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Uma investigação do impacto de uma intervenção motora ao longo do tempo : que mudanças persistem?Teixeira, Rafael Gambino January 2011 (has links)
Este estudo objetivou verificar o impacto e a persistência de um Programa de Intervenção Motora com enfoque no contexto Motivacional para a Maestria no cotidiano das crianças participantes. Foi avaliado o desempenho motor (habilidades motoras fundamentais), a descrição dos contextos familiar e escolar e as medidas antropométricas (IMC e circunferência abdominal). A amostra desta pesquisa foi composta por 40 crianças (20 do grupo controle e 20 do grupo interventivo) participantes do Programa realizado no ano de 2008, na Escola de Educação Física da UFRGS, e de uma Escola Estadual do município de Porto Alegre. Para as avaliações das crianças foram utilizados: (1) o Teste de Desenvolvimento Motor Grosso (TDMG) de (ULRICH, 2000), adaptado e validado para a população do RS (VALENTINI; VILLWOCK; BARBOSA; PICK; SPESSATO; BALBINOTTI, 2008) para avaliar o desempenho motor bem como a descrição do contexto familiar (questionário (BERLEZE, 2002) adaptado de (SERRANO; NETO, 1997) e do contexto escolar (entrevista semi-estruturada) para melhor discutir o desempenho motor e; (2) as medidas da circunferência abdominal e, peso e estatura para cálculo do IMC, para a análise antropométrica. As crianças foram avaliadas em 03 momentos distintos: pré e pós-intervenção e 18 meses após o termino da intervenção (período de manutenção). O Programa de Intervenção Motora foi desenvolvido em 28 semanas, implementando os pressupostos da estrutura TARGET à aprendizagem das habilidades motoras básicas. Os resultados demonstraram que: (1) no desempenho motor, as crianças do grupo interventivo apresentaram ganhos na pós-intervenção e permaneceram com estes durante o período de manutenção (55% na categoria “Média”) enquanto que as crianças do grupo controle permaneceram com o mesmo desempenho em todos os períodos avaliados (60% na categoria “Muito Pobre”); (2) na análise antropométrica, ambos os grupos apresentaram a maior parte de seus participantes na categoria “Eutrófico” (70% interventivo; 60% controle) da pré para a pós-intervenção e no período de manutenção; (3) as avaliações antropométricas de IMC (p=0,795) e circunferência abdominal (p=0,751) apresentaram-se com resultados não significantes no período de manutenção bem como na interação com o desempenho motor no mesmo período. Conclui-se que as experiências proporcionadas em um ambiente adequado com a implementação de climas motivacionais apropriados contribui para o aumento do nível de interesse e desempenho final nas habilidades adquiridas, revelando assim, o impacto positivo do Programa Interventivo, bem como, a manutenção em mudanças positivas nas variáveis analisadas. / This study aimed to verify the impact and persistence of an intervention program focusing on the Motor Motivational context of Mastery in everyday life of the participants. We assessed motor performance (fundamental movement skills), the description of the family and school contexts, and anthropometric measurements (BMI and waist circumference). The sample in this study comprised 40 children (20 in the control group and 20 of the interventional group) participating in the program conducted in 2008, the School of Physical Education at UFRGS, and a state school in the city of Porto Alegre. For assessments of children were used: (1) Test of Gross Motor Development (TGMD) of (Ulrich, 2000), adapted and validated for the population of RS (VALENTINI; VILLWOCK; BARBOSA; PICK; SPESSATO; BALBINOTTI, 2008) to evaluate motor performance and a description of the family context (questionnaire (BERLEZE, 2002) adapted from (SERRANO; NETO, 1997) and the school context (semi-structured interview) to discuss the best motor performance and (2) measurements of waist circumference and, weight and height for BMI calculation, for anthropometric analysis. The children were evaluated in 03 separate stages: pre-and post-intervention and 18 months after the end of intervention (maintenance period). The Motor Intervention Program was developed in 28 weeks, implementing the assumptions of the structure of TARGET learning basic motor skills. The results showed that: (1) in motor performance, the children of the interventional group showed gains in postintervention and remained with them during the maintenance (55% in category "Medium") while children in the control group remained the same performance in all evaluated periods (60% in category "Very Poor"), (2) anthropometric analysis, both groups showed a Most of the participants in the "eutrophic" (70% interventional and 60% control) from pre-to post-intervention and in the maintenance period, (3) anthropometric assessments of BMI (p = 0.795) and waist circumference (p = 0.751) were non-significant results in the maintenance period as well as interaction with the motor performance in the same period. We conclude that the experiences provided in a suitable environment with the implementation of appropriate motivational climate contributes to the increased level of interest and ultimate performance in the acquired skills, thus revealing the positive impact of the Intervening Program, as well as the maintenance of positive changes in the variables analyzed.
