Cette thèse présente une méthode de proprioception alternative pour les manipulateurs robotiques sériels. Cette méthode ne dépend pas de la position des actionneurs et ne nécessite donc pas d'hypothèse de corps rigides. Cela permet, d'une part, d'envisager un paradigme différent pour la conception de robots légers et flexibles, mieux adaptés aux applications d'interaction physique-humain robot. D'autre part, cela permet de transformer la déformation de la structure du robot, habituellement perçue comme un désavantage, en un outil de détection des intentions de l'usager pendant une tâche d'interaction. Le premier chapitre présente la conception du système de rétroaction non colocalisée pour manipulateurs sériels flexibles. Le dispositif est une chaîne sérielle et passive d'encodeurs et de membrures légères, disposée en parallèle avec le manipulateur. Ce bras de mesure découple la proprioception du manipulateur de ses actionneurs en fournissant de l'information sur la pose réelle de son organe terminal, qui tient compte de la flexibilité des membrures et des articulations. Un schéma de commande dans l'espace des tâches, mettant à profit cette rétroaction additionnelle, est conçu et testé en simulation. Finalement, les résultats de simulation sont validés à l'aide d'un manipulateur expérimental léger à trois degrés de liberté, équipé d'un bras de mesure à cinq degrés de liberté. Le second chapitre présente une méthode permettant l'interaction physique humain-robot de façon intuitive avec les manipulateurs flexibles grâce au système de mesure précédemment mentionné. En mesurant la déviation de l'organe terminal par rapport à la base, toute la structure du manipulateur devient une interface potentielle d'interaction, peu importe si la flexion provient des membrures ou des articulations. Le schéma de commande proposé est basé sur un simple asservissement des vitesses articulaires et ne requiert que la connaissance de la matrice jacobienne rigide du manipulateur. L'approche est validée en simulation sur un modèle simplifié, ainsi qu'expérimentalement sur un prototype physique de robot sériel à trois degrés de liberté avec articulations et membrures flexibles. Le troisième et dernier chapitre présente une généralisation des concepts reliés aux actionneurs a élasticité en série (*series elastic actuators*, SEA) pour la commande en force de manipulateurs à articulations et membrures flexibles à plusieurs degrés de liberté. En utilisant la mesure de la pose de l'organe terminal, toute la structure d'un manipulateur peut être considérée comme un SEA. Une approche par éléments de raideur localisés (*lumped stiffness*) est proposée pour modéliser la raideur du manipulateur. Ce faisant, les schémas de commande développés pour l'interaction physique humain-robot avec les SEA peuvent être transposés à la commande en impédance de manipulateurs flexibles. Un résultat connu sur la raideur maximale passivement réalisable avec les SEA à un degré de liberté est généralisé pour les structures flexibles à plusieurs degrés de liberté. Finalement, les schémas de commande proposés sont validés expérimentalement. / This thesis presents an alternative proprioception method for flexible serial robotic manipulators. This method is independent from the actuators and requires no rigid body assumption. This enables, on one hand, a different design paradigm for lightweight and flexible robots, that are better suited for physical human-robot interaction (pHRI) applications. On the other hand, this allows structural deflection, usually perceived as a disadvantage, to be transformed into a tool enabling user intent detection during an interaction task. The first chapter presents the design of a non-collocated feedback system for flexible serial manipulators. The device is a passive serial chain of encoders and lightweight links, mounted in parallel with the manipulator. This measuring arm effectively decouples the manipulator's proprioception from its actuators by providing information on the actual end-effector pose, accounting for both joint and link flexibility. With this additional feedback, a task-space position controller is devised and tested in simulation. Finally, the simulation results are validated with an experimental 3-DoF lightweight manipulator prototype equipped with a five-joint measuring arm. The second chapter presents a method enabling intuitive pHRI with flexible robots using an end-point sensing device. The device is a passive serial chain of encoders and lightweight links, mounted in parallel with the manipulator. By measuring the deflection of the end-effector relative to the base, the whole body of the manipulator becomes a potential interaction interface, whether the compliance stems from the links or the joints. The proposed control scheme is a simple joint velocity control that only requires knowledge of the rigid-body Jacobian matrix of the manipulator. The approach is validated both in simulation on a simplified model and experimentally on a physical 3-DoF flexible-link flexible-joint serial robot. The third and final chapter proposes a task-space generalisation of series elastic actuation concepts for flexible-link flexible-joint robots with any number of degrees of freedom. Using end-point sensing, the whole body of the flexible manipulator can effectively be considered a task-space series elastic actuator (SEA). A lumped stiffness approach based on the virtual joint method is used to establish an elastostatic model of the flexible manipulator. A simple methodology is proposed in order to identify the elastostatic model parameters. This allows force control of the robot, with notable applications in physical human-robot interaction through admittance and impedance control schemes. A known result on the maximum passively renderable stiffness for single degree-of-freedom (dof) SEAs is generalised to n-dof flexible structures, providing bounds on the renderable stiffness matrix that apply to any causal controller. Finally, the task-space control schemes derived from the SEA literature are implemented and validated on a 3-dof flexible-link flexible-joint manipulator prototype.

