Touch Pressure Research Articles

Association of Lower Extremity Somatosensation Deficit with Balance and Gait in Sub-Acute Stroke Patients

Background: A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. There are three types of stroke ischemic stroke hemiplegic stroke and transient ischemic stroke. Objective: To determine the association of lower extremity somatosensory deficit in balance and gait in sub-acute stroke patients. Methods: Cross sectional survey was used in this study. The age group of participants was 40 to 75 years. Sample size was 204 calculated from Rao software and non-probability convenient sampling technique was used. Data was collected from Lahore General Hospital. Data was obtained from patient by applying distal proprioception test to assess the joint position sense. For the assessment of two point discrimination bolay gauge was used. The cutaneous vibration sensation was assessed through tuning fork. Soft goat hair brush was used to check the light touch pressure. For balance assessment berg balance scale and time up and go test was used. Gait was observed through Wisconsin gait index. Results: Mean value and standard deviation of age of participants were 62.99and 6.592 respectively. There was association of berg balance scale with two point discrimination test, light touch pressure and distal proprioception. There was no association between berg balance scale and vibration sense. Mean value and standard deviation of Wisconsin gait index was 23 and 4.986 respectively. Association between TUG and two point discrimination was found. There was no association of TUG with vibration sense, distal proprioception test and light touch pressure. Conclusion: This study concluded that balance was affected in sub-acute stroke patients due to the somatosensory deficit. Fall risk increased in the sub-acute stroke patient as the patients performance measured in time up and go test and berg balance scale. It was also inferred that while patients performing Wisconsin gait index scale, gait was affected in sub-acute stroke patients. Keywords: Balance, Gait, Sub-acute Stroke, fall risk, Somatosensory, Lower extremity

International Hand Function Study Following Distal Radial Access: The RATATOUILLE Study.

Distal radial access (DRA) has been proposed to improve procedure ergonomics and favor radial arterypatency. Although promising data, nothing is known on evolving hand function after DRA. This study sought to comprehensively evaluate hand function in patients undergoing DRA. Real-world patients undergoing DRA undertook a thorough multimodality assessment of hand function implementing multidomain questionnaires (Disabilities of the Arm, Shoulder and Hand and Levine-Katz), and motor (pinch grip test) and sensory (Semmes-Weinstein monofilaments test) examinations of both hands. All assessments were performed at preprocedural baseline and planned at 1-, 6-, and 12-month follow-up (FU). Adverse clinical and procedural events were documented too. Data of 313 patients (220 men, age 66 ± 10 years) from 9 international centers were analyzed. The Disabilities ofthe Arm, Shoulder and Hand and the Levine-Katz scores slightly improved from baseline to FU (P = 0.008 and P=0.029, respectively). Pinch strength mildly improved from baseline to FU (P< 0.001 for both the left and right hands). Similarly, touch pressure threshold appeared to faintly improve in both the left and right hands (P< 0.012 for all the sites). For both motor and sensory function tests, comparable findings were found for the DRA hand and the contralateral one, with no significant differences between them. Repeated assessment of all tests over all FU time points similarly showed lack of worsening hand function. Access-related adverse events included 19 harmless bleedings and 3forearm radial artery and 3 distal radial artery occlusions. None affected hand function at FU. In a systematic multidimensional assessment, DRA was not associated with hand function impairment. Moreover, DRA emerges as a safe alternative vascular access.

