Proprioceptive Awareness Research Articles

Neural correlates of the rubber hand illusion in amputees: A report of two cases

One of the current challenges in the field of advanced prosthetics is the development of artificial limbs that provide the user with detailed sensory feedback. Sensory feedback from our limbs is not only important for proprioceptive awareness and motor control, but also essential for providing us with a feeling of ownership or simply put, the sensation that our limbs actually belong to ourselves. The strong link between sensory feedback and ownership has been repeatedly demonstrated with the so-called rubber hand illusion (RHI), during which individuals are induced with the illusory sensation that an artificial hand is their own. In healthy participants, this occurs via integration of visual and tactile signals, which is primarily supported by multisensory regions in premotor and intraparietal cortices. Here, we describe a functional magnetic resonance imaging (fMRI) study with two upper limb amputees, showing for the first time that the same brain regions underlie ownership sensations of an artificial hand in this population. Albeit preliminary, these findings are interesting from both a theoretical as well as a clinical point of view. From a theoretical perspective, they imply that even years after the amputation, a few seconds of synchronous visuotactile stimulation are sufficient to activate hand-centered multisensory integration mechanisms. From a clinical perspective, they show that a very basic sensation of touch from an artificial hand can be obtained by simple but precisely targeted stimulation of the stump, and suggest that a similar mechanism implemented in prosthetic hands would greatly facilitate ownership sensations and in turn, acceptance of the prosthesis.

Biomechanical and Proprioceptive Differences during Drop Landings between Dancers and Non-dancers

The focus of this research was to determine if female dancers have differing kinematic and kinetic characteristics when landing from three heights (0.2, 0.5, and 0.8 m) both with and without vision compared to non-dancers. It was hypothesized that dancers would show differing kinematic and kinetic patterns of control due to their increased proprioceptive awareness. Eight collegiate dancers and seven collegiate controls who were neither dancers nor collegiate jumping athletes volunteered for this study. Sagittal plane lower limb joint angles were measured at 100 Hz prior to landing through stability with a high-speed camera, and peak vertical ground reaction forces relative to body weight were recorded with an indwelling force plate. Results indicated biomechanical differences across height and vision conditions, as well as between groups. Kinetic results showed a significant height effect with respect to vertical ground reaction forces. From the 0.8 m drop, both dancers and non-dancers produced significantly greater ground reaction forces when landing without vision compared to when they landed with vision. No significant kinetic differences were found between groups. Kinematic results revealed a significant height effect for the hip and knee angles across groups and vision conditions, meaning that as drop height increased, the participants demonstrated greater range of motion in their hip and knee joints. Dancers and non-dancers responded differently when dropping from 0.8 m without vision. Dancers significantly increased hip flexion compared to landing with vision, while non-dancers tended to stiffen up and reduced hip flexion. These findings suggest that dancers utilize proprioceptive input more effectively as they adopted a hip strategy (flexion of the hips) to maintain stability. Training dancers without vision may impact dance instruction and reduce the risk of injuries when landing.

Reflections on clinical applications of yoga in voice therapy with MTD

This paper explores the application of modified yoga techniques, as an adjunct to voice therapy, by a speech pathologist who is also a yoga teacher.Yoga practices, with effects that may be short-term, are not considered a substitute for comprehensive and integrated somatic retraining systems (such as the Alexander Technique or Feldenkrais ATM). However, when yoga is conducted emphasizing kinaesthetic and proprioceptive awareness, the client may achieve an ‘awareness state’ that facilitates the learning of vocal remediation techniques (for example, by more easily ‘tuning in’ to the subtle sensations of supralaryngeal deconstriction). Core yoga elements and clinical applications are identified. The potential benefits and considerations when using yoga as an adjunct to the treatment of muscle tension dysphonia (MTD) are explored.

