Thesis (M.S.)--University of British Columbia, 2002. / Includes bibliographical references (leaves 90-97)

Thesis (Ph. D.)--University of Oregon, 2006. / Includes bibliographical references (leaves 99-111). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (Ph. D.)--University of Oregon, 2006. / Includes bibliographical references (leaves 99-111).

Thesis (M.S.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains x, 185 p. : col. ill. Includes abstract. Includes bibliographical references.

Bakgrund Som den näst vanligaste orsaken att uppsöka primärvård är nackbesvär ett vanligt förekommande besvär i Sverige och andra delar av världen. Nackbesvär följs ofta av förändringar i proprioception, både medveten och omedveten, vilket kan leda till avvikelser i rörelsebeteenden inklusive den posturala kontrollen. Kliniska test av nackproprioception inkluderar vanligtvis undersökning genom ex positionssinnestest. I denna studie undersöks proprioception hos personer med nacksmärta genom mätning av posturalt svaj vid lokal vibration av nack-, underarms respektive vadmuskulatur. Studiedesign Tvärsnittsstudie. Syfte Syftet med denna studie var att beskriva skillnader i omedveten proprioception genom vibrationsstimulering av olika muskelgrupper vid mätning av posturalt svaj i stillastående hos personer med nacksmärta jämfört med personer utan nacksmärta samt att undersöka om smärtintensitet korrelerar med storleken på svajet. Metod Mätning av posturalt svaj gjordes på 50 personer, 25 med nackbesvär och 25 kontroller med och utan vibration av vadmuskulatur, underarmsmuskulatur och nackmuskulatur vid stillastående med slutna ögon på Wii Balance Board. Skattning av smärta gjordes genom NRS just nu respektive medel senaste veckan, dessutom skattades smärta vid nackrörelse. Resultat Vid vibration av nackmuskulatur ses signifikanta skillnader där nackgruppen har ett större svaj i antero-posterior och medio-lateral riktning både innan under och efter vibration av nacke (p<0,05). Innan vibration av vader ses ett signifikant större svaj hos nackgruppen i antero-posterior och medio-lateral riktning (p<0,05) men ej under eller efter vadvibration. Vissa gruppskillnader sågs före, under och efter underarmsvibration. Ett större svaj har ett samband med en högre smärtskattning på NRS genomsnitt senaste veckan (p<0,05). Konklusion Skillnader i posturalt svaj visar sig i form av ett större svaj hos personer med nacksmärta jämfört med kontrollgrupp. Vid högre smärtskattning ses ett större posturalt svaj. / Introduction. Neck pain is often followed by changes in proprioception, both conscious and unconscious, which can lead to deviations in movement behaviours including postural control.  Clinical testing of neckproprioception usually includes assessment of consiuos and unconscious proprioception, such as repositioning sence.  In this study unconsious proprioception is being assessed in people with neck pain through measuring of postural sway during local vibration of calf, forearm- and neckmuscles. Design Cross-sectional study. Aim The purpose of this study was to describe differences in unconscious proprioception by vibration stimulation of different muscle groups when measuring postural sway during static standing in people with neck pain compared to people without neck pain and to investigate whether pain intensity correlates with the size of the sway. Method Measurement of postural sway was conducted on 50 people, 25 with neck pain and 25 healthy controls with and without vibration of the calfs, forearms and neck when standing with eyes closed on the Wii Balance Board. Self-rated pain was recorded through NRS now and average last seven days, in addition to this pain was rated during neck movements. Results Significant differences are seen in which the neck group has a larger sway in the anterior posterior and medial lateral direction both before, during and after vibration of the neck (p<0.05). Before vibration of TSM, a significantly bigger sway of the neck group appears in the anterior posterior and medial lateral direction (p <0.05) but not during or after vibration of the calfs. Some differences between groups were observed before, during and after vibration of the forearms. A larger sway is associated with a higher self-rated pain on NRS average last week (p<0.05). Conclusion Differences in postural sway appear in the form of a greater sway in people with neck pain compared with control group. Higher self-rated pain correlates with a larger postural sway.