Enabling Low-Cost Full Surface Tactile Skin for Human Robot Interaction

Realizing full coverage, low-maintenance, and low-cost tactile skin is a <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">de facto</i> design dream since the invention of robots. It ensures safety and enables collaborative work protocols for human robot interactions (HRI). The on-robot tactile capability is realized by deploying an array of external sensors or inferring from proprioceptive information that comes with the robot, such as motor torque. However, these methods may be cumbersome, introduce extra management cost, expensive, lack real-world robustness, or require special robot designs. In this letter, we present <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">SonicSkin</i> , a low-cost ($2) and easy to deploy system that localizes the on-robot human touch and estimates the touch pressure without actually attaching sensors at potential touch locations. The system requires only a single pair of piezoelectric transducers ( <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">i.e.</i> one transmitter and one receiver) attached on the target robot and turns the robot itself into a versatile sensor. We present a set of novel algorithms to progressively address the unique challenges posed by our system design. We put together an end-to-end <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">SonicSkin</i> system on a Jaco robot arm that runs in real-time, and conducted an extensive real-world study including 57019 actual evaluation datapoints under various challenging conditions from 12 human subjects. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">SonicSkin</i> achieves less than 2 cm localization error for 96.4% of touches, with more than 96.7% cross-correlation similarity between the predicted touch pressure and the ground truth touch pressure.

Continuous Nonintrusive Mobile Device Soft Keyboard Biometric Authentication

Mobile banking, shopping, and in-app purchases utilize persistent authentication states for access to sensitive data. One-shot authentication permits access for a fixed time period. For instance, a username/password-based authentication allows a user access to all the shopping and payments data in the Amazon shopping app. Traditional user passwords and lock screens are easily compromised. Snooping attacks—observing an unsuspecting user entering passwords—and smudge attacks—examining touchscreen finger oil residue—enable compromised user authentication. Mobile device interactions provide robust human and device identity data. Such biometrics enhance authentication. In this paper, behavioral attributes during user input constitute the password. Adversary password reproduction difficulty increases since pure observation is insufficient. Current mobile continuous authentication schemes use, among others, touchscreen–swipe interactions or keyboard input timing. Many of these methods require cumbersome training or intrusive authentication. Software keyboard interactions provide a consistent biometric data stream. We develop biometric profiles using touch pressure, location, and timing. New interactions authenticate against a profile using a divergence measure. In our limited user–device data sets, the classification achieves virtually perfect accuracy.

Somatosensory Measures in Healthy and Neurologic Conditions: A Systematic Review

<h3>Objective(s)</h3> Identify assessment tools used to measure somatosensory function in adults, critically appraise and summarize the quality of their psychometric properties, and provide guidance for selecting sensory assessment tools for research or clinical purposes. <h3>Data Sources</h3> MEDLINE, CINAHL, and PsychInfo were searched for research indexed from 1990 to July 2020. English language and human subject filters were applied. Somatosensation, psychometric property, and nervous system-based health condition search terms were combined. <h3>Study Selection</h3> Studies that assessed reliability, construct validity, and/or measurement error of light touch/pressure, vibration, or proprioception assessment tools/techniques in neurologically healthy or disordered adults were reviewed. At least two reviewers examined each article. Discrepancies were resolved by a third reviewer or reviewer consensus. <h3>Data Extraction</h3> Individual reviewers performed extraction and managed data using Research Electronic Data Capture (REDCap). Extracted data included study sample demographics, characteristics of the assessment tools, statistical methods, results of measurement properties, and feasibility for clinical use. Methodological quality of results was evaluated using an adapted version of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. <h3>Data Synthesis</h3> 78 of 1851 articles were included for review. Adequate ratings of reliability were found in four tools measuring light touch/pressure, three tools measuring vibration, three tools measuring proprioception, and one neurophysiologic measure. Of the techniques demonstrating adequate reliability, none achieved minimal detectable change <30% or standard error of the measure <10% when assessed in people with neurologic conditions. Approximately 85% of the pooled study ratings were determined to be of low or very low quality according to modified GRADE criteria. Major sources of variation between studies included administration protocols, timing between assessments, versions of standardized devices, and assessor training protocols. <h3>Conclusions</h3> No assessment tool met all psychometric criteria. Pattern/texture discrimination tools, electrical perceptual tests, and the moving touch pressure test demonstrated the best overall psychometric properties in people with neurologic conditions. None of these tools are commercially available. There is a fundamental need to develop sensory assessments that are reliable, sensitive to change, and clinically accessible. <h3>Author(s) Disclosures</h3> None

Multimodal Assessments of Altered Sensation after Transoral Endoscopic Thyroidectomy.

