Observationally providing sensory input via cutaneous or sensory nerve stimulation improves task performance in some individuals, yet the sensory contribution is rarely evaluated or measured. Motor components of task performance are much easier to measure and quantify. Therapists frequently focus on strengthening as a primary intervention and outcome measure. Yet we see some very weak individuals with good timing and coordination be very functional while conversely there are very strong patients by traditional muscle testing who are very functionally deficient. How is somatic, schematic awareness and proprioception involved in motor learning and task performance and how might we measure? Has this been done? Any references?
Dear Lisa,
Very interesting and intriguing question. It could very well be that proprioception and somtic sensory awareness are prerequisite for functional training. Other way around: it is our assumption that many physical problems occur because of problems in the proprioceptive feedback. While training individuals with back, neck or pelvic pain adressing/emphasising somatic awareness and proprioception instead of strength/endurance is (from our perspective) very effective. In this respect you might want to read the studies of Aage Indahl and Sten Holm. They showed changes in muscular response when injecting saline solutions in facet joints and sacroiliac joints of pigs. This shows the interaction between capsule feedback (proprioception) on muscle performance. Maybe not exactly what you are looking for, but it is a start.
Goo dluck with this question! looking forward to other responses!
Makes me think about doing Tai Chi, strength constributes only so much to skilled behavior. Coordination and 'awareness' are important too.
For stroke and neuro related work you could check out Sarah Tyson, Louise Connell, Jane Sullivan, Susan Hillier and Lesley Crowe. I've been interested in testing somatosensory function and generally, in a clinical setting, testing is often linked with a measure of balance as it 'gives' information that can be linked to sensory depravation. Sensation often only really being tested when there is a clear problem demonstrated by a physical sign or a patient commenting on sensory loss. My impression is this is due to the time consuming nature of sensory testing and, as you say, how it links to motor performance. There is much to be done in this area.
From clinical neurological reasons, sensory peripheral testing should assess epicritic and protopathic stimuli, as these stimuli are processed by different neuroanatomic pathways to primary and secondary sensory cortical areas. These pathways have also branches to the unspecific ascending reticular activating system. Especially the fine finger movement guidance is dependent on this sensory input.
In neurorehab you can use fine finger movement exercises or a sensory discrimination paradigm to improve and restore sensory hand/finger functions. Such strategies are mainly needed when after an initial sensory loss some functions recover, but in the same time dysaesthesia or neuropathic pain developes.
With another perspective using the ICF framework you can measure at the level you want to improve and you said it was task performance. To obtain a better task performance there are several aspects that interact such as improved functions i.e. strenght, coordination, sensory functions etc, and a lot of other aspects such as compensatory techniques, awareness of problems, motivation and mood. If you evaluate the outcome in terms of task performance there is no need to separete which of the contributing factors in the complex interaction that makes the difference. If your intervention deal with provision of sensory input and you see more improvments at activity level than without it could be evidence enough.
Indeed, considering force capacities at peripheral level, independent of the role neural/central motor commands and sensory reafferences is false. Have a look at Clark and Manini's publications (e.g. 2008) for introduction in this respect.
Yes, motor performance proficiency depends on the sensory input and its integrity. A very strong muscle strength without adequate joint proprioception and kinaesthetic senses is as of no functional significance. However, sensory re-education: proprioception and kinaesthetic can conversely impact positively on muscle strength and improve functional performance and quality of life. I think this article will be a pointer to my hypothesis.
Joris,
Came across an interesting paper that speaks to your point . It was about the
impact of "mindfulness meditation on visuomotor performance, perceptual-motor awareness and the sense of self-agency"
here's the reference and link
Naranjo and Schmidt: Is it me or not me? Modulation of perceptual-motor awareness and visuomotor performance by mindfulness meditation. BMC Neuroscience 2012 13:88.
http://www.biomedcentral.com/content/pdf/1471-2202-13-88.pdf
Hi Patricia, Thanks, am busy, may look into this later. Some sportsmen try to visualise what might happen and report better performance... one might call it a kind of 'priming'.
How interesting that this question just appeared in my inbox after this same topic was just being discussed in a Feldenkrais practitioners web forum! A colleague had just posted the sentence: "The Feldenkrais lessons are exclusively designed to give the coordination system accurate and variable feedback and to clarify/ optimise the coordination processes". It is the attention to sensory processes that distinguishes the Feldenkrais Method from most other approaches. 50 years ago Dr Feldenkrais was trying to work out how the body image in the CNS can be optimised to improve function, and that is what most of his lessons are aiming to do. My article in the UK Physiotherapy journal a few years ago tried to 'unpack' a little of the Feldenkrais Method and might be of Interest.
- Badges
- Science method
- Similar topics
- Mathematics
- Statistics
- Statistical Techniques
- Meta-Analysis