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Neurocorrelates of speech-motor planning and execution in adults and children who stutterBrown, Bryan T. 01 December 2015 (has links)
There is a rich literature demonstrating that adults who stutter (AWS) demonstrate atypical functional brain activity during speech production. These differences can be characterized by increased activity in the right inferior frontal gyrus and premotor regions and decreased activity in the left inferior frontal gyrus, premotor area, and bilaterally in the superior temporal gyrus. The process of speech production requires motor movements first be planned and then executed. However, few studies have examined activity related to speech-motor planning independently from speech-motor execution. Additionally, due to methodological limitations, few investigations have examined functional brain activity in children who stutter (CWS). We hypothesized that AWS and CWS would demonstrate atypical brain activity related to both speech-motor planning and execution. Using Near Infrared Spectroscopy (fNIRS), we measured the change in oxygenated hemoglobin concentration (HbO) during speech-motor planning (repetition of nonwords with three repeated or different syllables) and speech-motor execution (covert/overt naming). Results indicated that both AWS and CWS demonstrated cortical activity that was atypical during speech-motor planning processes in the right inferior frontal gyrus and atypical speech-motor execution processes in the left inferior frontal gyrus. Deactivations in the left inferior frontal gyrus may reflect inefficient feedforward mechanisms for speech production. Inefficient feedforward mechanisms will likely result in more variable movements, for which larger feedback correction signals will be necessary. Overactivations in the right inferior frontal gyrus may reflect this increased correction. Additionally, AWS demonstrated atypical speech-motor planning activity in the right middle frontal gyrus, potentially related to the production of prosody. These results are presented within a theoretical framework of two competing theories of stuttering.
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Neural Mechanisms of Intervention in Residual Speech Sound DisorderSpencer, Caroline 29 September 2021 (has links)
No description available.
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The Effects of Divided Attention on Speech Motor, Verbal Fluency and Manual Motor Task PerformanceHamblin, Erin 08 July 2005 (has links) (PDF)
Research in dual task performance varies widely in its methodology and results. The present study employed three different types of activity to provide insights into the interference that occurs in dual task performance. Twenty young adults completed a speech task (repeating a sentence), a verbal fluency task (listing words beginning with the same letter), and right- and left-handed motor tasks (placing pegs and washers in a peg board) in isolation and in concurrent conditions. Speech kinematic data revealed that during concurrent performance of manual tasks, lip displacement and peak velocity decreased, while sound pressure level and spatiotemporal variability increased. The impact of manual motor performance on speech differed between the right and left hand. Manual motor scores significantly decreased when concurrently performed with the verbal fluency task. Also, verbal fluency results declined when performed concurrently with left-handed manual motor task. These findings suggest that cortical localization of control may be more complex than is predicted by the functional distance hypothesis.
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Vztah fluence řeči a motorického systému jako východisko pro fyzioterapii v komplexní léčbě koktavosti / Speech fluency and motor system relations as the outcome of physiotherapy in comprehensive stuttering treatmentHebík, Štěpán January 2016 (has links)
Tittle: Speech fluency and motor system relations as the outcome of physiotherapy in comprehensive stuttering treatment Objectives: The aim of this thesis is to summarize the accessible literary sources about functional and structural etiology of developmental dysfluency and its effects on motor system. The next aim of this paper is to research current position of physiotherapy in comprehensive stuttering therapy. Methods: The thesis used literature research method, the specific criteria for the selection of literary sources were stated. The first part contains theoretical ground regarding general issues of dysfluency. The second, descriptive and analytical part contains several chapters describing many studies dealing with functional and organ cause of stuttering, features of stutter motor system of stutterers and the current state of physiotherapy in the issue of stuttering. Results: The thesis points out the fundamental meaning of motor system, particularly motor planning in the ethiopathogenesis of stuttering. Certain variations in the structure and function of the CNS of stuttering people have been described. These deviations are specifically manifested on the motor system effectors. The research shows that physical therapy in the complex treatment of stuttering has no clearly defined role so...