Transoral endoscopic thyroidectomy, a novel technique, uses oral vestibule as the entry point and leaves no scar on the body surface. However, because the incisions are close to the mental nerve, nerve damage and the associated sensory impairment are concerning. Herein, we evaluated sensory alteration after transoral endoscopic thyroidectomy and determined factors associated with the prolonged sensory alteration. Patients who underwent transoral endoscopic thyroidectomy were enrolled. Sensation over the lower lip, chin, and neck was evaluated before and after the surgery. A self-assessment questionnaire, Semmes-Weinstein monofilament test, and two-point discrimination test were used to subjectively and objectively evaluate sensory changes. Fifty-one patients were enrolled; most of them reported altered sensation, with chin (72.5%) being the most common site, followed by lower lip (52.9%), upper neck (33.3%), and lower neck (5.9%) on postoperative day 2. The sensory disturbance resolved within 3months. Factors associated with prolonged sensory alteration are male sex and old age. Fourteen patients (27.5%) experienced mild drooling from the mouth, which was usually self-limiting in 1month. Sensory impairments in light touch pressure threshold and two-point discrimination were significant in the chin and neck on postoperative day 2 and at 1week. The ability to discern two-point was also compromised in the lower lip on postoperative day 2. All these significant changes normalized to preoperative baseline at 1month. There was an altered sensation after transoral endoscopic thyroidectomy with the most common and disturbed in the chin. Sensory impairment was usually transient and recovered in 3months.

A soft neuroprosthetic hand providing simultaneous myoelectric control and tactile feedback.

Neuroprosthetic hands are typically heavy (over 400 g) and expensive (more than US$10,000), and lack the compliance and tactile feedback of human hands. Here, we report the design, fabrication and performance of a soft, low-cost and lightweight (292 g) neuroprosthetic hand that provides simultaneous myoelectric control and tactile feedback. The neuroprosthesis has six active degrees of freedom under pneumatic actuation, can be controlled through the input from four electromyography sensors that measure surface signals from residual forearm muscles, and integrates five elastomeric capacitive sensors on the fingertips to measure touch pressure so as to enable tactile feedback by eliciting electrical stimulation on the skin of the residual limb. In a set of standardized tests performed by two individuals with transradial amputations, we show that the soft neuroprosthetic hand outperforms a conventional rigid neuroprosthetic hand in speed and dexterity. We also show that one individual with a transradial amputation wearing the soft neuroprosthetic hand can regain primitive touch sensation and real-time closed-loop control.

Foot and ankle somatosensory deficits in children with cerebral palsy: A pilot study.

To investigate foot and ankle somatosensory function in children with cerebral palsy (CP). Ten children with spastic diplegia (age 15 ± 5 y; GMFCS I-III) and 11 typically developing (TD) peers (age 15 ± 10 y) participated in the study. Light touch pressure and two-point discrimination were assessed on the plantar side of the foot by using a monofilament kit and an aesthesiometer, respectively. The duration of vibration sensation at the first metatarsal head and medial malleolus was tested by a 128 Hz tuning fork. Joint position sense and kinesthesia in the ankle joint were also assessed. Children with CP demonstrated significantly higher light touch pressure and two-point discrimination thresholds compared to their TD peers. Individuals with CP perceived the vibration stimulus for a longer period compared to the TD participants. Finally, the CP group demonstrated significant impairments in joint position sense but not in kinesthesia of the ankle joints. These findings suggest that children with CP have foot and ankle tactile and proprioceptive deficits. Assessment of lower extremity somatosensory function should be included in clinical practice as it can guide clinicians in designing more effective treatment protocols to improve functional performance in CP.

