The goal of this protocol is to demonstrate a practical method to temporarily interfere with proprioception in the upper limb of healthy humans.
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Method Article
A Simple Non-invasive Method for Temporary Knockdown of Upper Limb Proprioception
In This Article
Summary
Abstract
Proprioception may be the least well measured of all contributors to the neural control of movement. New precise, reliable measures of proprioception are needed for clinical diagnosis of impairment, and to measure outcomes of proprioceptive training. The purpose of this simple, non-invasive method is to temporarily knockdown upper limb proprioception in healthy adults, to an extent that would be useful in the development and testing of upper limb proprioception measures. Knockdown models have two main advantages over studying humans with impaired proprioception: participant availability and the ability to control the extent of impairment across participants. Current published methods of temporary proprioception knockdown of the upper limb, such as ischemic nerve blocks and cryotherapy, are invasive, impractical, or uncomfortable for the participant. Here, vibration over the ulnar groove was used to reduce upper limb proprioception. High frequency vibration may reduce proprioceptive acuity by inhibiting pacinian corpuscle-induced input. The effect of vibration used in this protocol was confirmed using two quantitative measures. This method was simple to administer, comfortable for participants, and practical.
Introduction
Of all contributors to the neural control of movement, proprioception may be the least well measured. Research measures of proprioception using specialized equipment have recently achieved reliability, validity, and precision;1,2,3 in contrast, clinical measures of proprioception, the most common being limb position sense testing,4 have low resolution, are contaminated by other sensory modalities,4 and have poor or no published psychometric properties.5 New precise, reliable measures of proprioception are....
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Protocol
The Institutional Review Board at the College of St. Scholastica has approved the study under which this protocol was developed and tested.
NOTE: The manufacturer's specifications of the vibrator used in this protocol indicated that the frequency on 'high' was 11,00 rpm (183.3 Hz). This frequency was confirmed using a sample of vibration data collected through one input of a differential amplifier sampled at 2 kHz. The mean period of the signal was 5.56 x 10-3 s, which is equivalent to 180 Hz. In individuals with Raynaud's disease, vibration may cause Raynaud's phenomenon, a temporary vasoconstriction at the s....
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Results
Using the protocol presented here, we tested 20 healthy adults, 8 were male (mean age (SD)= 32.5 (12.5) years; 19 right-, and 1 left- handed). The participants had no known pathology involving the upper extremities. Handedness was assessed using the Edinburgh Handedness Inventory.24 Study participants reported no adverse events.
Both upper limbs of each participant were tested using the VDT and the tBKT a.......
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Discussion
This protocol provides a method to knock down human proprioception in the upper limb. Across 20 healthy participants the effect of proprioceptive knockdown was large as measured by VDT a psychophysical measure of sensitivity thought to reflect Aα afferent axon transmission. The VDT was measured as quickly as possible after removal of vibration, when Aα afferent discharge is reduced.25 The effect of this protocol on error in reaching to a target with visual occlusion (tBKT) was moderate. .......
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Disclosures
The authors have nothing to disclose.
Acknowledgements
The authors would like to acknowledge Jon Nelson PhD, PT, for conducting the analysis to confirm the vibration frequency of the vibrator used in this protocol.
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Materials
| Name | Company | Catalog Number | Comments |
|---|---|---|---|
| Pure Enrichment-Massage Mini with Built in USB Rechargeable Battery | ebay | None | 183 Hz cordless vibrator, 7 inches total length including handle |
| Chattanooga 2.5 inch velcro strap | ebay | None | used to secure vibrator to arm |
| Tuning Fork C128 ENT Surgical Medical Instruments Exam Diagnostic Tools | ebay | None | Used in VDT |
| Handheld Digital stop watch | ebay | None | Used to time VDT |
| Universal Rubber Bands Size 33, 3 1/2 x 1/8 inch | ebay | Universal - UNV00433 | used to secure vibrator head to arm |
| Instructions to build Visual Screen were published here: https://www.jove.com/video/53178/design-fabrication-administration-hand-active-sensation-test |
References
- Dukelow, S. P., et al. Quantitative assessment of limb position sense following stroke. Neurorehabilitation and neural repair. 24, 178(2010).
- Cappello, L., et al. Robot-aided assessment of wrist proprioception. Frontiers in human neuroscience. 9, (2015).
- Han, J., Waddington, G., Adams, R., Anson, J., Liu, Y. ....
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