but is a distinct function requiring complex processing by the brain over time. Currently little is known about the effect of aging on sensory processing ability, nor the influence of other covariates such as motor function, proprioception, or cognition. In this study, we measured upper limb passive and active sensory processing, motor function, proprioception, and cognition in 40 healthy younger adults and 54 older adults. We analyzed age differences across all measures and evaluated the influence of covariates on sensory processing through regression. Our results showed larger effect sizes for age differences in sensory processing (r=0.38) compared to motor function (r=0.18-0.22) and proprioception (r=0.10-0.27), but smaller than for cognition (r=0.56-0.63). Aside from age, we found no evidence that sensory processing performance was related to motor function or proprioception, but active sensory processing was related to cognition (β=0.30-0.42). In conclusion, sensory processing showed an age-related decline, while some proprioceptive and motor abilities were preserved across age.

Wrist Flexibility, Upper Limb Proprioception And Eye-hand Coordination Of Amateur Basketball Players

Wrist Flexibility, Upper Limb Proprioception And Eye-hand Coordination Of Amateur Basketball Players

Measuring upper limb active joint position sense: Introducing a new clinical tool - The Upper Limb Proprioception Reaching Test

BackgroundProprioception is our sense of body awareness, including the sub-category of active joint position sense (AJPS). AJPS is fundamental to joint stability and movement coordination. Despite its importance, there remain few confident ways to measure upper limb AJPS in a clinic. ObjectiveTo assess a new AJPS clinical tool, the Upper Limb Proprioception Reaching Test (PRO-Reach; seven targets), for discriminant validity, intra-rater and absolute reliability. DesignCross-sectional measurement study. MethodsSeventy-five healthy participants took part in a single session with 2 consecutive evaluations (E1 and E2) (within-day reliability). Twenty participants were randomly selected to perform a dominant shoulder fatigue protocol (discriminant validity), whereafter a third evaluation was repeated (E3). The PRO-Reach was analyzed with paired t tests (discriminant validity), intra-class correlation coefficients (ICCs) and minimal detectable change [MDC]) (intra-rater: within-day and between-trial relative and absolute reliability). ResultsThe PRO-Reach supports moderate (mostly superior targets) to excellent (mostly inferior targets) reliability. Between-trial ICCs (T1/T2/T3) varied between 0.72 and 0.90, and within-day (E1/E2) ICCs between 0.45 and 0.72, with associated MDC95 values (3.9–5.0 cm). The overall scores (seven targets) supported the strongest within-day reliability (ICC = 0.77). The inferior targets demonstrated the highest between-trial and within-day reliability (ICCs = 0.90 and 0.72). A fatigue effect was found with the superior and superior-lateral targets (P < .05). ConclusionsThe inferior targets and overall scores demonstrate the strongest reliability. The use of the PRO-Reach tool may be suitable for clinical use upon further psychometric testing amongst pathological populations. Level of evidenceLevel III cross-sectional study.

Evaluation of Knee Position Sense in Children with Motor Disabilities and Children with Typical Development: A Cross-Sectional Study.

In children with motor disabilities, knee position during walking is often of concern in rehabilitation. This study aimed to investigate knee joint position sense. Thirty-seven children with Cerebral Palsy (CP), 21 with Myelomeningocele (MMC), 19 with Arthrogryposis (AMC), and 42 TD children participated in the study. Knee joint position sense, i.e., the difference between the criterion angle and the reproduced angle (JPS-error), was assessed in sitting while 3D motion capture was recorded at flexed knee 70 (Knee70), 45 (Knee45), and 20 (Knee20) degrees, and after three seconds at maintained criterion angle (CAM) and maintained reproduced angle (RAM). No differences were found between the groups in JPS-error, CAM, and RAM. At Knee70, CAM differed between the right and left legs in the TD group (p = 0.014) and RAM in the MMC group (p = 0.021). In the CP group, CAM was greater than RAM at Knee70 in the left leg (p = 0.002), at Knee45 in both legs (p = 0.004, p = 0.025), and at Knee20 in the right leg (p = 0.038). Difficulties in maintaining the knee position at CAM in the CP group sheds light on the need for complementary judgments of limb proprioception in space to explore the potential influence on knee position during walking.

Effectiveness of Functional Strength Training and Balance Training on Postural Stability and Gait in Patients with Diabetic Peripheral Neuropathy to Reduce the Risk of Falls

BACKGROUND: Diabetic peripheral Neuropathy (DPN) is one of the most common chronic complications of diabetes mellitus, mainly affects lower limbs in patients with diabetes. It may lead to distressing and expensive clinical sequelae like impairments in tactile sensitivity, vibration sense, lower limb proprioception, and kinesthesia. This lead to the increased risk of falls. Thus, taking into consideration, the debilitating effects of diabetic neuropathy, Functional strength training (ST) and Balance training is advocated for these individuals to prevent further deterioration AIM: The objective of this study was to study the effectiveness of functional ST and balance training on Postural stability and gait in patients with diabetic neuropathy. Methodology: This study was an experimental study and type of sampling was convenient sampling. The Sample size taken was 20 and the place of the study conducted was physiotherapy OPD. Results: The results were obtained using BBS, DGI and ABC scale on the basis of pre and post treatment data were collected. Statistical Analysis shows the positive effectiveness of Functional strength training and balance training on reducing the risk of falls in Diabetic peripheral neuropathy Conclusion: Functional strength training and Balance training can be included as a part of treatment for patients with Diabetic peripheral neuropathy. Keywords: Diabetic peripheral neuropathy, Functional strength training, Balance