A sensory intervention to improve sleep behaviours and sensory processing behaviours of children with sensory processing disorders

Purpose This paper aims to investigate if a sensory intervention of moderate pressure touch of children with sensory processing disorder (SPD) affects sleep behaviours and sensory processing behaviours. Design/methodology/approach A total of 50 children, aged 5–11 years with both SPD and sleep difficulties in Israel, were randomly divided into an experimental and a control group, nonblinded. Participants in the experimental group received three weeks of nightly massage by their parents, with a baseline week on both ends. Parents filled out questionnaires reporting on sensory and sleep behaviours and filled out a nightly sleep log. Parents determined outcome goals using goal attainment scoring. The assessment tools used were the short sensory profile and the child sleep habits questionnaire (Dunn, 1999; Owens et al., 2000). Findings Significant improvement was found in the total and subgroup scores of sleep participation measures including sleep onset, sleep anxiety, parasomnias, sleep duration, daytime sleepiness, as well as the total sleep score (F (1,48) = 24.71, p &lt; 0.001). Originality/value Results of this study suggest that consistent application of moderate pressure touch as advised or trained by an occupational therapist may be used in clinical practice to improve sleep participation in children with SPD.

Rivermead assessment of somatosensory performance: Italian normative data

The Rivermead assessment of somatosensory performance (RASP) provides a quantitative assessment of somatosensory processing, suitable for brain-damaged patients suffering from stroke. It consists of seven subcomponents: Subtest 1 (sharp/dull discrimination), Subtest 2 (surface pressure touch), Subtest 3 (surface localization), Subtest 4 (sensory extinction), Subtest 5 (2-point discrimination), Subtest 6 (temperature discrimination), and Subtest 7 (proprioception). Overall, the RASP assesses 5 bilateral body regions: face (cheek), hand (palm and back), and foot (sole and back). This study aimed at providing normative data and cut-off scores for RASP subtests, for each body region, in a large Italian population sample. We present results from 300 healthy Italian individuals aged 19 to 98 years. Data represent a comprehensive set of norms that cover each subtest and each body region tested. Performance in Subtests 1, 5, and 6 decreased, for some body regions, with increasing age. Based on these results, norms were stratified for age (seven groups), with the pathological/non-pathological cut-off coinciding with the 5th percentile. Conversely, other results were not influenced by age; in such cases, a single error, in each body region, has to be considered indicative of pathological performance. This independent investigation of all subcomponents of the somatosensory system, for each body region, further confirms RASP’s potential in clinical practice, for neurological assessment, as well as in research settings.

Human Hand Anatomy-Based Prosthetic Hand.

The present paper describes the development of a prosthetic hand based on human hand anatomy. The hand phalanges are printed with 3D printing with Polylactic Acid material. One of the main contributions is the investigation on the prosthetic hand joins; the proposed design enables one to create personalized joins that provide the prosthetic hand a high level of movement by increasing the degrees of freedom of the fingers. Moreover, the driven wire tendons show a progressive grasping movement, being the friction of the tendons with the phalanges very low. Another important point is the use of force sensitive resistors (FSR) for simulating the hand touch pressure. These are used for the grasping stop simulating touch pressure of the fingers. Surface Electromyogram (EMG) sensors allow the user to control the prosthetic hand-grasping start. Their use may provide the prosthetic hand the possibility of the classification of the hand movements. The practical results included in the paper prove the importance of the soft joins for the object manipulation and to get adapted to the object surface. Finally, the force sensitive sensors allow the prosthesis to actuate more naturally by adding conditions and classifications to the Electromyogram sensor.

Aging and the Relationship between Balance Performance, Vestibular Function and Somatosensory Thresholds.