Wide-Awake Wrist Arthroscopy and Open TFCC Repair

The wide-awake approach to hand surgery entails the use of local infiltration anesthesia using lidocaine with epinephrine and no tourniquet. The technique provides practitioners with an option to perform advanced hand surgical care in an ambulatory setting, without the need for general or regional anesthetics. We present our results using wide-awake approach in wrist surgery, both open and arthroscopic. Between June and August 2011, the wide-awake approach was used in nine elective wrist surgery cases; three arthroscopic procedures, four open triangular fibrocartilage complex (TFCC) repairs, and two combined arthroscopy/open surgery (eight men/one woman). The arthroscopic patients were anesthetized using dorsal infiltration of lidocaine with epinephrine (20 mL) with an additional intra-articular 5 mL injection 30 minutes before surgery. The open surgery patients received 40 mL of lidocaine with epinephrine around the ulnar aspect of the forearm, from 8-cm proximal to 3-cm distal to the distal radioulnar joint. Standard diagnostic radio- and midcarpal arthroscopies were performed, where one patient had a loose body removed and two patients underwent TFCC debridements due to central TFCC tears. The six open cases were all due to TFCC foveal disruptions, which were reinserted using osteosutures in the distal ulna. Following placement of the ligament sutures, a preliminary knot allowed active and passive motion testing of pronosupination, to determine the adequate amount of tension in the ligaments. The wide-awake approach to wrist surgery is a plausible and reliable technique that eliminates the need for general anesthesia, removes the need of a tourniquet, and provides a cost-efficient and safe approach to wrist surgery. The ability to control ligament reconstructions using active motion may additionally enhance the rehabilitation of these patients, both through early proprioceptive awareness and adequate tensioning of soft tissues.

Physical demands on high performance athletes with lower limb amputation

High performance sport places increasing physical demands on the athlete with lower limb amputation. The ability to maintain dynamic posture through stance and propulsive phases of gait are challenged by forces specific to the individual sport and also to the physical characteristics of the prosthetic limb. Reduced proprioceptive awareness and musculoskeletal balance restrict force production in the athlete with amputation. Extrinsic factors place further demands on the limb and prosthesis that can increase the risk of injury. There is an ever increasing demand to maintain musculoskeletal awareness of posture and dynamic control of the prosthetic limb, particularly when high level execution of skilled exercise is required in order to participate in high performance sport. The effects of physical disuse on muscle and bone place relatively higher loads on the side of the amputated limb. This presentation highlights the physical demands placed on the high performance athlete with amputation and introduces concepts aimed at improving muscle balance and preventing injury. Methods for the progression of exercises aimed at improving muscle strength and control of movement between the amputated and non amputated limbs will be discussed.

The case for proprioception

In formulating a theory of perception that does justice to the embodied and enactive nature of perceptual experience, proprioception can play a valuable role. Since proprioception is necessarily embodied, and since proprioceptive experience is particularly integrated with one’s bodily actions, it seems clear that proprioception, in addition to, e.g., vision or audition, can provide us with valuable insights into the role of an agent’s corporal skills and capacities in constituting or structuring perceptual experience. However, if we are going to have the opportunity to argue from analogy with proprioception to vision, audition, touch, taste, or smell, then it is necessary to eschew any doubts about the legitimacy of proprioception’s inclusion into the category of perceptual modalities. To this end, in this article, I (1) respond to two arguments that Shaun Gallagher (2003) presents in “Bodily self-awareness and objectperception” against proprioception’s ability to meet the criteria of object perception, (2) present a diagnosis of Gallagher’s position by locating a misunderstanding in the distinction between proprioceptive information and proprioceptive awareness, and (3) show that treating proprioception as a perceptual modality allows us to account for the interaction of proprioception with the other sensory modalities, to apply the lessons we learn from proprioception to the other sensory modalities, and to account for proprioceptive learning. Finally, (4) I examine Sydney Shoemaker’s (1994) identification constraint and suggest that a full-fledged notion of object-hood is unnecessary to ground a theory of perception.

Field dependence–independence and physical activity engagement among middle school students