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The Effect of Age on Speech Motor Performance During Divided AttentionBailey, Dallin J. 18 June 2013 (has links) (PDF)
The present study examined the divided attention effects of three non-speech tasks on concurrent speech motor performance. These tasks targeted linguistic, cognitive, and manual motor activity. Participants included 60 healthy adults separated into three different age groups of twenty participants each: college-age (20s), middle-aged (40s), and older adults (60s). Each participant completed a speech task once in isolation and once concurrently with each of the three non-speech tasks: a semantic decision task, a quantitative comparison task, and a manual motor task. The non-speech tasks were also performed in isolation. The speech task involved repeating a target phrase each time a beep sounded, for a total of fourteen repetitions. Dependent measures for speech were derived from lip kinematic recordings from a head-mounted strain gauge system. Dependent measures for the other tasks included timed response counts and accuracy rates. Results indicated significant divided attention effects, impacting speech and nonspeech measures in the linguistic and cognitive conditions, and impacting speech measures in the manual motor condition. A significant age effect for utterance duration was also found, as well as a divided attention interaction with age for cognitive task accuracy. The results add to what is known about bidirectional interference between speech and other concurrent tasks, as well as age effects on speech motor control.
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Bedömning av oralmotorik och talmotorik med VMPAC hos typiskt utvecklade barn, 4-10 årGruhonjic, Amela, Stengård, Lovisa January 2010 (has links)
<p>Syftet med denna studie är att undersöka hur en grupp typiskt utvecklade, svenska barn, i åldrarna fyra till tio år presterar på tre deltest i VMPAC, för att därmed skapa ett underlag för en referens för svenska barn i bedömningen av avvikande utveckling. Studiens frågeställningar är: 1. <em>Hur presterar en grupp typiskt utvecklade, svenska barn, i åldrarna fyra till tio år, på tre deltest i VMPAC (Focal Oromotor Control, Sequencing Maintenance Control och Connected Speech and Language Control)? </em>och 2. <em>Förekommer det några skillnader mellan en grupp typiskt utvecklade, svenska barn, jämfört med den amerikanska normeringen i VMPAC och barn med verbal dyspraxi (CAS) undersökta inom ramen för en magisteruppsats (Björelius-Hort, 2009)?</em> Oral- och talmotorisk förmåga hos 23 svenska barn i åldrarna fyra till tio år, som åldersmatchats mot barn med verbal dyspraxi (Björelius-Hort, 2009), testades med deltest två, tre och fyra ur VMPAC. Prövning av inter- och intrabedömarreliabiltet visade statistiskt signifikanta resultat, r =. 923 respektive r =. 913, med p <. 001 i båda fallen. Utifrån resultatet kan följande slutsatser dras: 1. att de studerade barnen, generellt presterade över 80 % på deltest två, tre och fyra i VMPAC, oavsett ålder, 2. att skillnaderna mellan den amerikanska normeringen i VMPAC och studiens deltagare är små och 3. att barnen med verbal dyspraxi generellt presterar sämre än den studerade gruppen på samtliga deltest.</p> / <p>The study investigates speech and oral motor skills in typically developed children at different ages. The results are intended to serve as a basis for future reference in the assessment of atypical development in Swedish children. The questions addressed within the study are: 1. <em>How does a group of typically developed, Swedish children, in the ages four to ten years, perform on three subtests in VMPAC (Focal Oromotor Control, Sequencing Maintenance Control and Connected Speech and Language Control)?</em> and 2. <em>Are there any differences in performance between a group of typically developed, Swedish children, and the American standardization in VMPAC and also with the children with childhood apraxia of speech (CAS) from the study by Björelius-Hort (2009)?