The objective of this study was two-fold: (1) To evaluate the impact of the physiological aging process on somatosensory, vestibular, and balance functions, and (2) To examine the extent to which age and somatosensory and vestibular functions can predict balance performance. In this cross-sectional study, 141 asymptomatic subjects were assessed for touch pressure thresholds (TPT) with Semmes-Weinstein monofilaments (SWF), vibration thresholds (VT) with a neurothesiometer (NT) and a Rydel-Seiffer tuning fork 128Hz (RSTF). Horizontal vestibulo-ocular reflexes (HVOR gain and asymmetry) were assessed using the video Head Impulse Test (vHIT). A modified version of the Romberg test was used to assess standing balance and the Timed Up and Go test (TUG) and tandem gait (TG) to evaluate dynamic balance. Significant age effects were found for TPT, VT, and balance but not for HVOR gain or asymmetry. Standing balance was explained for 47.2% by age, metatarsal 1 (MT1) (NT), and heel (SWF). The variance in TUG performance was explained for 47.0% by age, metatarsal 5 (MT5) (SWF), and medial malleolus (MM) (NT). Finally, the variance in TG performance was predicted for 43.1% by age, MT1 (NT), HVOR gain, and heel (SWF). Among asymptomatic adult population, both somatosensation and balance performance deteriorate with aging. In contrast, HVOR remains rather constant with age, which is possibly explained by the process of vestibular adaptation. Furthermore, this study provides evidence that the VT, TPT, HVOR gain, and age partly predict balance performance. Still, further research is needed, especially with bigger samples in decades 8 and 9.

Telomere Length and Structured Deep Touch Pressure Therapy in Autism Spectrum Disorder-A Project Synopsis

Autism spectrum disorder is characterised by inability of the child to socially interact with people , poor eye to eye contact, absent or perverted speech, abnormally received sensory stimuli (more or less than optimum response to sensory stimulus),self stimulating, self injurious behaviour ,with associated intellectual disability of varying severity, liking for sameness, abnormal stereotactic movements. Hyperactivity and sleep disorders are usually associated ,making it difficult for parents to look after the child. Mostly this abnormal behaviour is noticed at the age of 11/2 to 3 years. This is a progressive condition worsening with age.1 The incidence has been noticed to increase over the years in most parts of world.2 The incidence in western world is said to be around 1 in 59 children.3 In India the incidence has been estimated to increase but real prevalence is not known. Many of these children remain undiagnosed and untreated due to difficulty in diagnosis by health care personnel and poor understanding by parents. Two scales developed for Indian children4,5 have now made the work easy. Juneja et al found prevalence around 0.9/1000.6 This study will test the utility of deep touch pressure therapy on telomere length and development of the child. Keywords: Deep touch pressure therapy; Autism Spectrum Disorder; Synopsis.

MNIS+7 and lower limb function in inotersen treatment of hereditary transthyretin-mediated amyloidosis.

IntroductionInotersen, an antisense oligonucleotide inhibitor of transthyretin (TTR) protein production, demonstrated significant benefit versus placebo in the modified Neuropathy Impairment Score (NIS) +7 neurophysiologic tests (mNIS+7) in patients with hereditary TTR‐mediated amyloidosis (hATTR) with polyneuropathy. This analysis assessed the mNIS+7 components by anatomic location and the lower limb function (LLF) test.MethodsAdults with hATTR in the NEURO‐TTR trial (NCT01737398) were randomly assigned to receive weekly doses of subcutaneous inotersen 300 mg or placebo for 65 weeks. The mNIS+7 and LLF were assessed at 35 and 66 weeks.ResultsAll major mNIS+7 components (muscle weakness, muscle stretch reflexes, sensation) and the LLF showed significant efficacy in patients receiving inotersen versus placebo; however, NIS‐reflexes (upper limb), touch pressure (upper and lower limbs), and heart rate during deep breathing did not show significant effects.DiscussionThe results of this analysis reinforce the beneficial effect of inotersen on slowing neuropathy progression in patients with hATTR polyneuropathy.

Effectiveness of Occupational Therapy Sensory Interventions for Children and Adolescents: A Systematic Review

Abstract Date Presented 03/28/20 A systematic review of literature from 2010 to 2019 yielded 2,035 studies of sensory interventions for children and youth. Using established criteria, 22 qualifying studies were identified that spanned six interventions: environmental modifications, deep touch pressure, sensory integration, sensory diet, weighted vests, and stability balls. Strong evidence supported one approach, with moderate evidence in support of three approaches. The results yielded moderate evidence against two approaches. Primary Author and Speaker: Victoria Battin Additional Authors and Speakers: Julia Panzone, Marguerite Fish, Nicole Lorthioir, Justine Odierna, Andrea Dow, Alexandra Regimbald, Gabrielle Lukovich, Taylor Heitmann, Morgan Eberley

Weighted Blankets: Anxiety Reduction in Adult Patients Receiving Chemotherapy.