Background: Field dependence–independence (FDI) is a tendency to rely on external frames (given situations and authoritative people) or internal frames (oneself, including one's own body) for one's information processing and behavior. Literature has constantly reported that field-dependent (FD) individuals, who are less autonomous in decision-making processes and less effective in detecting and using body information (kinesthetic feedback and proprioceptive awareness), tend to demonstrate less desirable performance in sport, motor learning, and physical education settings compared with their field-independent (FI) counterparts. Little attempt, however, has been made to investigate whether FD individuals have less desirable physical activity (PA) levels than FI individuals. Lack of knowledge might pose a potential risk of health problems to FD individuals. Purpose: This study was intended to investigate and compare PA levels as well as organized sports participation between FI and FD middles school students. It was hypothesized that FDI would be associated with higher PA levels and more participation in organized sports for FI students as opposed to FD students. Participants and setting: One hundred and thirty eight middle school students (72 girls and 66 boys) in the USA participated in data collection of this study. Of these 138 participants, 46 FI participants (22 girls and 24 boys) and 46 FD participants (24 girls and 22 boys) were identified as final participants whose data were analyzed. Research design: A cross-sectional design was utilized in this study. Participants were grouped based on their FDI status, gender, and cross-classification of FDI status and gender to compare PA variables and participation in organized sports. FDI status and gender were independent variables, and PA variables and participation in organized sports were dependent variables. Data collection: The Rod-and-Frame Test was used to identify FI and FD participants, the Self-Administered Physical Activity Checklist was administered to determine participants' PA amounts, and a demographic inventory was employed to obtain information regarding participants' participation in organized sports. Data analysis: A two-way (FDI × gender) MANOVA was used to detect differences in PA variables among groups, and a Chi-square analysis was employed to test independence of FDI from participation in organized sports. An alpha of .05 was set for significant levels. Findings: This study revealed the contrasting PA levels and participation in organized sports between the FI and FD students. The FD students demonstrated much lower PA levels and were less engaged in organized sports than the FI students. Further, the FD students tended to choose activities that were less related to sports, resulting in shorter PA minutes and lower energy expenditure compared with the FI students. Conclusions: FDI is related to PA levels in addition to being related to sport, motor learning, and physical education. Specifically, FD students have lower sports potential and are less physically active compared with FI students and this could put FD students at a higher risk level in terms of health problems now and in the future. Lifestyle PA and other non-competitive activities might be good choices for FD students to enhance their PA levels.

Pain Coping Strategies for Tension-Type Headache: Possible Implications for Insomnia?

Insomnia has been identified as a risk factor for tension-type headache, although the pathogenesis of sleep disturbance in this population is unclear. The present study examined pain-related self-management strategies in a nonclinical, young-adult sample for preliminary evidence to support a novel hypothesis for the development of insomnia in this population. Self-report data on triggers of headache, pain interference with sleep, and pain-related self-management strategies were analyzed for 32 women with tension-type headache and 33 women with minimal pain who served as controls. The results revealed that a significantly greater proportion of the headache group relative to the control group reported sleep problems as a trigger of headaches, stress as a trigger of headache, and going to sleep as a coping strategy for pain. The headache group also reported significantly higher ratings of pain interference with sleep. Going to sleep was the most commonly used self-management strategy (81%) by headache sufferers and also rated as the most effective strategy (5.5 out of 7.0). These findings suggest that a bidirectional relationship between sleep disturbance and headache is present in this young-adult sample. Furthermore, the frequent use of sleep as a self-management strategy for pain is consistent with the hypothesis that sleep-seeking behavior might be a mediating factor in the development of insomnia among people with tension-type headache. This hypothesis fits within the most widely accepted conceptual model of chronic insomnia and should be further investigated in individuals with both tension-type headache and insomnia.

Bodily self-awareness and object perception

In this paper I would like to argue that proprioceptive awareness (including both somatic and ecological proprioception) is primarily a form of non-perceptual awareness. This might seem to be an obscure point, but it turns out to be philosophically significant in regard to what Shoemaker calls ‘immunity to error through misidentification’. Although it is possible to make a mistake in identifying one’s body via sense-perceptual modalities such as vision, some philosophers argue that one is immune to error through misidentification in regard to knowing one’s own body by means of proprioception (Cassam, 1995; Evans, 1982). If proprioception were a form of perception then it would be possible for one to proprioceptively misidentify oneself in referring to one’s body. In arguing that proprioception is not a form of perception I am defending the immunity principle in this regard.

Psychophysiological Responses of Female Headache Sufferers and Controls Using a Picture-Viewing Paradigm

Despite the advancement of the biopsychosocial model, the interrelationship between behavioral, emotional, and physiological factors in tension-type headache (TTH) remains unclear. Using a picture-viewing paradigm, the present study investigated differences between females with TTH and controls on physiological reactivity, affective valence and arousal, and oral motor habits. In addition, the concordance between EMG activity and self-reported oral habits (i.e., proprioceptive awareness) and EMG activity and self-reported affect (i.e., affective coherence) were measured using within-subject correlations per individual and then compared between groups. Data were analyzed for 27 TTH sufferers and 27 controls who completed a questionnaire packet followed by a psychophysiological assessment consisting of 3 phases (adaptation, scheduled-viewing, recovery) with EMG activity recorded continuously at 3 sites (frontalis, corrugator, zygomatic). During the scheduled-viewing phase, participants were presented with 24 pictures designed to elicit positive, neutral, and negative affect. Compared to controls, the headache group reported elevations in pain, oral habits, and stress across the 3 phases of the assessment, along with elevations in arousal while viewing the pictures. There were no significant differences between the groups in EMG activity while viewing the pictures. Analyses on concordance revealed partial evidence for poor proprioceptive awareness and affective coherence among the headache group, although the correlations were not significantly different than the control group. These findings suggest that arousal, stress perception, and oral habits may play a role in the pathophysiology of TTH and that within-subject designs should be tested further against group designs when measuring psychophysiological concordance.