</em> Speech and oral motor abilities were assessed using subtests two, three and four in VMPAC. The participants were 23 Swedish children, aged four to ten years old, who had been age-matched based on the children with CAS from the study by Björelius-Hort (2009). Inter- and intra-rater reliability showed statistically significant results, r =. 923 and r =. 913, with p <. 001, in both cases. From the results of the study the following conclusions can be drawn: 1. that the investigated group of children in general performed over 80 % on subtests two, three and four in VMPAC independent of age, 2. that the differences between the American standardization in VMPAC and the participants in this study were almost nonexistent and 3. that children with CAS in general performed poorer than the investigated group of children in all subtests.</p>
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Bedömning av oralmotorik och talmotorik med VMPAC hos typiskt utvecklade barn, 4-10 årGruhonjic, Amela, Stengård, Lovisa January 2010 (has links)
Syftet med denna studie är att undersöka hur en grupp typiskt utvecklade, svenska barn, i åldrarna fyra till tio år presterar på tre deltest i VMPAC, för att därmed skapa ett underlag för en referens för svenska barn i bedömningen av avvikande utveckling. Studiens frågeställningar är: 1. Hur presterar en grupp typiskt utvecklade, svenska barn, i åldrarna fyra till tio år, på tre deltest i VMPAC (Focal Oromotor Control, Sequencing Maintenance Control och Connected Speech and Language Control)? och 2. Förekommer det några skillnader mellan en grupp typiskt utvecklade, svenska barn, jämfört med den amerikanska normeringen i VMPAC och barn med verbal dyspraxi (CAS) undersökta inom ramen för en magisteruppsats (Björelius-Hort, 2009)? Oral- och talmotorisk förmåga hos 23 svenska barn i åldrarna fyra till tio år, som åldersmatchats mot barn med verbal dyspraxi (Björelius-Hort, 2009), testades med deltest två, tre och fyra ur VMPAC. Prövning av inter- och intrabedömarreliabiltet visade statistiskt signifikanta resultat, r =. 923 respektive r =. 913, med p <. 001 i båda fallen. Utifrån resultatet kan följande slutsatser dras: 1. att de studerade barnen, generellt presterade över 80 % på deltest två, tre och fyra i VMPAC, oavsett ålder, 2. att skillnaderna mellan den amerikanska normeringen i VMPAC och studiens deltagare är små och 3. att barnen med verbal dyspraxi generellt presterar sämre än den studerade gruppen på samtliga deltest. / The study investigates speech and oral motor skills in typically developed children at different ages. The results are intended to serve as a basis for future reference in the assessment of atypical development in Swedish children. The questions addressed within the study are: 1. How does a group of typically developed, Swedish children, in the ages four to ten years, perform on three subtests in VMPAC (Focal Oromotor Control, Sequencing Maintenance Control and Connected Speech and Language Control)? and 2. Are there any differences in performance between a group of typically developed, Swedish children, and the American standardization in VMPAC and also with the children with childhood apraxia of speech (CAS) from the study by Björelius-Hort (2009)? Speech and oral motor abilities were assessed using subtests two, three and four in VMPAC. The participants were 23 Swedish children, aged four to ten years old, who had been age-matched based on the children with CAS from the study by Björelius-Hort (2009). Inter- and intra-rater reliability showed statistically significant results, r =. 923 and r =. 913, with p <. 001, in both cases. From the results of the study the following conclusions can be drawn: 1. that the investigated group of children in general performed over 80 % on subtests two, three and four in VMPAC independent of age, 2. that the differences between the American standardization in VMPAC and the participants in this study were almost nonexistent and 3. that children with CAS in general performed poorer than the investigated group of children in all subtests.