L’objectif principal de la présente thèse était de déterminer les facteurs susceptibles d’influencer l’efficacité des processus de contrôle en ligne des mouvements d’atteinte manuelle. De nos jours, les mouvements d’atteinte manuelle réalisés dans un environnement virtuel (déplacer une souris d’ordinateur pour contrôler un curseur à l’écran, par exemple) sont devenus chose commune. Par comparaison aux mouvements réalisés en contexte naturel (appuyer sur le bouton de mise en marche de l’ordinateur), ceux réalisés en contexte virtuel imposent au système nerveux central des contraintes importantes parce que l’information visuelle et proprioceptive définissant la position de l’effecteur n’est pas parfaitement congruente. Par conséquent, la présente thèse s’articule autour des effets d’un contexte virtuel sur le contrôle des mouvements d’atteinte manuelle. Dans notre premier article, nous avons tenté de déterminer si des facteurs tels que (a) la quantité de pratique, (b) l’orientation du montage virtuel (aligné vs. non-aligné) ou encore (c) l’alternance d’un essai réalisé avec et sans la vision de l’effecteur pouvaient augmenter l’efficacité des processus de contrôle en ligne de mouvement réalisés en contexte virtuel. Ces facteurs n’ont pas influencé l’efficacité des processus de contrôle de mouvements réalisés en contexte virtuel, suggérant qu’il est difficile d’optimiser le contrôle des mouvements d’atteinte manuelle lorsque ceux-ci sont réalisés dans un contexte virtuel. L’un des résultats les plus surprenants de cette étude est que nous n’avons pas rapporté d’effet concernant l’orientation de l’écran sur la performance des participants, ce qui était en contradiction avec la littérature existante sur ce sujet. L’article 2 avait pour but de pousser plus en avant notre compréhension du contrôle du mouvement réalisé en contexte virtuel et naturel. Dans le deuxième article, nous avons mis en évidence les effets néfastes d’un contexte virtuel sur le contrôle en ligne des mouvements d’atteinte manuelle. Plus précisément, nous avons observé que l’utilisation d’un montage non-aligné (écran vertical/mouvement sur un plan horizontal) pour présenter l’information visuelle résultait en une importante diminution de la performance comparativement à un montage virtuel aligné et un montage naturel. Nous avons aussi observé une diminution de la performance lorsque les mouvements étaient réalisés dans un contexte virtuel aligné comparativement à un contexte naturel. La diminution de la performance notée dans les deux conditions virtuelles s’expliquait largement par une réduction de l’efficacité des processus de contrôle en ligne. Nous avons donc suggéré que l’utilisation d’une représentation virtuelle de la main introduisait de l’incertitude relative à sa position dans l’espace. Dans l’article 3, nous avons donc voulu déterminer l’origine de cette incertitude. Dans ce troisième article, deux hypothèses étaient à l’étude. La première suggérait que l’augmentation de l’incertitude rapportée dans le contexte virtuel de la précédente étude était due à une perte d’information visuelle relative à la configuration du bras. La seconde suggérait plutôt que l’incertitude provenait de l’information visuelle et proprioceptive qui n’est pas parfaitement congruente dans un contexte virtuel comparativement à un contexte naturel (le curseur n’est pas directement aligné avec le bout du doigt, par exemple). Les données n’ont pas supporté notre première hypothèse. Plutôt, il semble que l’incertitude soit causée par la dissociation de l’information visuelle et proprioceptive. Nous avons aussi démontré que l’information relative à la position de la main disponible sur la base de départ influence largement les processus de contrôle en ligne, même lorsque la vision de l’effecteur est disponible durant le mouvement. Ce résultat suggère que des boucles de feedback interne utilisent cette information afin de moduler le mouvement en cours d’exécution. / The main objective of this thesis was to identify factors that may influence the effectiveness of the online control processes of manual reaching movements. Nowadays, producing manual movements made in a virtual environment (moving a computer mouse to control a cursor on the screen, for example) have become commonplace. As compared to movements made in natural settings (pushing the start button on the computer), those made in virtual context pose serious challenges to the central nervous system because the proprioceptive and visual information defining the position of the effector is not perfectly congruent. This thesis focuses on the effects of a virtual environment on the control of manual reaching movements. In our first article, we examined whether such factors as (a) the amount of practice, (b) the orientation of the virtual display (aligned vs. non-aligned) or (c) the availability of the visual feedback on alternated trials could increase the efficiency of online control processes of movements made under virtual context. These factors did not influence the effectiveness of process control movements made in virtual context, suggesting that it is difficult to optimize the control of manual reaching movements when they are made under a virtual context. One of the most surprising results of this study is that we have not reported detrimental effects of screen orientation on the performance of participants, which was inconsistent with the existing literature on this subject. Section 2 was intended to push forward our understanding of online control processes of movements made in virtual and natural contexts. In the second