Weighted blankets have been used as a deep touch pressure (DTP) tool to alleviate anxiety in many patient populations. Patients with cancer can experience anxiety related to diagnosis and treatments, such as chemotherapy infusions. Research on the effectiveness of weighted blankets as a DTP tool to alleviate anxiety in patients receiving chemotherapy is limited. This study assessed the effectiveness of a medical-grade therapeutic weighted blanket on anxiety in patients receiving their first and second chemotherapy infusions at an outpatient infusion center. A randomized controlled trial with a crossover design was performed with new patients in the outpatient chemotherapy infusion center. Patients were randomized to one of two study arms (given the weighted blanket during their first infusion or given the weighted blanket during their second infusion). Anxiety was measured using an anxiety inventory and a visual analog scale. Anxiety was reduced among patients receiving chemotherapy when the weighted blanket was used. Based on the results, a standard-weight, medical-grade therapeutic weighted blanket can be safely used to reduce anxiety in patients of various weights, and a visual analog scale can be a reliable indicator of patients' state anxiety.

Neonatal Tactile Stimulations Affect Genetic Generalized Epilepsy and Comorbid Depression-Like Behaviors.

Recent studies suggest that development of absence epilepsy and comorbid depression might be prevented by increased maternal care of the offspring, in which tactile stimulation induced by licking/grooming and non-nutritive contact seem to be crucial. In this study, we aimed to evaluate the effect of neonatal tactile stimulations (NTS) on absence epilepsy and depression-like behaviors in adulthood. Wistar Albino Glaxo from Rijswijk (WAG/Rij) rat pups with a genetic predisposition to absence epilepsy were divided into tactile stimulation (TS) group, deep touch pressure (DTP) group, maternal separation (MS) group or control group. Between postnatal day 3 and 21, manipulations (TS, DTP, and MS) were carried out for 15 min and three times a day. Animals were submitted to locomotor activity, sucrose consumption test (SCT) and forced swimming test (FST) at five months of age. At the age of six months, the electroencephalogram (EEG) recordings were conducted in order to quantify the spike-wave discharges (SWDs), which is the hallmark of absence epilepsy. The TS and DTP groups showed less and shorter SWDs in later life in comparison to maternally separated and control rats. SWDs’ number and total duration were significantly reduced in TS and DTP groups whereas mean duration of SWDs was reduced only in DTP group (p < 0.05). TS and DTP also decreased depression-like behaviors measured by SCT and FST in adult animals. In the SCT, number of approaches was significantly higher in TS and DTP groups than the maternally separated and control rats. In the FST, while the immobility latency of TS and DTP groups was significantly higher, only TS group showed significantly decreased immobility and increased swimming time. The results showed that NTS decreases both the number and length of SWDs and the depression-like behaviors in WAG/Rij rats probably by increasing arousal level and causing alterations in the level of some neurotrophic factors as well as in functions of the neural plasticity in the developing rat’s brain.

Self-healable sticky porous elastomer for gas-solid interacted power generation.

A previously unknown gas-solid interacted power generation is developed using triboelectric effect. We designed an adhesive, gas-tight, and self-healing supramolecular polysiloxane-dimethylglyoxime-based polyurethane (PDPU) porous elastomer based on segmented oxime-carbamate-urea. It is an intrinsically triboelectric negative material with trapped air within closed voids, exhibiting ultrahigh static surface potential and excellent compressibility. This porous PDPU generates electricity from interactions between the trapped air and the elastomeric matrix under periodical compression. The positively charged trapped air (or other gas) dominates the tribo-electrification with PDPU, inducing electron transfer from gas to the solid polymer for electricity generation. The self-healable elastomer renders gas-solid interacted triboelectric nanogenerator, GS-TENG, with high stretchability (~1200%). The inherently adhesive surface enables adherance to other substrates, allowing mechanical energy harvesting from deformations such as bending, twisting, and stretching. GS-TENG promises a freestanding wearable functional tactile skin for self-powered sensing of touch pressure, human motions, and Parkinsonian gait.