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Contrôle de la production de la parole chez l’enfant de 4 ans : l'anticipation comme indice de maturité motrice / Speech motor control in 4-year-old children : anticipation as an index of speech motor control maturityBarbier, Guillaume 08 September 2016 (has links)
Ce travail de thèse étudie la production de la parole à l'âge de 4 ans, en comparaison avec l'adulte, sous l'angle du contrôle moteur. Un intérêt particulier a été porté à deux indices : la variabilité liée à la répétition de voyelles isolées et la coarticulation anticipatoire intra et extra-syllabique dans le cadre de la production de séquences de type V1-C-V2. Des données acoustiques et articulatoires ont été enregistrées via l'échographie linguale et le dispositif HOCUS. Les données acoustiques ont été analysées pour 20 enfants et 10 adultes et les données articulatoires ont été analysées pour 6 de ces enfants et 2 de ces adultes. En accord avec de nombreuses études de la littérature, la variabilité liée à la répétition est plus importante chez les enfants que chez les adultes. Une forte anticipation de V2 dans la réalisation de V1 a été observée pour tous les adultes. Chez les enfants, cette anticipation n'est pas systématique, et lorsqu'elle est observée, elle est d'amplitude plus faible que chez les adultes. Ainsi, seulement 5 enfants parmi les 20 étudiés montrent des signes d'anticipation, majoritairement dans la dimension antéropostérieure, manifestée dans l'espace acoustique par la dimension F2. La coarticulation anticipatoire intra-syllabique semble également être d'amplitude plus faible chez les enfants. Enfin, les gestes de parole des enfants sont plus lents que ceux des adultes. Dans leur ensemble, ces résultats sont interprétés comme la preuve de l'immaturité du système moteur pour la production de la parole chez l'enfant, selon deux perspectives : des patrons moteurs insuffisamment stables pour la production de gestes vocaliques et un manque d'efficacité dans l'anticipation les gestes futurs lors de la production d'une séquence de sons de parole. Selon une perspective empruntée aux théories du contrôle moteur optimal, nous proposons que la coarticulation anticipatoire repose sur l'usage de modèles internes, représentations sensori-motrices du système moteur de la parole dans le système nerveux central, et que son amplitude reflète la maturation progressive de ces représentations sensori-motrices à mesure que la production de la parole se développe. / This thesis work investigates speech production in 4-year-old children, in comparison with adults, from a speech motor control perspective. It focuses on two indices: measures of token-to-token variability in the production of isolated vowels and on anticipatory intra and extra-syllabic coarticulation within V1-C-V2 sequences. Acoustic and articulatory data were recorded thanks to ultrasound tongue imaging within the HOCUS system. Acoustic data from 20 children and 10 adults have been analyzed. Ultrasound data have been analyzed from a subset of these participants: 6 children and 2 adults. In agreement with former studies, token-to-token variability was greater in children than in adults. Strong anticipation of V2 in V1 realization was found in all adults. In children, anticipation was not systematic, and when observed, it was of smaller amplitude than in adults. In more details, only 5 children among the 20 studied showed a small amount of anticipation, mainly along the antero-posterior dimension, manifested in the acoustic F2 dimension. Anticipatory intra-syllabic coarticulation also seems to be of smaller amplitude in children than in adults. Last, children's speech gestures are slower than those of adults. These results are interpreted as evidence for the immaturity of children's speech motor control from two perspectives: insufficiently stable motor control patterns for vowel production, and a lack of effectiveness in anticipating forthcoming gestures. In line with theories of optimal motor control, we assume that anticipatory coarticulation is based on the use of internal models, i.e. sensori-motor representations of the speech production apparatus in the central nervous system, and that the amplitude of anticipatory coarticulation reflects the increasing maturation of these sensori-motor representations as speech develops.
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Uncontrolled manifolds et réflexes à courte latence dans le contrôle moteur de la parole : une étude de modélisation / Uncontrolled manifolds and short-delay reflexes in speech motor control : a modeling studySzabados, Andrew 27 November 2017 (has links)
Ce travail exploite un modèle biomécanique de la production de la parole comme sujet de référence pour étudier plusieurs phénomènes liés à l'adaptabilité et à la stabilité du contrôle moteur de la parole, en particulier l'équivalence motrice et le contrôle postural.La première partie de cette thèse s’intéresse au phénomène de l'équivalence motrice. L'équivalence motrice est une caractéristique essentielle du contrôle moteur de la parole, car les locuteurs doivent s'adapter constamment à des contextes phonétiques toujours différents et à conditions variables de production de la parole. Le concept de « Uncontrolled Manifold » (UCM) offre un cadre théorique pour comprendre les mécanismes sous-jacents à l'équivalence motrice : il propose de représenter la coordination entre les variables de contrôle moteur en deux sous-espaces séparés, un dans lequel tout changement des variables de contrôle affectent la sortie et un autre dans lequel ces changements n'influencent aucunement la sortie.Ce concept est développé et étudié pour la production de la parole en utilisant un modèle biomécanique 2D du conduit