article, we highlighted the adverse effects of a virtual environment on the online control of manual reaching movements. More specifically, we observed that the use of a non-aligned display to present visual information resulted in a significant decrease in performance as compared to an aligned or natural display. We also observed a decrease in performance when the movements were performed in a virtual aligned display as compared to a natural context. The decrease in performance observed in the two virtual conditions was largely due to a decrease of the effectiveness of online control processes. We therefore suggest that the use of a virtual representation of the hand introduced uncertainty as to its position in space, which in turn led to less efficient online control. In our third article, we wanted to determine the origin of this uncertainty and how it impacted on movement control. In the third article, two hypotheses were considered. The first suggested that the increase in uncertainty reported in the virtual context of the previous study was due to loss of visual information relative to the configuration of the arm. The second suggested instead that the uncertainty came from the proprioceptive and visual information that is not perfectly congruent in a virtual context as compared to a natural one (the cursor is not directly aligned with the finger for example). The data have not supported our first hypothesis. It rather appears that the uncertainty is caused by the dissociation of visual and proprioceptive information. We also demonstrated that the information on the starting base on the position of the hand greatly influences the control process online, even when vision is available during the effector movement. This result suggests that internal feedback loops use this information to modulate the ongoing movement.

La proprioception cervicale joue un rôle important dans le contrôle postural, mais la nature exacte de sa contribution est controversée. Dans certains cas de « coup du lapin », une atteinte posturale a été démontrée, sans que l'atteinte du rachis cervical puisse être tenue pour seule responsable. Malgré la forte prévalence des pathologies cervicales dégénératives, leurs conséquences posturales ont été peu étudiées dans la littérature scientifique. Il n'existe aucune publication centrée sur les deux types de pathologie responsables de névralgies cervicobrachiales : les hernies discales cervicales et l'arthrose cervicale. Cette étude a eu pour but d'évaluer le contrôle postural de deux groupes de patients présentant une pathologie cervicale dégénérative avec et sans stimulation optocinétique avant et après traitement chirurgical. Dix-sept patients présentant une radiculalgie ont été inclus dans cette étude et répartis en deux groupes selon l'origine arthrosique ou discale de la compression neurologique. Tous les patients ainsi que 31 témoins ont été soumis à un examen de posturographie statique comprenant 12 enregistrements : les quatre premiers enregistrements ont été réalisés la tête dans l'axe (à 0°) : yeux fermés, yeux ouverts sans stimulation optocinétique, yeux ouverts avec stimulation optocinétique dans le sens horaire, puis antihoraire. Ces quatre situations sensorielles ont été répétées tête tournée 30° à gauche, puis 30° à droite. Les patients ont à nouveau été soumis à ces 12 enregistrements six semaines après l'intervention. Aucun patient ne s'est plaint de sensations vertigineuses que ce soit en pré ou en postopératoire. Avant intervention, les yeux fermés, le groupe hernie discale était plus stable que le groupe arthrose. Après intervention, la contribution visuelle au contrôle postural avait diminué dans les deux groupes dans un environnement visuel dynamique, alors que dans un environnement visuel stable, elle n'avait diminué que dans le groupe arthrose. L'importance relative des informations visuelles et proprioceptives pour le contrôle postural varie selon le type de pathologie et la chirurgie tend à réduire la contribution visuelle surtout pour les patients présentant une arthrose cervicale / Cervical proprioception plays a key role in postural control, but its specific contribution is controversial. Postural impairment was shown in whiplash injuries without demonstrating the sole involvement of the cervical spine. The consequences of degenerative cervical spine diseases are underreported in posture-related scientific literature in spite of their high prevalence. No report has focused on the two different mechanisms underlying cervicobrachial pain: herniated discs and spondylosis. This study aimed to evaluate postural control of two groups of patients with degenerative cervical spine diseases with or without optokinetic stimulation before and after surgical treatment. Seventeen patients with radiculopathy were recruited and divided into two groups according to the spondylotic or discal origin of the nerve compression. All patients and a control population of 31 healthy individuals underwent a static posturographic test with 12 recordings; the first four recordings with the head in 0° position: eyes closed, eyes open without optokinetic stimulation, with clockwise and counter clockwise optokinetic stimulations. These four sensorial situations were repeated with the head rotated 30° to the left and to the right. Patients repeated these 12 recordings 6 weeks postoperatively. None of the patients reported vertigo or balance disorders before or after surgery. Prior to surgery, in the eyes closed condition, the herniated disc group was more stable than the spondylosis group. After surgery, the contribution of visual input to postural control in a dynamic visual environment was reduced in both cervical spine diseases whereas in a stable visual environment visual contribution was reduced only in the spondylosis group. The relative importance of visual and proprioceptive inputs to postural control varies according to the type of pathology and surgery tends to reduce visual contribution mostly in the spondylosis group