M.Tech. (Chiropractic) / Purpose: The aim of this study was to compare the effects of chiropractic adjustment versus mobilization to the cervical spine in participants with chronic cervical facet syndrome with regards to neck pain, cervical spine range of motion and position sense. Method: Thirty participants, male or female between the ages of 18 and 45 years, diagnosed with cervical facet syndrome were used in the study. The thirty participants were divided into two groups consisting of fifteen individuals each, ensuring equal male to female and age ratios. Group 1 received chiropractic adjustments over the restricted joints to the cervical spine. Group 2 received mobilization over the restricted joints to the cervical spine. The trial consisted of seven visits over a treatment period of three weeks, of which the first six visits the participants received treatment and the seventh visit served the purpose of obtaining the final data. The data was gathered on the first, fourth and seventh visits. Subjective data was obtained by using the Vernon-Mior Neck Pain and Disability Index and the Visual Analogue Scale for pain intensity. Objective data consisted of measuring cervical spine range of motion with a CROM instrument and Laser Pointer Device to measure head repositioning accuracy (position sense). Results: Subjective results indicated that group 1 (chiropractic adjustment) proved to be the most effective treatment protocol in decreasing neck pain intensity by 92%, and neck pain disability index by 65.7%. Group 2 (mobilization), also showed good results with a decrease in neck pain intensity by 53.9%,and neck pain disability index by 23.8%. Subjective results produced statistically significant results with VAS score (p= 0.000) for both groups and NDI score (p=0.000) for group 1 and (p=0.002) for group 2. Objective results also proved that chiropractic treatment was most effective in increasing cervical spine range of motion by 21.9% (right rotation) and 21.07% (left rotation). In group 2 by 9.93% (right rotation) and 12.72% (left rotation). Results were statistically significant for both groups with CROM score (p=0.002) for group 1 (right rotation) and (p= 0.000) (left rotation). Group 2 CROM score (p=0.040) (right rotation) and (p= 0.007) (left rotation). Objective results also proved that chiropractic adjustment was most effective in improving position sense by 76.54% (right rotation) and 72.06% (left rotation). In group 2 by 38.01% (right rotation) and 13.03% (left rotation). Results were statistically significant for group 1 with Kinesthetic Sensibility Test score (p=0.000) (right rotation) and (p=0.002) (left rotation). In group 2, the result for right rotation was statistically significant with (p=0.019) and not statistically significant for left rotation with (p=0.167). Both subjective and objective results showed that although group 2 produced statistically significant results, group 1 showed the best clinical results overall. Thus it was noted that in order to obtain a vii lasting increase in range of motion of the cervical spine, a decrease in neck pain and disability and an improvement in position sense, the treatment protocol used for group 1 should be the treatment of choice. Conclusion: Based on the results of the study, it was concluded that chiropractic adjustment was more effective than mobilization in the treatment of cervical facet syndrome. This conclusion is based on the results that chiropractic adjustment was more effective in all the objective and all the subjective measurements. However, this does not rule out mobilization as a treatment for neck pain, because mobilization treatment did show improvement in cervical spine ROM, a decrease in pain and slight improvement in position sense although not as efficiently as chiropractic treatment.

This thesis investigates the differential effects of muscle fatigue on center of pressure (COP) sway and associated central processes (attentional demands and sensory re-weighting) in older compared with young adults. More specifically, we first sought to determine whether the effect of muscle fatigue on unipedal stance was greater during a dual-task in older versus young adults, and second, to determine whether the effect of muscle fatigue on bipedal stance was greater in a condition with less reliable proprioceptive information in older versus young adults. Our main results show that with different muscle groups fatigued (ankle or hip) and postural tasks with varying difficulty (unipedal stance or bipedal stance on compliant surface), young adults increased their COP sway displacement and velocity with muscle fatigue, but not the associated attentional demands. When the central nervous system needed to increase the weight of the vestibular inputs due to sensory information being less reliable at the ankle joints from standing on a compliant surface (peripheral somatosensory information), COP sway displacement and velocity in young adults were greater with ankle muscle fatigue. We also found that healthy older adults were able to compensate for muscle fatigue just as well as young adults when visual information was available during a unipedal stance or when visual information was not available during a bipedal stance on a firm surface. However, when standing on a compliant surface, older adults showed a greater increase in COP sway displacement compared to young adults and increased attentional demands when visual information was not available during a bipedal stance. Our results suggest that healthy young and older adults are able to compensate for ankle muscle fatigue to limit postural control alterations during quiet standing under different conditions, and that the extent of postural control alterations largely depends on the tasks performed. The compensation strategies may be less efficient for older adults with less reliable proprioceptive information and without vision. Thus, a frailer group of older adults, with already reduced proprioception and/or reduced vision could possibly have more difficulty to efficiently use the same compensation strategies, and may be more at risk of falling when fatigued.

