Sensorimotor Training Research Articles

Therapeutic effects of sensory input training on motor function rehabilitation after stroke.

Motor dysfunction is a common and severe complication of stroke that affects the quality of life of these patients. Currently, motor function rehabilitation predominantly focuses on active movement training; nevertheless, the role of sensory input is usually overlooked. Sensory input is very important to motor function. Voluntary functional movement necessitates preparation, execution, and monitoring functions of the central nervous system, while the monitoring needs the participation of the sensory system. Sensory signals affect motor functions by inputting external environment information and intrinsic physiological status as well as by guiding initiation of the motor system. Recent studies focusing on sensory input-based rehabilitation training for post-stroke dyskinesia have demonstrated that sensory function has significant effects on voluntary functional movements. In conclusion, sensory input plays a crucial role in motor function rehabilitation, and the combined sensorimotor training modality is more effective than conventional motor-oriented approaches.

Sensorimotor training and whole-body vibration training have the potential to reduce motor and sensory symptoms of chemotherapy-induced peripheral neuropathy-a randomized controlled pilot trial.

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and clinically relevant side effect of chemotherapy. The symptoms diminish patients' quality of life and represent a decisive limiting factor for medical therapy. To date, effective treatment options are lacking. Specific exercise interventions have proven promising to target relevant symptoms. We conducted a prospective, four-armed, randomized, controlled trial, to evaluate the effects of sensorimotor training (SMT) and whole-body vibration training (WBV) on patients with CIPN. Participants (N = 40) were randomized to either one of two intervention groups (SMT N = 10 or WBV N = 10) or oncological control group (N = 10) and matched by gender and age with a healthy control (N = 10). The intervention groups exercised twice a week for 6weeks. Primary endpoint was the reduction of CIPN-related symptoms (improve peripheral deep sensitivity, Achilles tendon reflex (ASR) and patellar tendon reflex (PSR), light-touch perception, sense of position, and lower leg strength). Secondary endpoints were nerve conduction velocity and amplitude, balance control, quality of life, and CIPN-related pain. Patients exercising improved sensory and associated motor symptoms. Significant intergroup differences were found for the tendon reflexes (ASR P = .017 and PSR P = .020), peripheral deep sensitivity (P = .010), and pain (P = .043). Furthermore, tendencies were found regarding the subjective improvement of symptoms (P = .075) and two subscales of the EORTC-QLQ-C30 questionnaire: pain (P = .054) and dyspnea (P = .054). The results for the SMT group were superior regarding the tendon reflexes, and a tendency regarding the subjective report of symptoms, while WBV was superior regarding pain. SMT and WBV behold a large potential to reduce CIPN-related symptoms and can be considered feasible and safe for patients with CIPN (compliance 97.5%, no adverse events).Registration: DRKS00013027.

Relieving phantom limb pain with multimodal sensory-motor training

Objective. The causes for the disabling condition of phantom limb pain (PLP), affecting 85% of amputees, are so far unknown, with few effective treatments available. Sensory feedback based strategies to normalize the motor commands to control the phantom limb offer important targets for new effective treatments as the correlation between phantom limb motor control and sensory feedback from the motor intention has been identified as a possible mechanism for PLP development. Approach. Ten upper-limb amputees, suffering from chronic PLP, underwent 16 days of intensive training on phantom-limb movement control. Visual and tactile feedback, driven by muscular activity at the stump, was provided with the aim of reducing PLP intensity. Main results. A 32.1% reduction of PLP intensity was obtained at the follow-up (6 weeks after the end of the training, with an initial 21.6% reduction immediately at the end of the training) reaching clinical effectiveness for chronic pain reduction. Multimodal sensory-motor training on phantom-limb movements with visual and tactile feedback is a new method for PLP reduction. Significance. The study results revealed a substantial reduction in phantom limb pain intensity, obtained with a new training protocol focused on improving phantom limb motor output using visual and tactile feedback from the stump muscular activity executed to move the phantom limb.

