Thesis (M.Sc.)--University of British Columbia, 2005. / Includes bibliographical references (leaves 44-53). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Made available in DSpace on 2015-07-22T20:50:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-03-31 / Objetivo: Avaliar a efetividade e segurança do treinamento proprioceptivo na melhora da capacidade funcional em pacientes com artrite reumatóide. Métodos: Revisão Sistemática utilizando a metodologia da Colaboração Cochrane. Estratégia de busca: As bases pesquisadas foram: Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 4), MEDLINE (1966 to 2008) via PubMed, EMBASE (1980 to 2008), LILACS (1982 to 2008), CINAHL (1982 to 2008), PEDro e Scirus. Também realizamos busca manual em anais de congressos, listas de referências de artigos publicados e contatos com especialistas. Não houve restrição de idioma. Critérios de Seleção: ensaios clínicos randomizados ou ensaios clínicos controlados comparando o treinamento proprioceptivo com alguma outra intervenção ou com nenhuma intervenção, em pacientes com artrite reumatóide, de acordo com os critérios do Colégio Americano de Reumatologia (ACR).de 1987 Coleta de dados e análise: Dois revisores independentemente avaliaram títulos e/ou resumos para critérios de inclusão e para risco de viés. Resultados: A pesquisa eletrônica identificou 864 estudos. Para esta busca, 17 estudos descreveram exercícios gerais em pacientes com artrite reumatóide como o principal tópico. Após analisá-los, observamos que o principal desfecho foi a melhora na força muscular, resistência, e exercícios dinâmicos (natação, caminhada, etc). Portanto nós não encontramos nenhum estudo investigando os efeitos do treinamento proprioceptivo isolado em pacientes com artrite reumatóide, não foi possível incluir nenhum dado em relação ao tópico escolhido em nossa revisão sistemática. Conclusão: Não houve nenhum estudo disponível avaliando a eficácia do treinamento proprioceptivo em pacientes com artrite reumatóide. A efetividade e segurança do treinamento proprioceptivo em melhorar a capacidade funcional destes pacientes permanece desconhecido. / Objective: To assess the effectiveness and safety of balance training (proprioceptive training) to improve functional capacity in patients with rheumatoid arthritis. Methods: Systematic review with Cochrane methodology. Search strategy: Databases Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 4), MEDLINE (1966 to 2008) via PubMed, EMBASE (1980 to 2008), LILACS (1982 to 2008), CINAHL (1982 to 2008), PEDro e Scirus. We also carried out a handsearching and contact professional associates of the eligible studies when necessary. There was no language restriction. Selection criteria: All eligible randomised controlled trials or controlled clinical trials comparing balance training (proprioceptive training) with any other intervention or with no intervention, in patients with rheumatoid arthritis of according to the 1987 American College of Rheumatology (ACR) criteria. Data collection e analysis: Two reviewers independently assessed titles and/or abstracts for inclusion criteria and for risk of bias. Results: The electronic search identified 864 studies. From this search, 17 studies described general exercises in rheumatoid arthritis patients as the main topic. After analysing them, we observed that the main outcomes were improvement in muscle strength, endurance, and dynamic exercises (swimming, walking, etc). As we did not find any studies investigating the effects of proprioceptive training alone in patients with rheumatoid arthritis, it was not possible to include any data regarding the chosen topic in our systematic review. Conclusion: There is no research available examining the efficacy of balance training in patients with rheumatoid arthritis. The effectiveness and safety of balance training to improve functional capacity of these patients remains unclear, however, it is suggested that future research should give more importance to the balance training by either increasing the number and duration of sessions or investigating its efficacy alone. / TEDE / BV UNIFESP: Teses e dissertações