A reliable and efficient adaptive Bayesian method to assess static lower limb position sense

BackgroundLower limb proprioception is critical for maintaining stability during gait and may impact how individuals modify their movements in response to changes in the environment and body state, a process termed “sensorimotor adaptation”. However, the connection between lower limb proprioception and sensorimotor adaptation during human gait has not been established. We suspect this gap is due in part to the lack of reliable, efficient methods to assess global lower limb proprioception in an ecologically valid context. New MethodWe assessed static lower limb proprioception using an alternative forced choice task, administered twice to determine test-retest reliability. Participants stood on a dual-belt treadmill which passively moved one limb to stimulus locations selected by a Bayesian adaptive algorithm. At the stimulus locations, participants judged relative foot positions and the algorithm estimated the point of subjective equality (PSE) and the uncertainty of lower limb proprioception. ResultsUsing the Bland-Altman method, combined with Bayesian statistics, we found that both the PSE and uncertainty estimates had good reliability. Comparison with existing method(s)Current methods assessing static lower limb proprioception do so within a single joint, in non-weight bearing positions, and rely heavily on memory. One exception assessed static lower limb proprioception in standing but did not measure reliability and contained confounds impacting participants’ judgments, which we experimentally controlled here. ConclusionsThis efficient and reliable method assessing lower limb proprioception will aid future mechanistic understanding of locomotor adaptation and serve as a useful tool for basic and clinical researchers studying balance and falls.

Mountain Hiking: Prolonged Eccentric Muscle Contraction during Simulated Downhill Walking Perturbs Sensorimotor Control Loops Needed for Safe Dynamic Foot–Ground Interactions

Safe mountain hiking requires precise control of dynamic foot-ground interactions. In addition to vision and vestibular afferents, limb proprioception, sensorimotor control loops, and reflex responses are used to adapt to the specific nature of the ground contact. Diminished leg dexterity and balance during downhill walking is usually attributed to fatigue. We investigated the supplementary hypothesis that the eccentric contractions inherent to downhill walking can also disrupt muscle proprioception, as well as the sensorimotor control loops and reflex responses that depend on it. In this study, we measured leg dexterity (LD), anterior-posterior (AP) and medio-lateral (ML) bipedal balance, and maximal voluntary leg extension strength in young and healthy participants before and after 30 min of simulated downhill walking at a natural pace on a treadmill at a 20° decline. Post-pre comparisons of LD (p < 0.001) and AP balance (p = 0.001) revealed significant reductions in dynamic foot-ground interactions after eccentric exercise without an accompanying reduction in leg extension strength. We conclude that eccentric contractions during downhill walking can disrupt the control of dynamic foot-ground interactions independently of fatigue. We speculate that mountaineering safety could be improved by increasing conscious attention to compensate for unadjusted proprioception weighting, especially in the descent.

The Benefits of Combining Mixed Virtual Reality Exergaming with Occupational Therapy for Upper Extremity Dexterity

Virtual Reality (VR) is expanding worldwide in education, training, gaming, and healthcare to achieve distinct outcomes. This paper aimed to identify to what extent physiotherapy based on mixed VR technology and occupational therapy serves the functionality of healthy subjects’ upper extremities; it also analyzed the benefits of this protocol for therapy guidelines in hand dexterity re-habilitation. Fifteen VR exergames and occupational therapy sessions were performed for 60 min in three weeks with a sample of sixteen people. The Jebsen Taylor Hand Function Test Scale (JTHFTS), Nine-Hole Peg test (9 Hole), Box and Blocks Test (BBT), and Timed Functional Test for the Arm and Shoulder (TFAST) were used for pre and post-therapy assessment. Linear regression was used to identify healthy subjects’ main tasks, predicting upper extremity dexterity. The results of pre- and post-exercise assessments suggested significant improvements for both upper extremities, dominant and non-dominant. BBT, the nine-hole peg test, and FAST showed significant differences in pre- and post-therapy, favoring prophylactical exercises. Hence, in the linear regression results for the dominant hand, five models emerged as potential predictors for upper extremity agility. The capacity to pick up large light objects seemed to bring the most critical influence on hand dexterity. However, regarding the non-dominant hand, the results suggested that writing ability was the most potent predictor of dexterity. In this respect, the protocol used in this research can be used as a guideline for further upper extremity dexterity training since VR exergames combined with occupational therapy can bring essential contributions to upper limb proprioception and dexterity functioning.