Balance Training With a Dynamometric Platform Following Total Knee Replacement: A Randomized Controlled Trial.

Sensorimotor training has proven to be an efficient approach for recovering balance control following total knee replacement (TKR). The purpose of this trial was to evaluate the influence of specific balance-targeted training using a dynamometric platform on the overall state of balance in older adults undergoing TKR. This was a randomized controlled clinical trial conducted at a university hospital rehabilitation unit. Patients meeting the inclusion criteria were randomly assigned to a control group or an experimental group. Both groups participated in the same 4-week postoperative rehabilitation training protocol. Participants in the experimental group performed additional balance training with a dynamometric platform consisting of tests related to stability challenges, weight-shifting, and moving to the limits of stability. The primary outcome measure was the overall state of balance rated according to the Berg Balance Scale. Secondary outcomes in terms of balance were the Timed Up and Go Test, Functional Reach Test, and Romberg open and closed-eyes tests. Data processing included between-group analysis of covariance, minimal detectable change assessment for the primary outcome measure, and effect size estimation. Confidence intervals (CIs) were set at 95%. Forty-three participants meeting the inclusion criteria and having signed the informed consent were randomly assigned to 2 groups. Thirty-seven completed the training (86.1%). Significant between-group differences in balance performance were found as measured with the Berg Balance Scale (P = .03) and Functional Reach Test (P = .04) with a CI = 95%. Significant differences were not recorded for the Timed Up and Go Test or Romberg open and closed-eyes tests (P > .05). Furthermore, Cohen's effect size resulted in a value of d = 0.97, suggesting a high practical significance of the trial. According to the Berg Balance Scale and Functional Reach Test, participants with TKR who have followed a 4-week training program using a dynamometric platform improved balance performance to a higher extent than a control group training without such a device. The inclusion of this instrument in the functional training protocol may be beneficial for recovering balance following TKR.

Comparison of the effects of sensorimotor training programs on pain, electromyography and kinematics in patients with scapular downward rotation syndrome

ObjectivesComparison of the effects of six weeks sensorimotor and sensorimotor with passive interventions programs on pain, electromyography (EMG) and kinematics in patients with scapular downward rotation syndrome (SDRS). DesignRandomized Controlled Trial. SettingInstitutional practice. Participants140 active subjects with unilateral SDRS were randomized to three groups. Group one received sensorimotor (n = 46), group two received sensorimotor with passive interventions (n = 48), and group three received active self-exercise as a control group (n = 46). Pain, EMG of the levator scapula (LS), upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA), as well as kinematics were measured at the baseline and after the interventions. Main outcome measuresPrimary outcome: Pain – Secondary outcomes: EMG and kinematics. ResultsThere were significant between-group differences between intervention groups one and two in pain, LS and SA onset activation favoring group two and LS muscle activity favoring group one. There were significant within-group changes in almost all dependent variables except LT muscle onset activation in both groups one and two. ConclusionsThe addition of passive interventions on the scapula and neck may be superior to conservative training alone on the scapula and neck for improving neck pain, EMG and kinematics in participants with SDRS.

Gender-Dependent Changes in Time Production Following Quadrato Motor Training in Dyslexic and Normal Readers.

Time estimation is an important component of the ability to organize and plan sequences of actions as well as cognitive functions, both of which are known to be altered in dyslexia. While attention deficits are accompanied by short Time Productions (TPs), expert meditators have been reported to produce longer durations, and this seems to be related to their increased attentional resources. In the current study, we examined the effects of a month of Quadrato Motor Training (QMT), which is a structured sensorimotor training program that involves sequencing of motor responses based on verbal commands, on TP using a pre-post design. QMT has previously been found to enhance attention and EEG oscillatory activity, especially within the alpha range. For the current study, 29 adult Hebrew readers were recruited, of whom 10 dyslexic participants performed the QMT. The normal readers were randomly assigned to QMT (n = 9) or Verbal Training (VT, identical cognitive training with no overt motor component, and only verbal response, n = 10). Our results demonstrate that in contrast to the controls, longer TP in females was found following 1 month of intensive QMT in the dyslexic group, while the opposite trend occurred in control females. We suggest that this longer TP in the female dyslexics is related to their enhanced attention resulting from QMT. The current findings suggest that the combination of motor and mindful training, embedded in QMT, has a differential effect depending on gender and whether one is dyslexic or not. These results have implications for educational and contemplative neuroscience, emphasizing the connection between specifically-structured motor training, time estimation and attention.