Proprioception is an ability to perceive the position and speed of body parts that is important for construction of the body schema in the brain. Proper updating of the body schema is necessary for appropriate voluntary movement. However, the mechanisms mediating such an updating are not well understood. To study these mechanisms when the body part was at rest, electroencephalography (EEG) and evoked potentials studies were employed, and when the body was in motion, kinematic studies were performed. An experimental approach to elicit proprioceptive P300 evoked potentials was developed providing evidence that processing of novel passive movements is similar to processing of novel visual and auditory stimuli. The latencies of the proprioceptive P300 potentials were found to be greater than those elicited by auditory, but not different from those elicited by the visual stimuli. The features of the functional networks that generated the P300s were analyzed for each modality. Cross-correlation networks showed both common features, e.g. connections between frontal and parietal areas, and the stimulus-specific features, e.g. increases of the connectivity for temporal electrodes in the visual and auditory networks, but not in the proprioceptive ones. The magnitude of coherency networks showed a reduction in alpha band connectivity for most of the electrodes groupings for all stimuli modalities, but did not demonstrate modality-specific features. Kinematic study compared performances of 19 models previously proposed in the literature for movements at the shoulder and elbow joints in terms of their ability to reconstruct the speed profiles of the wrist pointing movements. It was found that lognormal and beta function models are most suitable for wrist speed profile modeling. In addition, an investigation of the blinking rates during the P300 potentials recordings revealed significantly lower rates in left-handed participants, compared to the right-handed ones. Future work will include expanding the experimental and analytical methodologies to different kinds of proprioceptive stimuli (displacements and speeds) and experimental paradigms (error-related negativity potentials), and comparing the models of the speed profiles produced by the feet to those of the wrists, as well as replicating the observations made on the blinking rates in a larger scale study.

Patients with subacromial pain syndrome (SPS) display a number of sensorimotor deficits including alterations in pain processing, poor proprioception, and weakness at the symptomatic limb. The primary purpose of this dissertation was to explore whether the aforementioned deficits: (1) can be quantified by using the non-involved limb as a measure of control, (2) are purely localized to the symptomatic limb or represent a more generalized deficit, (3) are influenced by the presence of subacromial pain, and (4) present similarly in male and female patients. Here, we utilized modern clinical techniques in both a patient cohort with SPS and uninjured control cohort to address these aims. The results of this dissertation are applicable towards treatment of SPS as well as scientific understanding of sex on sensorimotor behavior.

abstract: The ability to plan, execute, and control goal oriented reaching and grasping movements is among the most essential functions of the brain. Yet, these movements are inherently variable; a result of the noise pervading the neural signals underlying sensorimotor processing. The specific influences and interactions of these noise processes remain unclear. Thus several studies have been performed to elucidate the role and influence of sensorimotor noise on movement variability. The first study focuses on sensory integration and movement planning across the reaching workspace. An experiment was designed to examine the relative contributions of vision and proprioception to movement planning by measuring the rotation of the initial movement direction induced by a perturbation of the visual feedback prior to movement onset. The results suggest that contribution of vision was relatively consistent across the evaluated workspace depths; however, the influence of vision differed between the vertical and later axes indicate that additional factors beyond vision and proprioception influence movement planning of 3-dimensional movements. If the first study investigated the role of noise in sensorimotor integration, the second and third studies investigate relative influence of sensorimotor noise on reaching performance. Specifically, they evaluate how the characteristics of neural processing that underlie movement planning and execution manifest in movement variability during natural reaching. Subjects performed reaching movements with and without visual feedback throughout the movement and the patterns of endpoint variability were compared across movement directions. The results of these studies suggest a primary role of visual feedback noise in shaping patterns of variability and in determining the relative influence of planning and execution related noise sources. The final work considers a computational approach to characterizing how sensorimotor processes interact to shape movement variability. A model of multi-modal feedback control was developed to simulate the interaction of planning and execution noise on reaching variability. The model predictions suggest that anisotropic properties of feedback noise significantly affect the relative influence of planning and execution noise on patterns of reaching variability. / Dissertation/Thesis / Ph.D. Bioengineering 2012