vocal. D'abord, une représentation des UCM linéarisées basée sur des matrices de projection orthogonale est proposée. Les UCM de différentes configurations du conduit vocal des 10 voyelles orales françaises sont ensuite caractérisées en étudiant les réponses aux perturbations de leurs commandes. On étudie alors si chaque catégorie phonétique, telle que les phonèmes, les voyelles antérieures/postérieures, ou les voyelles arrondies/non-arrondies, peut être caractérisée par une UCM unique ou si les UCM varient considérablement entre les différents représentants de chacune de ces classes. On a constaté que les UCM linéarisées, celles qui sont spécifiquement calculées pour chaque configuration du conduit vocal, mais aussi celles, plus globales, des classes phonétiques, permettent une réponse efficace aux perturbations des commandes. Cela suggère que des stratégies équivalentes d'équivalence motrice peuvent être mises en œuvre dans chacune de ces classes et que les UCM en fournissent des caractérisations exploitables. Des suggestions sont faites pour de futurs travaux pour déterminer quelles classes pourraient être utilisées dans la pratique.La deuxième partie étudie dans quelle mesure le contrôle postural de la langue exploit des mécanismes passifs - tels que les propriétés mécaniques et élastiques intrinsèques de la langue- ou des réflexes à faible latence - comme le réflexe d’étirement.Une perturbation en force a été appliquée au modèle biomécanique 2D, dans laquelle la langue est tirée vers l'avant par une force exercée sur le corps de la langue à l'aide d'un robot relié à la partie supérieure de la lame de la langue. Les simulations ont été comparées à des données expérimentales recueillies au Gipsa-lab dans des conditions similaires.Cette perturbation a été simulée avec différentes valeurs du paramètre qui dans le modèle module le feedback induit par l’étirement des fibres musculaires. Les résultats ont montré un effet de rebond dans les mouvements de la langue suite à la perturbation qui est imputable au mécanisme réflexe. Étant donné qu'un rebond similaire est observé dans les données expérimentales sur des sujets humains, ce résultat suggère qu’un mécanisme réflexe joue un rôle significatif dans la stabilité posturale de la langue. Les caractéristiques temporelles de ce réflexe ont été analysées et il s’avère que la précision du modèle est insuffisante pour tirer des conclusions sur l'origine, corticale ou spinale, de ce réflexe. Des pistes pour de futures études expérimentales sont proposées. / This work makes use of a biomechanical model of speech production as a reference subject to address several phenomena related to the adaptability and stability of speech motor control, namely motor equivalence and postural stability. The first part of this thesis is related to the phenomenon of motor equivalence. Motor equivalence is a key feature of speech motor control, since speakers must constantly adapt to various phonetic contexts and speaking conditions. The Uncontrolled Manifold (UCM) idea offers a theoretical framework for considering motor equivalence in which coordination among motor control variables is separated into two subspaces, one in which changes in control variables modify the output and another one in which these changes do not influence the output.This concept is developed and investigated for speech production using a 2D biomechanical model. First, a representation of the linearized UCM based on orthogonal projection matrices is proposed. The UCMs of various vocal tract configurations of the 10 French oral vowels are then characterized using their command perturbation responses. It is then investigated whether each phonetic class such as phonemes, front/back vowels, rounded/un-rounded vowels can be characterized by a unique UCM, or whether the UCMs vary significantly across representatives of these different classes. It was found that linearized UCMs, especially those that are specifically computed for each configuration, but also across many of the phonetic classes allow for a command perturbation response that is effective. This suggests that similar motor equivalence strategies can be implemented within each of these classes and that UCMs provide a valid characterization of an equivalence strategy. Further work is suggested to elaborate which classes might be used in practice.The second part addresses the question of the degree to which postural control of the tongue is accomplished through passive mechanisms - such as the mechanical and elastic properties of the tongue itself - or through short-latency reflexes - such as the stretch reflex.A specific external force perturbation, was applied to the 2D biomechanical model , namely one in which the tongue is pulled anteriorly using specific force profile exerted on the tongue body using a force effector attached to the superior part of the tongue blade. Simulation results were compared to experimental data collected at Gipsa-lab under similar conditions.This perturbation was simulated with various values of the model's parameter modulating the reflex strength (feedback gain). The results showed that a perturbation rebound seen in simulated data is due to a reflex mechanism. Since a compatible rebound is seen in data from human subjects, this can be taken as evidence of a reflex mechanism being involved in postural stability of the tongue. The time course of the mechanisms of this reflex, including the generation of force and the movement of the tongue, were analyzed and it was determined that the precision of the model was insufficient to make any conclusions on the origin of this reflex (whether cortical or brainstem). Still, numerous experimental directions are proposed.
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