Cervicocephalic kinaesthesia reveals novel subgroups of motor control impairments in patients with neck pain.

Cervical-spine sensorimotor control is associated with chronicity and recurrence of neck pain (NP). Tests used to measure sensorimotor impairments lack consistency in studied parameters. Interpretation is often based on either a handful or numerous parameters, without considering their possible interrelation. Different aspects of motor-control could be studied with different parameters, but this has not yet been addressed. The aim of this study was to determine if different parameters of cervical position (JPE) and movement (Butterfly) sense tests represent distinct components of motor-control strategies in patients with chronic NP. Principal component analysis performed on 135 patients revealed three direction-specific (repositioning from flexion, extension or rotations) and one parameter-specific (variability of repositioning) component for JPE, two difficulty-specific (easy or medium and difficult trajectory) and one movement-specific (undershooting a target) component for Butterfly test. Here we report that these components could be related to central (neck repositioning and control of cervical movement) and peripheral sensorimotor adaptations (variability of repositioning) present in NP. New technologies allow extraction of greater number of parameters of which hand-picking could lead to information loss. This study adds towards better identification of diverse groups of parameters offering potentially clinically relevant information and improved functional diagnostics for patients with NP.

The effects of periodic and noisy tendon vibration on a kinesthetic targeting task.

Tendon vibration is used extensively to assess the role of peripheral mechanoreceptors in motor control, specifically, the muscle spindles. Periodic tendon vibration is known to activate muscle spindles and induce a kinesthetic illusion that the vibrated muscle is longer than it actually is. Noisy tendon vibration has been used to assess the frequency characteristics of proprioceptive reflex pathways during standing; however, it is unknown if it induces the same kinesthetic illusions as periodic vibration. The purpose of the current study was to assess the effects of both periodic and noisy tendon vibration in a kinesthetic targeting task. Participants (N = 15) made wrist extension movements to a series of visual targets without vision of the limb, while their wrist flexors were either vibrated with periodic vibration (20, 40, 60, 80, and 100 Hz), or with noisy vibration which consisted of filtered white noise with power between ~ 20 and 100 Hz. Overall, our results indicate that both periodic and noisy vibration can induce robust targeting errors during a wrist targeting task. Specifically, the vibration resulted in an undershooting error when moving to the target. The findings from this study have important implications for the use of noisy tendon vibration to assess proprioceptive reflex pathways and should be considered when designing future studies using noisy vibration.

Proprioceptive short-term memory in passive motor learning.

A physical trainer often physically guides a learner's limbs to teach an ideal movement, giving the learner proprioceptive information about the movement to be reproduced later. This instruction requires the learner to perceive kinesthetic information and store the instructed information temporarily. Therefore, (1) proprioceptive acuity to accurately perceive the taught kinesthetics and (2) short-term memory to store the perceived information are two critical functions for reproducing the taught movement. While the importance of proprioceptive acuity and short-term memory has been suggested for active motor learning, little is known about passive motor learning. Twenty-one healthy adults (mean age 25.6 years, range 19-38 years) participated in this study to investigate whether individual learning efficiency in passively guided learning is related to these two functions. Consequently, learning efficiency was significantly associated with short-term memory capacity. In particular, individuals who could recall older sensory stimuli showed better learning efficiency. However, no significant relationship was observed between learning efficiency and proprioceptive acuity. A causal graph model found a direct influence of memory on learning and an indirect effect of proprioceptive acuity on learning via memory. Our findings suggest the importance of a learner's short-term memory for effective passive motor learning.

Integration of proprioception in upper limb prostheses through non-invasive strategies: a review.