A Doença de Parkinson (DP) caracteriza-se por sintomas motores típicos e déficits proprioceptivos. Considerando-se o papel do estresse oxidativo na doença, o uso de agentes antioxidantes pode ter potencial terapêutico. Depois de uma revisão sobre déficits proprioceptivos na DP, esta dissertação apresenta um estudo empírico sobre o efeito da epicatequina (EC), sobre o modelo animal da 6- hidroxidopamina (6-OHDA). Ratos (n = 75) infundidos unilateralmente com 6- OHDA na via nigroestriatal receberam, após 24h, infusões intracerebrais de EC no estriado (0,031mg/mL, 0,1mg/mL, 0,31mg/mL, 1mg/mL ou veículo). O tratamento foi avaliado através dos testes de rotações induzidas por metilfenidato (40mg/kg) e apomorfina (1mg/kg), teste de motricidade sobre grade e teste da fita adesiva, além de imunoistoquímica. Os resultados mostraram que não houve diferenças entre os grupos em nenhuma das avaliações. Com base nesses resultados, concluímos que a EC, nas concentrações e condições empregadas, não foi capaz de retardar a lesão nigroestriatal ou recuperá-la. / Besides the typical motor symptoms, Parkinson´s disease (PD) is characterized by deficits in proprioception. Considering the putative role of oxidative stress in PD, antioxidants might have therapeutic value. After a review on proprioception in PD, this dissertation presents an empirical study based on the evaluation of epicatechin (EC), in 6-hydroxidopamine (6-0HDA) model of Parkinsonism. Rats (n=75) where unilaterally lesioned into the nigrostriatal pathway and treated 24h later with intracerebral infusions of EC in the striatum (0.031mg/mL, 0.1mg/mL, 0.31mg/mL, 1mg/mL or vehicle). The behavioral effects were assessed through methylphenidate (40 mg/kg) and apomorphine (1 mg/kg)-induced rotations, footfault and stick-tape tests; and brain tissue was analyzed by imunohistochemistry. There were no significant differences between groups neither in the behavioral assessments nor the histological analyses. These results showed that EC was incapable to act on either the reversal or retardation of the lesion in the nigrostriatal pathway.

The human shoulder complex relies on the sensorimotor system to maintain stability. The sensorimotor system includes sensory feedback, control of the central nervous system and motor output. Exercise is considered an important part of shoulder rehabilitation and sports training to help improve control of the sensorimotor system. However, few studies have investigated the effect of exercise on the sensorimotor system. The first study of this dissertation explored the central control of the deltoid and rotator cuff (infraspinatus). Although both the deltoid and infraspinatus contribute to shoulder abduction, the results from this study showed that the modulation of their corticospinal excitability was affected differently by elevation angle. This could be explained by the fact that they play different roles at the shoulder: the deltoid is a prime mover while the infraspinatus is a stabilizer. The second study of this dissertation investigated scapular proprioception, which has not been assessed in previous studies. The findings of this study demonstrated that joint position sense errors of the overall shoulder joint mainly came from the glenohumeral joint. Scapular proprioception may need to be tested separately in addition to overall shoulder proprioception. In the third study, the effect of the exercise on shoulder sensorimotor system was investigated by measuring shoulder kinematics, shoulder joint position sense and cortical excitability before and after a four-week exercise training program. This protocol included strengthening and neuromuscular exercises targeting rotator cuff and scapular muscles. After the training protocol, although strength increased overall, the only observed sensorimotor adaptations were a decrease in upper trapezius activation and a decrease in the corticospinal excitability of the supraspinatus. There were no changes in other key parameters. Exercises focusing on specific muscles, combined with low-intensity closed-chain exercises, were not found to improve shoulder joint position sense or scapular kinematics. Combined with the findings of the decrease in corticospinal excitability of the supraspinatus and no change in muscle activity of the rotator cuff, it appears that while the exercises increased rotator cuff strength, these gains did not transfer to an increase in muscle activation during motion. This dissertation includes previously published co-authored material.

Swallowing is a neurologically centrally driven event; however, a variety of sensory factors (e.g., bolus volume) have been shown to influence swallow-related events (e.g., swallow apnea duration). External factors (e.g., proprioception) have been previously shown to influence preparatory swallow movements (e.g., mouth opening). Yet, it is not known whether these external factors may influence the more automatic components of swallowing. This study was designed to determine whether proprioception influences the onset of swallow apnea. Participants (N = 14, Mage = 25.71 years) were presented with bites/sips of applesauce and water during self and assisted feeding conditions. Results indicated that proprioception had no impact on the timing of swallow apnea onset, supporting that swallow apnea is a centrally driven event. By gaining a better understanding of the physiological impact assisted feeding has on individuals, we can best serve individuals who rely on feeding assistance and optimize swallow safety across all populations.