Mirror Illusion for Sensori-Motor Training in Stroke: A Randomized Controlled Trial

BackgroundPoststroke, sensory deficits are not uncommon. In spite of the close association between the sensory and motor recovery, the deficits are usually underemphasized. Mirror therapy (MT), a neural-based approach for the motor deficit has not been explored for the sensory impairment. The objective of the present study was to develop and determine the effect of a MT program for sensori-motor impairment among poststroke subjects. Methods DesignRandomized controlled trial. SettingFunctional therapy laboratory of Rehabilitation Institute. ParticipantsThirty-one chronic poststroke subjects (17 experimental and 14 controls), aged between 30 and 60years, with ≤ diminished light touch in the hand. Outcome MeasureSemmes Weinstein Monofilament (cutaneous threshold), 2-Point discrimination test (touch discrimination) and Fugl-Meyer Assessment (hand motor recovery). InterventionThe experimental group received sensory stimulus such as tactile perception and motor tasks on the less-affected hand using mirror box. The control counterparts underwent only dose-matched conventional program. 30 sessions with a frequency of 5/week were imparted to the groups. ResultsPost intervention, there was a significant (P < .004) increase up to 30% positive touch-response for the hand quadrants among the experimental group in comparison to only 13.5% rise for the same among the controls. The cutaneous threshold of the less-affected palm also improved significantly among the experimental subjects in comparison to the controls (P = .04). ConclusionMT may be considered as a promising regime for enhancing cutaneous sensibility in stroke. The mirror illusion induced by MT may be utilized for sensory and motor deficits as well as for the more-affected and less-affected hands.

Sensory-motor training improves health-related quality of life and fall efficacy in chronic stroke survivors

Stroke survivors struggle with an array of disabilities, which can be divided into physical, social as well as emotional debilities. The primary objective was to assess the influence of an eight-week sensory-motor training program on health-related quality of life and concern for falling in chronic stroke survivors. This was a double-blind randomized control trial. Chronic stroke participants (≥ 6 months) were divided into two groups namely, sensory-motor training group ( n = 12; 68 ± 13 years old) and attention-control group ( n = 10; 71 ± 11 years old). Both interventions were executed three times a week for 45-60 minute sessions over an eight-week period. The sensory-motor training consisted out of task-specific balance exercises while manipulating the visual, vestibular and proprioceptive sensory systems. Health-related quality of life was measured with the Short Form Health Survey (SF-36) and concern for falling with the Fall Efficacy Scale International (FES-I). Participants were evaluated pre-intervention and post-intervention. A significant group × time interaction was identified for physical functioning ( P = 0.005) and FES-I ( P = 0.03). Additionally, the experimental group showed a significant improvement in physical ( P = 0.01) and social functioning ( P = 0.02) subdomains of SF-36 after training. Lastly, the sensory-motor training group perceived their physical and social functioning to be better compared to attention-matched group ( P < 0.05). The results of this study indicate that balance training under sensory manipulated conditions can improve the perception of physical and social functioning as well as concern for falling in chronic stroke survivors.