1203 Worth The Weight: Weighted Blanket Improves Sleep And Increases Relaxation

Abstract Introduction Weighted blankets are designed to create deep touch pressure stimulation, to simulate the feeling of being held or hugged. The deep pressure provided by a weighted blanket, along with consistent sensory input from its weight, is thought to work by lowering stress and reducing physiological arousal, thereby improving sleep. We tested whether a weighted blanket would improve sleep. Methods 30 participants with objectively measured sleep onset and sleep maintenance issues participated in a 6-week field study, using a non-counterbalanced pre-post intervention design. Intervention consisted of the use of a weighted blanket every night at home. The blanket was filled with microbeads and weighed approximately 10 percent of each participant’s body weight. Sleep was measured objectively using ResMed S+ every night and by daily self-report. Paired t-tests and multilevel regression were used to test for statistical significance. Results Objective sleep data from the 28 participants who completed all study requirements showed 7% improvement of Wake After Sleep Onset, 2% decrease in Light Sleep, and slight improvement in Sleep Efficiency (1.5%) and Sleep Maintenance (1.4%) during intervention (all ps &amp;lt; 0.05). Additionally, participants felt they fell asleep faster (13% faster), experienced better sleep quality (14% better), felt more rested in the morning (17% more rested), and felt they slept better through the night without waking up (36% improvement). They also reported feeling 13% less stressed at bedtime and 17% more relaxed while trying to fall asleep. Conclusion Using a weighted blanket reduces self-reported feelings of stress, enhances feelings of relaxation, and can improve sleep and reduce time awake at night in people with sleep onset and sleep maintenance issues. Support Gravity Blanket

Foot and Ankle Somatosensory Deficits Affect Balance and Motor Function in Children With Cerebral Palsy.

Sensory dysfunction is prevalent in cerebral palsy (CP). Evidence suggests that sensory deficits can contribute to manual ability impairments in children with CP, yet it is still unclear how they contribute to balance and motor performance. Therefore, the objective of this study was to investigate the relationship between lower extremity (LE) somatosensation and functional performance in children with CP. Ten participants with spastic diplegia (Gross Motor Function Classification Scale: I-III) and who were able to stand independently completed the study. Threshold of light touch pressure, two-point discriminatory ability of the plantar side of the foot, duration of cutaneous vibration sensation, and error in the joint position sense of the ankle were assessed to quantify somatosensory function. The balance was tested by the Balance Evaluation System Test (BESTest) and postural sway measures during a standing task. Motor performance was evaluated by using a battery of clinical assessments: (1) Gross Motor Function Measure (GMFM-66-IS) to test gross motor ability; (2) spatiotemporal gait characteristics (velocity, step length) to evaluate walking ability; (3) Timed Up and Go (TUG) and 6 Min Walk (6MWT) tests to assess functional mobility; and (4) an isokinetic dynamometer was used to test the Maximum Volitional Isometric Contraction (MVIC) of the plantar flexor muscles. The results showed that the light touch pressure measure was strongly associated only with the 6MWT. Vibration and two-point discrimination were strongly related to balance performance. Further, the vibration sensation of the first metatarsal head demonstrated a significantly strong relationship with motor performance as measured by GMFM-66-IS, spatiotemporal gait parameters, TUG, and ankle plantar flexors strength test. The joint position sense of the ankle was only related to one subdomain of the BESTest (Postural Responses). This study provides preliminary evidence that LE sensory deficits can possibly contribute to the pronounced balance and motor impairments in CP. The findings emphasize the importance of developing a thorough LE sensory test battery that can guide traditional treatment protocols toward a more holistic therapeutic approach by combining both motor and sensory rehabilitative strategies to improve motor function in CP.