A Doença de Parkinson (DP) caracteriza-se por sintomas motores típicos e déficits proprioceptivos. Considerando-se o papel do estresse oxidativo na doença, o uso de agentes antioxidantes pode ter potencial terapêutico. Depois de uma revisão sobre déficits proprioceptivos na DP, esta dissertação apresenta um estudo empírico sobre o efeito da epicatequina (EC), sobre o modelo animal da 6- hidroxidopamina (6-OHDA). Ratos (n = 75) infundidos unilateralmente com 6- OHDA na via nigroestriatal receberam, após 24h, infusões intracerebrais de EC no estriado (0,031mg/mL, 0,1mg/mL, 0,31mg/mL, 1mg/mL ou veículo). O tratamento foi avaliado através dos testes de rotações induzidas por metilfenidato (40mg/kg) e apomorfina (1mg/kg), teste de motricidade sobre grade e teste da fita adesiva, além de imunoistoquímica. Os resultados mostraram que não houve diferenças entre os grupos em nenhuma das avaliações. Com base nesses resultados, concluímos que a EC, nas concentrações e condições empregadas, não foi capaz de retardar a lesão nigroestriatal ou recuperá-la. / Besides the typical motor symptoms, Parkinson´s disease (PD) is characterized by deficits in proprioception. Considering the putative role of oxidative stress in PD, antioxidants might have therapeutic value. After a review on proprioception in PD, this dissertation presents an empirical study based on the evaluation of epicatechin (EC), in 6-hydroxidopamine (6-0HDA) model of Parkinsonism. Rats (n=75) where unilaterally lesioned into the nigrostriatal pathway and treated 24h later with intracerebral infusions of EC in the striatum (0.031mg/mL, 0.1mg/mL, 0.31mg/mL, 1mg/mL or vehicle). The behavioral effects were assessed through methylphenidate (40 mg/kg) and apomorphine (1 mg/kg)-induced rotations, footfault and stick-tape tests; and brain tissue was analyzed by imunohistochemistry. There were no significant differences between groups neither in the behavioral assessments nor the histological analyses. These results showed that EC was incapable to act on either the reversal or retardation of the lesion in the nigrostriatal pathway.

abstract: Our ability to estimate the position of our body parts in space, a fundamentally proprioceptive process, is crucial for interacting with the environment and movement control. For proprioception to support these actions, the Central Nervous System has to rely on a stored internal representation of the body parts in space. However, relatively little is known about this internal representation of arm position. To this end, I developed a method to map proprioceptive estimates of hand location across a 2-d workspace. In this task, I moved each subject's hand to a target location while the subject's eyes were closed. After returning the hand, subjects opened their eyes to verbally report the location of where their fingertip had been. Then, I reconstructed and analyzed the spatial structure of the pattern of estimation errors. In the first couple of experiments I probed the structure and stability of the pattern of errors by manipulating the hand used and tactile feedback provided when the hand was at each target location. I found that the resulting pattern of errors was systematically stable across conditions for each subject, subject-specific, and not uniform across the workspace. These findings suggest that the observed structure of pattern of errors has been constructed through experience, which has resulted in a systematically stable internal representation of arm location. Moreover, this representation is continuously being calibrated across the workspace. In the next two experiments, I aimed to probe the calibration of this structure. To this end, I used two different perturbation paradigms: 1) a virtual reality visuomotor adaptation to induce a local perturbation, 2) and a standard prism adaptation paradigm to induce a global perturbation. I found that the magnitude of the errors significantly increased to a similar extent after each perturbation. This small effect indicates that proprioception is recalibrated to a similar extent regardless of how the perturbation is introduced, suggesting that sensory and motor changes may be two independent processes arising from the perturbation. Moreover, I propose that the internal representation of arm location might be constructed with a global solution and not capable of local changes. / Dissertation/Thesis / Ph.D. Bioengineering 2012