Effect of sensory-motor training on gait quality and executive functioning of chronic stroke survivors

Traditionally gait was believed to be an automated task; however current research shows that walking involves higher cognitive functions i.e. executive function (EF). Optimal EF allows allocation of appropriate attentional resources to performing motor tasks correctly and effectively and is severely affected in stroke survivors. Limited research has been done on the effectiveness of sensory-motor training (SMT) on cognitive functioning in stroke. It is hypothesized that SMT may improve this motor-cognitive interaction during gait, as well as EF. This study endeavoured to determine if an eight-week SMT programme would influence executive functioning and dual task gait quality in chronic stroke survivors. This pre-post study design consisted of ten chronic stroke survivors (67 ± 14 years; ≥ 6 months since stroke) with no severe cognitive impairment (24 ± 2 score on Montreal Cognitive Assessment) who participated in the eight-week SMT programme, three times a week (45–60 minutes per session) under therapist-supervision. A two-minute walk test assessed single (ST) and dual task (DT) spatial-temporal gait variables; while EF was assessed with an adapted Stroop, Trail Making (Part A and B) and Verbal Digit Span Forward and Backward tests. Stroke-related self-efficacy was determined by completing the Stroke Self-efficacy Questionnaire. No significant changes were found in EF or ST gait variables. DT stride velocity ( P = 0.05, d = 0.39, 95% CI: −11.07 to −0.73), paretic stride velocity ( P = 0.04, d = 0.40, 95% CI: −11.34 to −1.18), cadence ( P = 0.03, d = 0.78, 95% CI: −19.04 to −2.50), stride time ( P = 0.02, d = 0.82, 95% CI: 0.00 to 0.40) and peak medio-lateral trunk acceleration ( P = 0.02, d = 0.45, 95% CI: −5.93 to −1.16) showed improvement. Stroke-related self-efficacy ( P < 0.001; d = 2.66, 95% CI: 1.26 to 4.57) also improved. Preliminary findings suggest that SMT have some benefits for improving cognitive-motor interaction during walking, while also improving factors that specifically influence performance in stroke survivors. Furthermore, studies should investigate the use of DT as an ecological assessment tool for stroke survivor's EF.

Effects of a 6-month balance intervention on postural control of preschoolers born with biological risk factors

AbstractStudy aim: To investigate the effects of 6-month sensorimotor training on postural control of 5-6-year-old preschool children born with ‘biological risk factors’ (BRF). Material and methods: Sixty-four Hungarian preschoolers participated in this study, and were assigned to an experimental group (n = 17), control group 1 (n = 23) and control group 2 (n = 24). The experimental group (born with BRF) attended a 6-month balance intervention based on Ayres’ therapy, while control group 1 (born with BRF) and control group 2 (born with no BRF) fol­lowed the regular preschool schedule. Birth weight, gestational age at birth, Apgar score and other abnormalities during pregnancy and birth were considered to be BRF. A moveable platform (stabilometer) was used to examine the distance of center of pressure movements of all participants prior to the start and after the end of the intervention. The testing procedure was performed with four enjoyable tests in the same sequence (‘Mouse in the hole’, ‘Center’, ‘Christmas tree’, ‘Square painting’). Results: The balance intervention program resulted in significant improvements in postural control of the experimental group. In three of six variables the balance index scores of the intervention group approached the scores of their peers born without BRF, and they even had better performance in three of six variables. Conclusions: Balance training with instability training devices could help children born with BRF attain a higher level of inte­gration through the stimulation of tactile and balancing senses.

Sensorimotor Activity Partially Ameliorates Pain and Reduces Nociceptive Fiber Density in the Chronically Injured Spinal Cord.