L’objectif principal de la présente thèse était de déterminer les facteurs susceptibles d’influencer l’efficacité des processus de contrôle en ligne des mouvements d’atteinte manuelle. De nos jours, les mouvements d’atteinte manuelle réalisés dans un environnement virtuel (déplacer une souris d’ordinateur pour contrôler un curseur à l’écran, par exemple) sont devenus chose commune. Par comparaison aux mouvements réalisés en contexte naturel (appuyer sur le bouton de mise en marche de l’ordinateur), ceux réalisés en contexte virtuel imposent au système nerveux central des contraintes importantes parce que l’information visuelle et proprioceptive définissant la position de l’effecteur n’est pas parfaitement congruente. Par conséquent, la présente thèse s’articule autour des effets d’un contexte virtuel sur le contrôle des mouvements d’atteinte manuelle. Dans notre premier article, nous avons tenté de déterminer si des facteurs tels que (a) la quantité de pratique, (b) l’orientation du montage virtuel (aligné vs. non-aligné) ou encore (c) l’alternance d’un essai réalisé avec et sans la vision de l’effecteur pouvaient augmenter l’efficacité des processus de contrôle en ligne de mouvement réalisés en contexte virtuel. Ces facteurs n’ont pas influencé l’efficacité des processus de contrôle de mouvements réalisés en contexte virtuel, suggérant qu’il est difficile d’optimiser le contrôle des mouvements d’atteinte manuelle lorsque ceux-ci sont réalisés dans un contexte virtuel. L’un des résultats les plus surprenants de cette étude est que nous n’avons pas rapporté d’effet concernant l’orientation de l’écran sur la performance des participants, ce qui était en contradiction avec la littérature existante sur ce sujet. L’article 2 avait pour but de pousser plus en avant notre compréhension du contrôle du mouvement réalisé en contexte virtuel et naturel. Dans le deuxième article, nous avons mis en évidence les effets néfastes d’un contexte virtuel sur le contrôle en ligne des mouvements d’atteinte manuelle. Plus précisément, nous avons observé que l’utilisation d’un montage non-aligné (écran vertical/mouvement sur un plan horizontal) pour présenter l’information visuelle résultait en une importante diminution de la performance comparativement à un montage virtuel aligné et un montage naturel. Nous avons aussi observé une diminution de la performance lorsque les mouvements étaient réalisés dans un contexte virtuel aligné comparativement à un contexte naturel. La diminution de la performance notée dans les deux conditions virtuelles s’expliquait largement par une réduction de l’efficacité des processus de contrôle en ligne. Nous avons donc suggéré que l’utilisation d’une représentation virtuelle de la main introduisait de l’incertitude relative à sa position dans l’espace. Dans l’article 3, nous avons donc voulu déterminer l’origine de cette incertitude. Dans ce troisième article, deux hypothèses étaient à l’étude. La première suggérait que l’augmentation de l’incertitude rapportée dans le contexte virtuel de la précédente étude était due à une perte d’information visuelle relative à la configuration du bras. La seconde suggérait plutôt que l’incertitude provenait de l’information visuelle et proprioceptive qui n’est pas parfaitement congruente dans un contexte virtuel comparativement à un contexte naturel (le curseur n’est pas directement aligné avec le bout du doigt, par exemple). Les données n’ont pas supporté notre première hypothèse. Plutôt, il semble que l’incertitude soit causée par la dissociation de l’information visuelle et proprioceptive. Nous avons aussi démontré que l’information relative à la position de la main disponible sur la base de départ influence largement les processus de contrôle en ligne, même lorsque la vision de l’effecteur est disponible durant le mouvement. Ce résultat suggère que des boucles de feedback interne utilisent cette information afin de moduler le mouvement en cours d’exécution. / The main objective of this thesis was to identify factors that may influence the effectiveness of the online control processes of manual reaching movements. Nowadays, producing manual movements made in a virtual environment (moving a computer mouse to control a cursor on the screen, for example) have become commonplace. As compared to movements made in natural settings (pushing the start button on the computer), those made in virtual context pose serious challenges to the central nervous system because the proprioceptive and visual information defining the position of the effector is not perfectly congruent. This thesis focuses on the effects of a virtual environment on the control of manual reaching movements. In our first article, we examined whether such factors as (a) the amount of practice, (b) the orientation of the virtual display (aligned vs. non-aligned) or (c) the availability of the visual feedback on alternated trials could increase the efficiency of online control processes of movements made under virtual context. These factors did not influence the effectiveness of process control movements made in virtual context, suggesting that it is difficult to optimize the control of manual reaching movements