Inledning Muskuloskeletala besvär inklusive nackbesvär är vanligt förekommande. Besvären är associerade med neurofysiologiska förändringar som påverkar motoriska kontrollen genom förändrade neuromuskulära synergier mellan global och stabiliserande muskulatur. Försämrad sensomotorisk funktion i nacken kan även försämra balansförmågan. Motoriskt svåra uppgifter via instabila system som kräver anpassad kraft och/eller precision har potential att användas i behandling av nackbesvär. Syftet var att utvärdera två träningsmetoders effekt på nackens proprioception respektive balansfunktion i stående. Båda träningsmetoderna involverar instabila system, den ena via kontroll av en kula placerad på en platta på huvudet och den andra genom ståendes på ett instabilt underlag. Metod Åtta deltagare rekryterades, fyra slumpades till nackkoordinationsträningsgruppen (NT) och fyra till balansträningsgruppen (BT). Sju deltagare fullföljde hela studien. Tre tester utfördes före och efter träningsperioden – proprioception undersöktes med repositioneringstest av nacken och balans undersöktes med test av posturalt svaj i stillastående på stabilt respektive instabilt underlag. Resultat visade en förbättring hos NT i form av minskning i nackrepositioneringstestet på 20,43% och vid balanstesten sågs en minskning på 11,45% på hårt underlag och en minskning på 12,11% mjukt underlag i totalt svaj. I gruppen som utförde balansträning sågs en ökning med 21,19% i nackrepositioneringstestet men en förbättring vid balanstesten i form av minskning på 2,92% på hårt underlag och en minskning på 8,93% på mjukt underlag i totalt svaj. Konklusion Resultatet indikerar att NT med instabilit system kan ha positiva effekter på nackproprioception och balans. Fler studier med större deltagarantal krävs för att möjliggöra statistiska analyser.

The intent of this thesis is to provide an account of the phenomenology of movement that collapses the distinction between mental and physical without the elimination of the mental. There are two main ways in which mental and physical converge in this account. First of all, the type of knowledge involved in learning movement skills is a type of nonpropositional knowledge that is literally embodied in the neuromuscular system of the body. Thus the mental phenomena of knowing-how and thinking how to do movement skills are body-wide phenomena. Furthermore, this type of knowledge is genuinely self-referential, since the knower and known are identical. Second, the phenomenology of self-actuated movement reveals that the self is experienced as a psychophysical unity through the experience of the coherence of action and the proprioception of that action. This is due to the sense of effort provided by sensorimotor integration of the peripheral nervous system. This sense of effort is the direct awareness of physical properties of muscle lengths, tensions, and speeds of contraction, and is thus a genuine psychophysical phenomenon. It is also argued that we enjoy a high degree of epistemic security regarding experiences of this type.

We compared sense of movement and position in unconstrained 3-dimensional tasks in younger and older adults to investigate whether older adults have diminished kinesthetic sense. Active and passive kinesthesia were compared in a novel dynamic-position sense task and also in a static-position sense task. Older (65-85 years) and younger (18-22) adults performed tasks in which they moved the right arm to touch the right index tip to the moving and stationary left index (target) fingertip in different conditions. In the dynamic task the participant or experimenter moved the left upper limb and, after a variable delay, the subject moved the right arm to attempt to touch the right index-tip to the moving target index-tip. Participants performed the dynamic task with vision actively moving both limbs (VDA), without vision while actively moving both limbs (NVDA), and without vision with the experimenter moving the target limb (NVDP). In the static task the participant (NVSA) or experimenter (NVSP) moved the target limb to a position and held it stationary while the participant moved the right arm to attempt to touch the right index tip to the target fingertip. Both younger and older adults performed the dynamic task remarkably accurately with errors averaging less than 1.6 cm across the 3 conditions. Mean 3-dimensional distance errors averaged slightly (0.19 cm) larger in older adults in the dynamic task (F₁,₂₅=5.88, p=0.02). Variable distance errors did not differ between age groups in the dynamic task (F₁,₂₅=0.90, p=0.35). Small errors were observed in all conditions. NVDP had the largest mean distance errors (1.81 cm) of moving conditions, followed by NVDA (1.65 cm), and VDA had the smallest errors (1.27 cm) (F₂,₅₀=49.55, pcorr< .001, all post hoc tests less than p< 0.05). There was no evidence of errors depending on target index-tip peak speed or location. Interestingly, distance errors in the static tasks averaged 3.0 cm and were clearly larger than in the dynamic tasks (F₁,₂₅=57.78, p< 0.001). Within the two static conditions, average errors were 0.5 cm larger in the NVSP condition than in the NVSA condition (F₁,₂₅=7.56, p=0.01). Average distance errors trended to being larger in older adults in static conditions (F₁,₂₅=3.53, p=0.07). Variable distance errors were similar for the two age groups in the static conditions (F₁,₂₅=.25, p=0.35), averaging 1.77 cm in NVSP and 1.38 cm in NVSA (F₁,₂₅=.7.98, p< 0.01). These results suggest that regardless of age, availability of visual information, active/passive target limb movement, or reaching to static versus moving targets that adults are generally quite accurate at localizing fingertip position. The finding that accuracy in the static and dynamic tasks when vision was not allowed was only slightly better when the subjects actively moved the target arm (i.e., NVDA, NVSA) than when the target arm was moved by the experimenter (NVDP, NVSP) indicates that internal models may contribute only very slightly to proprioceptive localization of the upper limb. However, it is clear that kinesthetic sensory information from the periphery is sufficient to allow the central nervous system to accurately calculate position of the endpoint of the limb (tip of the index) while unconstrained in 3-dimensional space.