A large proportion of patients suffering from spinal cord injury (SCI) develop chronic central neuropathic pain. Previously, we and others have shown that sensorimotor training early after SCI can prevent the development of mechanical allodynia. To determine whether training initiated in the subchronic/chronic phase remains effective, correlates of below-level neuropathic pain were analyzed in the hindpaws 5-10 weeks after a moderate T11 contusion SCI (50 kDyn) in adult female C57BL/6 mice. In a comparison of SCI and sham mice 5 weeks post-injury, about 80% of injured animals developed mechanical hypersensitivity to light mechanical stimuli, whereas testing of noxious stimuli revealed hypo-responsiveness. Thermal sensitivity testing showed a decreased response latency after injury. Without intervention, mechanical and thermal hyper-responsiveness were evident until the end of the experiment (10 weeks). In contrast, treadmill training (2 × 15 min/day; 5 × /week) initiated 6 weeks post-injury resulted in partial amelioration of pain behavior and this effect remained stable. Analysis of calcitonin gene-related peptide (CGRP)-labeled fibers in lamina III-IV of the lumbar dorsal horn revealed an increase in labeling density after SCI. This was not due to changes in the number or size distribution of CGRP-labeled lumbar dorsal root ganglion neurons. Treadmill training reduced the CGRP-labeling density in the spinal cord of injured mice, whereas the density of non-peptidergic isolectin-B4 (IB4)+ fibers showed no changes in lamina IIi and a slight reduction of sparse IB4 labeling in laminae III-IV. Thus, sensorimotor activity initiated in the subchronic/chronic phase of SCI remains effective in ameliorating pain behavior and influencing structural changes of the nociceptive system.

Comparison of device-supported sensorimotor training and splint intervention for myofascial temporomandibular disorder pain patients.

This study was to compare the short-term therapeutic efficacy of device-supported sensorimotor training with that of standard splint therapy for patients with myofascial temporomandibular disorder (TMD) pain over a treatment period of 3months. We tested the hypothesis that both types of intervention are equally effective for pain reduction. In addition, the electromyographic (EMG) activity of the temporal and masseter muscles was recorded under conditions of force-controlled submaximum and maximum biting in intercuspation. Of consecutive patients seeking treatment for non-odontogenic oro-facial pain, 45 patients with myofascial TMD pain (graded chronic pain status, GCPS, I and II) were randomly assigned to 2 treatment groups (sensorimotor training and conventional splint treatment). Patients were evaluated 4 times (initial examination, 2, 6 and 12weeks later) by use of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Electromyographic activity was recorded at the initial session and after 3months. Ease-of-use of the treatment options was also evaluated. Significant (P<.0001) pain reduction (sensorimotor training 53%, splint therapy 40%) was achieved for both groups, with no significant differences (P>.05) between the groups. Force-controlled sub-maximum normalized electromyographic activity was significantly different between T0 and T3 for group A (sensorimotor training, P < .05) but was not significantly different for group B (splint, P > .05). For normalized maximum-biting EMG activity in intercuspation, however, a significant increase in EMG activity was observed for group A for the masseter and temporal muscles (P < .001) and for group B for the masseter muscle only (P < .001). Moreover, sensorimotor training was significantly (P<.05) less easy to use than the splint. The results of this study confirm the pain-reducing effect of sensorimotor training for patients with myofascial TMD pain (GCPS I and II). This innovative active treatment might be a promising option for TMD pain patients.

Neuromuscular Re-Education Programs for Musicians with Focal Hand Dystonia: A Systematic Review.

The purpose of this systematic review was to evaluate the effectiveness of neuromuscular re-education programs on reducing abnormal movements during instrument play in musicians with focal hand dystonia (FHD). A systematic literature search of published articles was performed. Databases searched included MEDLINE, CINAHL, PsycINFO, OTseeker, and the Cochrane Library. Additional articles were identified from reference lists. Studies meeting inclusion criteria were independently assessed by the two coauthors for eligibility and quality of methods. Study data were summarized in a critical appraisal chart. Nine studies met the inclusion criteria for review, including 1 non-randomized two-group study, 6 single-group repeated measures studies, and 2 single-subject studies. The studied neuromuscular re-education programs included constraint-induced therapy plus motor control retraining, sensory motor retuning, learning- based sensorimotor training, and slow-down exercise. The results of this review indicate there is moderate evidence to support the effectiveness of neuromuscular re-education programs on reducing abnormal movements during instrument play in musicians with FHD. However, additional research should evaluate the effectiveness of neuromuscular re-education programs using reliable and valid outcome measures, as well as study methods which provide higher levels of evidence.