身体的行為と自己観察

In this paper I focus on the roles of proprioception and of perception in forming the cognitive picture of ourselves as physical agents in the world. Our proprioceptive awareness is plausibly characterized in terms of its distinctive epistemic unmediatedness and constancy, and this fact may seem to support the view that the primary core of our self-conception is constituted by our proprioceptive self-awareness, not by ordinary modes of self-perception. I criticize some main arguments for this view, and suggest that the proper understanding of the significance of proprioception needs the appreciation of its intricate involvement with our perceptual bodilyawareness. I conclude with the remark that the notion of basic action should be restored on this epistemological footing.

Sensory integration activity in nursing home residents' cognitions, affect, self-esteem and behavior.

Persons residing in a nursing home experience a variety of both age-related and pathological disabilities which combined with a relatively unchanging environment may diminish sensory and perceptual processing abilities. Deprivation has been related to cognitive, mood and other behavioral problems in several studies (8, 9, 10, 11 ). Sensory Integration ( 7 ) is a therapeutic modality focusing on stimulation of the five senses and includes exercises in proprioceptive and kinesthetic awareness. Group sessions were held three days a week, 45 min. per session, for 10 wk. To examine the effect of Sensory Integration group activities, 23 nursing home residents (age range 57-96 years; 21 males, 2 females; length of stay 10-184 mo.) were randomly assigned to an activity or control group. Two male residents died during the study and their data are not included. The activity group was significantly older than the control group (Activity M = 81.2 yr., S D = 9.16; Control M = 68.6 yr., SD = 6.84; tm = 3.56, p < .01). About one month prior to group activity all subjects were pretested with a variety of measures to assess affect, self-esteem, cognition, and ward behaviors. Tests included The Geriatric Depression Scale ( 1 ), Zung Depression Scale ( 12) , Center for Epidemiological Studies Depression Scale ( 5 ) , Cognitive Capacity Screening Exam~narion (2 ) , Geriatric Interpersonal Evaluation Scale ( 3 ) , Geriatric Rating Scale (4), and Self-esteem ( 6 ) . Multiple measures were used for assessing depression because the scales tend to emphasize different depressive symptoms. Subjects were retested on the same tests in the same order one month following termination of the group activities. Analyses by t test indicate no significant differences between groups. A slight trend for increased posttest scores was observed on both groups' depression scales and the Geriatric Rating Scale, Antisocial/Disruptive subscale indicated a slight but nonsignificant trend towards less disruption in the activity group. The sample size of nursing home residents may have been too small or the activity program of insufficient length considing the significantly older activity group. A ceiling and floor effect was also observed on some of the brief measures. Further study is needed to clarify the therapeutic role of activity-groups in enhancing the quality of life of elderly nursing home residents.

Proprioceptive awareness, information about response-reinforcement contingencies, and operant heart-rate control

Twenty subjects were conditioned to raise their operant heart rates during the presentation of one stimulus and to lower operant heart rate during the presentation of a second stimulus. A 2 by 2 factorial design was utilized to examine the effects of proprioceptive awareness [high overall score on the Automonic Perception Questionnaire (APQ) vs. low APQ score] and instructions about the response-reinforcement contingencies (informed subjects vs. uninformed subjects) on operant heart- rate control. The results indicated that informed subjects achieved better control over operant heart rate than uninformed subjects. No effects attributable to APQ score were detected. It is suggested that proprioceptive awareness may influence heart-rate control when no external feedback is available (e.g., Bergman & Johnson, 1971), or when external feedback is relatively weak (e.g., Blanchard, Young, & McLeod, 1972), but information about contingencies of reinforcement appears to have more impact on heart-rate control than proprioceptive awareness when relatively powerful external feedback is available. The heart-rate results appeared to be relatively independent of changes in skin responding and cephalic pulse amplitude.