Proprioception plays a key role in moving our body dexterously and effortlessly. Nevertheless, the majority of investigations evaluating the benefits of providing supplemental feedback to prosthetics users focus on delivering touch restitution. These studies evaluate the influence of touch sensation in an attempt to improve the controllability of current robotic devices. Contrarily, investigations evaluating the capabilities of proprioceptive supplemental feedback have yet to be comprehensively analyzed to the same extent, marking a major gap in knowledge within the current research climate. The non-invasive strategies employed so far to restitute proprioception are reviewed in this work. In the absence of a clearly superior strategy, approaches employing vibrotactile, electrotactile and skin-stretch stimulation achieved better and more consistent results, considering both kinesthetic and grip force information, compared with other strategies or any incidental feedback. Although emulating the richness of the physiological sensory return through artificial feedback is the primary hurdle, measuring its effects to eventually support the integration of cumbersome and energy intensive hardware into commercial prosthetic devices could represent an even greater challenge. Thus, we analyze the strengths and limitations of previous studies and discuss the possible benefits of coupling objective measures, like neurophysiological parameters, as well as measures of prosthesis embodiment and cognitive load with behavioral measures of performance. Such insights aim to provide additional and collateral outcomes to be considered in the experimental design of future investigations of proprioception restitution that could, in the end, allow researchers to gain a more detailed understanding of possibly similar behavioral results and, thus, support one strategy over another.

Variation of corticospinal excitability during kinesthetic illusion induced by musculotendinous vibration.

Despite being studied for more than 50 years, the neurophysiological mechanisms underlying vibration (VIB)-induced kinesthetic illusions are still unclear. The aim of this study was to investigate how corticospinal excitability tested by transcranial magnetic stimulation (TMS) is modulated during VIB-induced illusions. Twenty healthy adults received vibration over wrist flexor muscles (80 Hz, 1 mm, 10 s). TMS was applied over the primary motor cortex representation of wrist extensors at 120% of resting motor threshold in four random conditions (10 trials/condition): baseline (without VIB), 1 s, 5 s, and 10 s after VIB onset. Means of motor-evoked potential (MEP) amplitudes and latencies were calculated. Statistical analysis found a significant effect of conditions (stimulation timings) on MEP amplitudes (P = 0.035). Paired-comparisons demonstrated lower corticospinal excitability during VIB at 1 s compared with 5 s (P = 0.025) and 10 s (P = 0.003), although none of them differed from baseline values. Results suggest a time-specific modulation of corticospinal excitability in muscles antagonistic to those vibrated, i.e., muscles involved in the perceived movement. An early decrease of excitability was observed at 1 s followed by a stabilization of values near baseline at subsequent time points. At 1 s, the illusion is not yet perceived or not strong enough to upregulate corticospinal networks coherent with the proprioceptive input. Spinal mechanisms, such as reciprocal inhibition, could also contribute to lower the corticospinal drive of nonvibrated muscles in short period before the illusion emerges. Our results suggest that neuromodulatory effects of VIB are likely time-dependent, and that future work is needed to further investigate underlying mechanisms.NEW & NOTEWORTHY The modulation of corticospinal excitability when perceiving a vibration (VIB)-induced kinesthetic illusion evolves dynamically over time. This modulation might be linked to the delayed occurrence and progressive increase in strength of the illusory perception in the first seconds after VIB start. Different spinal/cortical mechanisms could be at play during VIB, depending on the tested muscle, presence/absence of an illusion, and the specific timing at which corticospinal drive is tested pre/post VIB.

Visual and kinesthetic motor imagery in adults with different degrees of self-reported motor coordination difficulties.

Developmental Coordination Disorder (DCD) involves difficulties in performing coordinated movements with fine and/or gross motor skills deficits. Several studies showed that DCD is characterized by motor imagery deficits as well. Here we investigated in neurotypical adults (N = 334) the relationships between the ease of imaging two main motor imagery components, that is the visual and the kinesthetic one, self-reported motor coordination difficulties and handwriting speed. Self-reported motor difficulties were measured by the Adult Developmental Co-ordination Disorders/Dyspraxia Checklist (ADC) and scores were used to distinguish three groups: participants at risk of DCD (with both relevant childhood and current motor coordination difficulties); with motor coordination difficulties (relevant current but not childhood difficulties); without motor coordination difficulties (neither current nor childhood difficulties). The main results showed more kinesthetic and visual imagery difficulties in participants at risk of DCD than in those both with and without motor coordination difficulties. Interestingly, the relationships between the two imagery components and motor difficulties were different in the three groups, depending on: 1) the developmental phase (childhood or adulthood) to which motor coordination difficulties referred, and 2) the point of view (self or other), from which images were judged. Instead, no relationship was found between imagery abilities and handwriting speed. Thus, a nuanced pattern of the ease of imaging motor imagery emerged in adults with different degrees of self-reported motor coordination difficulties. These findings could be relevant for the assessment of people candidate to undergo a motor imagery training.