Sensorimotor Exercises and Enhanced Trunk Function: A Randomized Controlled Trial.

The aim of this study was to investigate the effect of a 6-week sensorimotor or resistance training on maximum trunk strength and response to sudden, high-intensity loading in athletes.Forty-three healthy, well-trained participants were randomized into sensorimotor (SMT; n=11), resistance training (RT; n=16) and control groups (CG; n=16). Treatment groups received either sensorimotor training (SMT) or resistance training (RT) for 6 weeks, 3 times a week. At baseline and after 6 weeks of intervention, participants' maximum isokinetic strength in trunk rotation and extension was tested (concentric/eccentric 30°/s). In addition, sudden, high-intensity trunk loading was assessed for eccentric extension and rotation, with additional perturbation. Peak torque [Nm] was calculated as the outcome.Interventions showed no significant difference for maximum strength in concentric and eccentric testing (p>0.05). For perturbation compensation, higher peak torque response following SMT (Extension: +24 Nm 95%CI±19 Nm; Rotation: +19 Nm 95%CI±13 Nm) and RT (Extension: +35 Nm 95%CI±16 Nm; Rotation: +5 Nm 95%CI±4 Nm) compared to CG (Extension: -4 Nm 95%CI±16 Nm; Rotation: -2 Nm 95%CI±4 Nm) was present (p<0.05).This study showed that isokinetic strength gains were small, but that significant improvements in high-intensity trunk loading response could be shown for both interventions. Therefore, depending on the individual's preference, therapists have two treatment options to enhance trunk function for back pain prevention.

Early reduced behavioral activity induced by large strokes affects the efficiency of enriched environment in rats

The majority of stroke patients develop post-stroke fatigue, a symptom which impairs motivation and diminishes the success of rehabilitative interventions. We show that large cortical strokes acutely reduce activity levels in rats for 1–2 weeks as a physiological response paralleled by signs of systemic inflammation. Rats were exposed early (1–2 weeks) or late (3–4 weeks after stroke) to an individually monitored enriched environment to stimulate self-controlled high-intensity sensorimotor training. A group of animals received Anti-Nogo antibodies for the first two weeks after stroke, a neuronal growth promoting immunotherapy already in clinical trials. Early exposure to the enriched environment resulted in poor outcome: Training intensity was correlated to enhanced systemic inflammation and functional impairment. In contrast, animals starting intense sensorimotor training two weeks after stroke preceded by the immunotherapy revealed better recovery with functional outcome positively correlated to the training intensity and the extent of re-innervation of the stroke denervated cervical hemi-cord. Our results suggest stroke-induced fatigue as a biological purposeful reaction of the organism during neuronal remodeling, enabling new circuit formation which will then be stabilized or pruned in the subsequent rehabilitative training phase. However, intense training too early may lead to wrong connections and is thus less effective.

Anodal Transcranial Direct-Current Stimulation to Enhance Rehabilitation in Individuals With Rotator Cuff Tendinopathy: A Triple-Blind Randomized Controlled Trial.