when they are made under a virtual context. One of the most surprising results of this study is that we have not reported detrimental effects of screen orientation on the performance of participants, which was inconsistent with the existing literature on this subject. Section 2 was intended to push forward our understanding of online control processes of movements made in virtual and natural contexts. In the second article, we highlighted the adverse effects of a virtual environment on the online control of manual reaching movements. More specifically, we observed that the use of a non-aligned display to present visual information resulted in a significant decrease in performance as compared to an aligned or natural display. We also observed a decrease in performance when the movements were performed in a virtual aligned display as compared to a natural context. The decrease in performance observed in the two virtual conditions was largely due to a decrease of the effectiveness of online control processes. We therefore suggest that the use of a virtual representation of the hand introduced uncertainty as to its position in space, which in turn led to less efficient online control. In our third article, we wanted to determine the origin of this uncertainty and how it impacted on movement control. In the third article, two hypotheses were considered. The first suggested that the increase in uncertainty reported in the virtual context of the previous study was due to loss of visual information relative to the configuration of the arm. The second suggested instead that the uncertainty came from the proprioceptive and visual information that is not perfectly congruent in a virtual context as compared to a natural one (the cursor is not directly aligned with the finger for example). The data have not supported our first hypothesis. It rather appears that the uncertainty is caused by the dissociation of visual and proprioceptive information. We also demonstrated that the information on the starting base on the position of the hand greatly influences the control process online, even when vision is available during the effector movement. This result suggests that internal feedback loops use this information to modulate the ongoing movement.

Les informations sensorielles peuvent être atténuées de la périphérie jusqu'au cortex durant le mouvement. Notre hypothèse est que l'information somatosensorielle serait facilitée durant la planification du pas où il serait inopportun de supprimer ces informations cruciales. Nous avons enregistré les potentiels somatosensoriels (SEPs) évoqués par vibration bilatérale des muscles des chevilles afin de stimuler la proprioception.Les résultats montrent que la composante évoquée corticale précoce restait inchangée mais une composante tardive négative était significativement augmentée durant la planification du pas.Pour tester si cette facilitation proprioceptive était due aux contraintes d'équilibre, la même expérience fut effectuée en microgravité où cette facilitation disparut, malgré la restauration d'un cadre de référence spatial.Cette facilitation tardive survint pendant l'imagerie motrice kinesthésique d'un pas planifié, démontrant que l'imagerie mentale intègrerait les contraintes d'équilibre et posturales requises pour la tâche, ceci étant confirmé par la disparition de cette facilitation lors de la planification du pas imaginé en microgravité.Ceci démontre au niveau neurophysiologique, une modulation de la transmission des afférences sensorielles selon leur pertinence pour planifier un mouvement. Cette facilitation résulterait de mécanismes prédictifs reliés à l'importance de contrôler l'équilibre du corps avant l'initiation du pas, car ce processus survint durant la planification d'un pas exécuté ou imaginé. Il serait basé sur un modèle interne de l'action impliquant des lois physiques du mouvement (1-g modèle) car cette facilitation fut supprimée en microgravité. / Sensory inputs can be attenuated from the periphery to the cortex during voluntary movements. Our hypothesis is that the somatosensory information could be facilitated during the planning of a step. It would appear dysfunctional to suppress somatosensory information, which is considered to be of the utmost importance for gait planning. We recorded somatosensory potentials (SEPs) evoked by bilateral ankle vibration to stimulate proprioception. Results showed that cortical early evoked component remained unchanged but a negative late component was significantly increased during step planning. To determine whether this facilitation of proprioceptive inputs was related to gravitational equilibrium constraints, we performed the same experiment in microgravity. In the absence of equilibrium constraints, both components did not significantly differ between the static and stepping conditions, despite the restoration of a body in space reference frame.This late facilitation occurred during kinesthetic motor imagery of a planned step, suggesting that mental imagery would integrate postura and balance constraints required for the task, as it was confirmed byt the lack of this facilitation during the planning of an imagined step in microgravity.These observations provide neurophysiological evidence that the brain exerts a dynamic control over the transmission of the afferent signal according to their current relevance during movement preparation.These processes should be based on internal model of action involving the physical laws of motion (1g-model) as this sensory facilitation was suppressed in microgravity when planning motor imagery.