Background Anodal transcranial direct-current stimulation (a-tDCS) has been shown to enhance the effects of sensorimotor training in neurological populations. Sensorimotor training leads to reduced pain and increased function in the treatment of rotator cuff tendinopathy. The addition of a-tDCS during a rehabilitation program centered on sensorimotor training may improve treatment outcomes in individuals with rotator cuff tendinopathy. Objective To compare 2 groups of individuals with rotator cuff tendinopathy, one receiving a rehabilitation program centered on sensorimotor training with a-tDCS and the other receiving the same rehabilitation program with sham a-tDCS. Methods In this triple-blind, parallel-group randomized controlled trial, 40 adults with rotator cuff tendinopathy participated in a 6-week rehabilitation program (8 treatments with home exercises and including sensorimotor training, patient education, and strengthening). They were randomly assigned to 1 of 2 groups to receive either real a-tDCS (stimulation, 1.5 mA for 30 minutes) or sham a-tDCS during the first 5 treatments. Symptoms and functional limitations (Disabilities of the Arm, Shoulder and Hand questionnaire, Western Ontario Rotator Cuff index) of all participants were evaluated at baseline and at 3, 6, and 12 weeks. Acromiohumeral distances (ultrasonographic measurement at 0°, 45°, and 60° of arm elevation) were assessed at baseline and 6 weeks. Two-way or 3-way repeated-measures analyses of variance were used for statistical analyses. Results Both groups showed statistically significant improvement in Disabilities of the Arm, Shoulder and Hand questionnaire and Western Ontario Rotator Cuff index scores at 3, 6, and 12 weeks, and in acromiohumeral distance at 45° and 60° at 6 weeks (P<.05). No significant group-by-time interaction was observed for all outcomes (P>.43). Conclusion Results do not demonstrate any improved treatment outcomes from the addition of a-tDCS during a rehabilitation program for individuals with rotator cuff tendinopathy. Level of Evidence Therapy, level 1b. J Orthop Sports Phys Ther 2018;48(7):541-551. Epub 10 May 2018. doi:10.2519/jospt.2018.7871.

Consolidation of human somatosensory memory during motor learning

Sensorimotor learning is a bidirectional process associated with concurrent neuroplastic changes in the motor and somatosensory system. While motor memory consolidation and retention have been extensively studied during skill acquisition, little is known about the formation and consolidation of somatosensory memory associated with motor learning. Using a robotic exoskeleton, we tracked markers of somatosensory and motor learning while healthy participants trained to make goal-directed wrist reaching movements over five days and evaluated retention for up to 10 days after practice. Markers of somatosensory learning were changes in wrist position sense bias (systematic error) and precision (random error). The main results are as follows: First, somatosensory (proprioceptive) memory consolidation shows signs of cost savings with repeated sensorimotor training – the same feature is known for motor memory formation. Moreover, somatosensory learning generalized to untrained workspace. Second, somatosensory learning over days can be characterized as an early improvement in sensory precision and a later improvement in sensory bias. Third, the time course of learning gains in position sense acuity coincided with improvements in spatial movement accuracy. Finally, the gains of somatosensory learning were retained for several days. Improvements in position sense bias were still visible up to 3 days after the end of practice for the trained workspace positions, but decayed faster in the untrained workspace. Improvements in position sense precision were retained for up to 10 days and were workspace independent. The findings are consistent with the view that an internal model of somatosensory joint space is formed during motor learning.

Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial

Objective: To assess the effects of early self-managed focal sensorimotor training compared to functional exercise training after total knee replacement on functional mobility and sensorimotor function. Design: A single-blind controlled clinical trial. Setting: University Hospital of Rion, Greece. Subjects: A total of 52 participants following total knee replacement. Outcome measures: The primary outcome was the Timed Up and Go Test and the secondary outcomes were balance, joint position error, the Knee Outcome Survey Activities of Daily Living Scale, and pain. Patients were assessed on three separate occasions (presurgery, 8 weeks post surgery, and 14 weeks post surgery). Intervention: Participants were randomized to either focal sensorimotor exercise training (experimental group) or functional exercise training (control group). Both groups received a 12-week home-based programme prescribed for 3–5 sessions/week (35–45 minutes). Results: Consistently greater improvements (F2,98 = 4.3 to 24.8; P < 0.05) in group mean scores favour the experimental group compared to the control group: Timed Up and Go (7.8 ± 2.9 seconds vs. 4.6 ± 2.6 seconds); balance (2.1 ± 0.9° vs. 0.7 ± 1.2°); joint position error (13.8 ± 7.3° vs. 6.2 ± 9.1°); Knee Outcome Survey Activities of Daily Living Scale (44.2 ± 11.3 vs. 26.1 ± 11.4); and pain (5.9 ± 1.3 cm vs. 4.6 ± 1.1 cm). Patterns of improvement for the experimental group over time were represented by a relative effect size range of 1.3–6.5. Conclusions: Overall, the magnitude of improvements in functional mobility and sensorimotor function endorses using focal sensorimotor training as an effective mode of rehabilitation following knee replacement.

The preventive effect of sensorimotor- and vibration exercises on the onset of Oxaliplatin- or vinca-alkaloid induced peripheral neuropathies - STOP

BackgroundChemotherapy-induced peripheral neuropathy (CIPN) is a common and clinically relevant side effect of chemotherapy. Approximately 50% of all leukemia, lymphoma, colorectal- and breast cancer patients are affected.CIPN is induced by neurotoxic chemotherapeutic agents and can manifest with sensory and/or motor deficits. It is associated with significant disability and poor recovery. Common symptoms include pain, altered sensation, reduced or absent reflexes, muscle weakness, reduced balance control and insecure gait.These symptoms not only affect activities of daily living, subsequently reducing patients’ quality of life, they have far more become a decisive limiting factor for medical therapy, causing treatment delays, dose reductions, or even discontinuation of therapy, which can affect the outcome and compromise survival. To date, CIPN cannot be prevented and its occurrence presents a diagnostic dilemma since approved and effective treatment options are lacking.Promising results have recently been achieved with exercise. We have revealed that sensorimotor training (SMT) or whole body vibration (WBV) can reduce the symptoms of CIPN and attenuate motor and sensory deficits. We furthermore detected a tendency that it may also have a preventive effect on the onset of CIPN.MethodsWe are therefore conducting a prospective, multicentre, controlled clinical trial involving 236 oncological patients receiving either oxaliplatin (N = 118) or vinca-alkaloid (N = 118) who are randomized to one of two interventions (SMT or WBV) or a treatment as usual (TAU) group. Primary endpoint is the time to incidence of neurologically confirmed CIPN. Secondary endpoints are pain, maintenance of the functionality of sensory as well as motor nerve fibres as well as the level of physical activity. The baseline assessment is performed prior to the first cycle of chemotherapy. Subsequent follow-up assessments are conducted at 12 weeks, after completion of chemotherapy, and at a 3-month follow-up. Patients who develop CIPN receive an additional assessment at this time point, as it represents the primary endpoint.DiscussionWe hypothesize that SMT and WBV prevent the onset or delay the progression of CIPN, decrease the likelihood of dose reductions or discontinuation of cancer treatment and improve patients’ quality of life.Trial registrationDeutsche Register Klinischer Studien (DRKS00006088, registered 07.05.2014).

Mirroring 'meaningful' actions: Sensorimotor learning modulates imitation of goal-directed actions.

Imitation is important in the development of social and technological skills throughout the lifespan. Experiments investigating the acquisition and modulation of imitation (and of its proposed neural substrate, the mirror neuron system) have produced evidence that the capacity for imitation depends on associative learning in which connections are formed between sensory and motor representations of actions. However, evidence that the development of imitation depends on associative learning has been found only for non-goal-directed actions. One reason for the lack of research on goal-directed actions is that imitation of such actions is commonly confounded with the tendency to respond in a spatially compatible manner. However, since the most prominent account of mirror neuron function, and hence of imitation, suggests that these cells encode goal-directed actions, it is important to establish whether sensorimotor learning can also modulate imitation of goal-directed actions. Experiment 1 demonstrated that imitation of goal-directed grasping can be measured while controlling for spatial compatibility, and Experiment 2 showed that this imitation effect can be modulated by sensorimotor training. Together, these data support the hypothesis that the capacity for behavioural imitation and the properties of the mirror neuron system are constructed in the course of development through associative learning.