Attention uses sensory inputs and goals to select information from our environment. Monkey electrophysiological literature demonstrates that visuo-tactile bimodal neurons (respond to visual and tactile stimuli presented on/near the hand) facilitate multisensory integration. Human behavioral studies show that hand position/function bias visual attention. Event-related potentials (ERPs) reveal the cortical dynamics coordinating visual inputs, body position, and action goals. Early, sensory ERPs (N1) indicate multisensory integration. Later, cognitive ERPs (P3) reflect task-related processing. Study 1 investigates a discrepancy between monkey and human literatures. Monkey studies demonstrate bimodal neuron responses equidistantly around the whole hand, but human studies demonstrate attentional bias for grasping space. In a visual detection paradigm, participants positioned their hand so target and non-target stimuli appeared near the palm or back of the hand; ERPs were measured. N1 components indicated no amplitude differences between Palm vs. Back conditions, but P3 components revealed greater target vs. non-target differentiation for Palm conditions. Results suggest cortical timing underlies grasping vs. whole hand bias differences: early processing does not differentiate using hand function, but cognitive processing does when stimuli are discriminated for action. Study 2 investigates whether proprioceptive inputs facilitate visual processing. In a visual detection paradigm, participants viewed stimuli presented between occluders blocking view of a hand positioned either near or far from the stimuli. N1 amplitudes were similar for near and far conditions, but P3 amplitudes for target/non-target differences were accentuated for near conditions. Proprioceptive effects emerge later in processing. ERP reveals the cortical dynamics underlying hand position effects on vision.

Submitted in fulfillment of Masters Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background: Myofascial therapies are widely researched with regards to their effects on pain, disability and range of motion. The benefits of such therapies are attributed to the mechanical changes that myofascial therapies are proposed to have on the fascial and myofascial structures. Breakthrough imaging and laboratory techniques, have allowed the in vivo study of these structures, resulting in new hypotheses regarding the roles that connective tissues might play in proprioception. Objectives: The purpose of this investigation was to assess the effects of two myofascial therapies, in terms of immediate changes in navicular pronation, great toe extension measurements and balance tests, as indicated by the postural stability (eyes open and closed) and limits of stability tests. Pre-, post-intervention analysis was used to determine if there were significant changes between the groups. Aims: The myofascial interventions aimed to reduce myofascial restriction and adhesions, within the plantar and crural fasciae’s of individuals with bilateral pronation. Methods: The study recruited 45 subjects with bilateral pronation (2 or more degrees) and randomly allocated them into a placebo ultrasound, ischaemic compression or myofascial release group. Each subject underwent a case history, physical examination, foot, ankle and knee regional examinations, as well as screened for contraindications. A blinded assistant examiner helped measured and record the baseline measurements for navicular position and great toe extension, using a standard two arm goniometer. The researcher then tested participants for postural stability (eyes open, eyes closed) and limits of stability, on the Biosway Portable Balance System. Subjects were then examined and treated bilaterally, for myofascial restrictions in the foot, lower leg and ankle, related or unrelated to the pronation present. Pre- and post-intervention measurements were recorded within a 20 minute window immediately before and after the relevant intervention. Statistical Analysis: Repeated measures ANOVA testing was used to compare the rate of change (between pre- and post-intervention measurements) amongst the three groups, and a p-value <0.05 was considered statistically significant. Post hoc Bonferroni adjusted tests were done to compare all pair wise groups, as well as identify trends between groups. Results and Discussion: The data showed that both myofascial groups, significantly improved in postural stability (eyes closed) overall, post hoc testing showed the ischaemic compression group (p=0.004) and myofascial release group (p=0.031), compared to changes in the placebo ultrasound group.The overall changes were predominantly found in the anterior-posterior axes, with significant improvements in ischaemic compression (p=0.007) and myofascial release group (p=0.053) axes compared to placebo. For the other outcome variables, statistically significant treatment effects were not consistant bilaterally between the groups. Significant (p=0.051) time*group differences for changes in right navicular position. Post hoc testing revealed a borderline significant (p=0.056) improvement in pronation for the myofascial release group in comparison to the ischaemic compression group, which on average got worse. With regards to passive non-weight bearing great toe extension left, significant (p=0.067) improvements for the ischaemic compression group were shown compared to placebo, although this was not consistent for all the great toe extension tests. A borderline significant (p=0.059) time*group effect for postural stability (eyes open) medial-lateral test was obtained. Post hoc Bonferroni adjusted testing showed a non-significant (p=0.063) correlation between the myofascial release group and placebo ultrasound group. Conclusion: The results of this study, rejects the Null hypothesis for changes in balance measurements and suggests that both myofascial interventions had a significant positive outcome for postural stability, compared to placebo. The postural stability (eyes closed) test gave an indication of positive or negative changes in centre of pressure displacement, about the centre of gravity. It is noted that the sham ultrasound, used as a placebo intervention may have produced a treatment effect and is therefore not a reliable placebo measure for this type of investigation. / M

Osteoarthritis is a degenerative disease of joints, which can be solved with implantation of total joints prosthesis. A high-quality proprioception of knee joint protects the joint against possible bending injury, it is also participating in stabilizing the knee in static position and it is important in the process of coordination of the motion system and precise flexibility of the knee joint. In this thesis are summed up the knowledge of osteoarthritis, total joints prosthesis and proprioception, all is taken in context of connection. The research includes comparison of proprioception of knee joint with arthrosis and total joints prosthesis. Also, the research compared mentioned knee joints with the healthy verification group. All monitored individuals absolved a medical examination of the quality of proprioception in the form of move sensitivity in position of 30ř, 50ř and 80ř. Amongst the knees with arthrosis and knees with total joints prosthesis there were not found a differences with static importance in each of the angle test. In the total comparison there was significantly better proprioception of the knees with the total joints prosthesis. The knee joints of the verification group unlike the joints with arthrosis and total prosthesis showed significantly better flexibility in position of...

Introdução: Tem se afirmado que não há a possibilidade de haver melhora da estabilidade dinâmica postural utilizando exercícios na água, isto é, onde a gravidade apresenta-se diminuída. Neste estudo randomizado e controlado avaliamos e comparamos a estabilidade dinâmica postural em indivíduos saudáveis que realizaram exercícios sensório-motor no solo ou na água. Métodos: Através do Biodex Balance System®, foram avaliados os limites de estabilidade postural, antes e após um programa de exercícios, de 60 indivíduos saudáveis do sexo masculino divididos em 3 grupos (solo, piscina e controle). Os indivíduos dos grupos solo e piscina realizaram um treinamento sensório-motor por 2 meses no solo e na água respectivamente; o grupo controle não realizou nenhum tipo de exercício. Resultados: 1) Foram encontradas diferenças significativas na estabilidade dinâmica entre o grupo solo e controle; 2) Foram encontradas diferenças significativas na estabilidade dinâmica entreo grupo piscina e controle; 3) Não foram encontradas diferenças significativas entre o grupo solo e piscina. Conclusões: realizar exercícios sensório-motor melhora a estabilidade postural em indivíduos saudáveis do sexo masculino, sem diferenças significativas entre os ambientes de treino (solo e água) comparados / Introduction: It has been stated that there is no way to improve dynamic postural stability using exercises in water, i.e. where there is reduced gravity. In this controlled, randomized study, we evaluate and compare postural dynamic stability in healthy individuals who performed sensory-motor exercises on the ground or in water. Methods: Through the Biodex Balance System®, the limits of postural stability were evaluated before and after a program of exercises, in 60 healthy males, divided into three groups (ground, swimming pool and control). The individuals in the ground and swimming pool groups carried out sensorial-motor training for two months, on the ground and in the water, respectively; the control group did not perform any kind of exercises. Results: 1) Significant differences were found in dynamic stability between the ground and control groups; 2) Significant differences were found in dynamic stability between the swimming pool and control groups; 3) No significant differences were found between the ground and swimming pool groups. Conclusions: performing sensory-motor exercises improves postural stability in healthy males, without significant differences between the training environments (ground and water) compared in this study

Esta dissertação parte da premissa de que o desalinhamento dos arcos plantares estão associados ao mal funcionamento do pé e a subseqüentes desequilíbrios mecânicos gerados por compensações na cadeia cinética e articulações adjacentes. A bandagem plantar é uma das técnicas comumente utilizadas no tratamento e prevenção de lesões decorrentes destes desalinhamentos; no entanto, sua eficácia no controle postural ainda é incerta. Nossas hipóteses são: (i) que sujeitos com arco rebaixado apresentariam déficits do controle postural que se acentuariam em condições de perturbação sensorial, e (ii) que a bandagem aplicada no médio-­pé para melhorar a acuidade sensorial traria benefícios para o controle postural destes sujeitos, principalmente nas condições de perturbação. Assim, apresentaremos nesta dissertação dois estudos, um para investigar as alterações no controle postural de indivíduos com rebaixamento do arco plantar (estudo 1), e outro para investigar as consequências da utilização bandagem plantar nestes indivíduos (estudo 2). Para ambos os estudos, avaliamos a velocidade média e o root mean square da trajetória do centro de pressão durante a manutenção da postura quasi-­-estática em quatro condições de perturbação sensorial: (1) plataforma fixa, olhos abertos; (2) plataforma fixa, olhos fechados; (3) plataforma móvel, olhos abertos; e (4) plataforma móvel, olhos fechados. No estudo 1, 24 mulheres com arcos normais foram comparadas a 13 mulheres com arco rebaixado. No estudo 2, a comparação foi feita entre as condições sem e com a bandagem plantar para as 13 mulheres com arco rebaixado. Os resultados indicam que mulheres com rebaixamento do arco oscilam menos e mais lentamente que mulheres com arco normal, em particular na condição de maior perturbação sensorial, o que pode representar uma resposta pior, ou mais lenta de um sistema com desequilíbrios mecânicos decorrentes de um pé pouco funcional. Já a utilização da bandagem plantar resultou em aumento da oscilação do centro de pressão para a maioria das condições de perturbação sensorial, principalmente na direção médio-­-lateral, o que pode ser explicado por uma dificuldade dos sujeitos em se ajustar a uma nova postura, ou indicar um ganho de confiança e um melhor funcionamento do pé, traduzido pelo aumento da utilização dos ajustes posturais. / This dissertation is based on the premise that misalignment of plantar arches are associated to poor foot function and to subsequent mechanical compensations in the kinetic chain and adjacent joints. Foot taping is a commonly used technique in the treatment and prevention of injuries caused by these misalignments; however, its efficacy on postural control is still uncertain. Our hypotheses are: (i) subjects with low plantar arch would present postural control deficits, detectable by center of pressure sway measurement, that would be worsened in conditions of sensory perturbation, and (ii) foot taping, applied on midfoot with the intention to improve the cutaneous sensorial acuity, would bring benefits to the postural control of these subjects, especially under conditions of sensory perturbation. Thus, two studies will be presented: the first meant to investigate postural control alterations in individuals with low plantar arch (study 1), and the second, to investigate the effects of foot taping use in these subjects (study 2). For both studies, the mean velocity and root mean square of center of pressure trajectory were assessed during the maintenance of quasi-static stance in four conditions of sensory perturbations: (1) fixed support, eyes opened; (2) fixed support, eyes closed; (3) moving support, eyes opened, and (4) moving support, eyes closed. In study 1, 24 women with normal plantar arch were compared to 13 with low plantar arch. For study 2, the same 13 low arched subjects were assessed with and without foot taping. Results indicate that women with low plantar arch have less and slower center of pressure sway, particularly in the condition of highest sensory perturbation level, which may indicate a worsened, or slower, response of a mechanically altered system. When foot taping was applied to the low arched individuals, a higher and faster center of pressure sway was observed in most of the sensory perturbation conditions, especially in the medio-lateral direction. This could be explained either by a difficulty for the subjects to adapt to a new imposed postural condition, or by a gain in confidence while using the taping, reflected by the increase in postural adjustments.