Brief Visual Deprivation Effects on Brain Oscillations During Kinesthetic and Visual-motor Imagery.

It is widely recognized that opening and closing the eyes can direct attention to external or internal stimuli processing. This has been confirmed by studies showing the effects of changes in visual stimulation changes on cerebral activity during different tasks, e.g., motor imagery and execution. However, an essential aspect of creating a mental representation of motion, such as imagery perspective, has not yet been investigated in the present context. Our study aimed to verify the effect of brief visual deprivation (under eyes open [EO] and eyes closed [EC] conditions) on brain wave oscillations and behavioral performance during kinesthetic imagery (KMI) and visual-motor imagery (VMI) tasks. We focused on the alpha and beta rhythms from visual- and motor-related EEG activity sources. Additionally, we used machine learning algorithms to establish whether the registered differences in brain oscillations might affect motor imagery brain-computer interface (MI-BCI) performance. The results showed that the occipital areas in the EC condition presented significantly stronger desynchronization during VMI tasks, which is typical for enhanced visual stimuli processing. Furthermore, the stronger desynchronization of alpha rhythms from motor areas in the EO, than EC condition confirmed previous effects obtained during real movements. It was also found that simulating movement under EC/EO conditions affected signal classification accuracy, which has practical implications for MI-BCI effectiveness. These findings suggest that shifting processing toward external or internal stimuli modulates brain rhythm oscillations associated with different perspectives on the mental representation of movement.

Utility and Usability of Two Forms of Supplemental Vibrotactile Kinesthetic Feedback for Enhancing Movement Accuracy and Efficiency in Goal-Directed Reaching.

Recent advances in wearable sensors and computing have made possible the development of novel sensory augmentation technologies that promise to enhance human motor performance and quality of life in a wide range of applications. We compared the objective utility and subjective user experience for two biologically inspired ways to encode movement-related information into supplemental feedback for the real-time control of goal-directed reaching in healthy, neurologically intact adults. One encoding scheme mimicked visual feedback encoding by converting real-time hand position in a Cartesian frame of reference into supplemental kinesthetic feedback provided by a vibrotactile display attached to the non-moving arm and hand. The other approach mimicked proprioceptive encoding by providing real-time arm joint angle information via the vibrotactile display. We found that both encoding schemes had objective utility in that after a brief training period, both forms of supplemental feedback promoted improved reach accuracy in the absence of concurrent visual feedback over performance levels achieved using proprioception alone. Cartesian encoding promoted greater reductions in target capture errors in the absence of visual feedback (Cartesian: 59% improvement; Joint Angle: 21% improvement). Accuracy gains promoted by both encoding schemes came at a cost in terms of temporal efficiency; target capture times were considerably longer (1.5 s longer) when reaching with supplemental kinesthetic feedback than without. Furthermore, neither encoding scheme yielded movements that were particularly smooth, although movements made with joint angle encoding were smoother than movements with Cartesian encoding. Participant responses on user experience surveys indicate that both encoding schemes were motivating and that both yielded passable user satisfaction scores. However, only Cartesian endpoint encoding was found to have passable usability; participants felt more competent using Cartesian encoding than joint angle encoding. These results are expected to inform future efforts to develop wearable technology to enhance the accuracy and efficiency of goal-directed actions using continuous supplemental kinesthetic feedback.

General Discretization Method for Enhanced Kinesthetic Haptic Stability.

The stability of haptic simulation systems has been studied for a safer interaction with virtual environments. In this work, the passivity, uncoupled stability, and fidelity of such systems are analyzed when a viscoelastic virtual environment is implemented using a general discretization method that can also represent methods such as backward difference, Tustin, and zero-order-hold. Dimensionless parametrization and rational delay are considered for device independent analysis. Aiming at expanding the virtual environment dynamic range, equations to find optimum damping values for maximize stiffness are derived and it is shown that by tuning the parameters for a customized discretization method, the virtual environment dynamic range will supersede the ranges offered by methods such as backward difference, Tustin and zero-order-hold. It is also shown that minimum time delay is required for stable Tustin implementation and that specific delay ranges must be avoided. The proposed discretization method is numerically and experimentally evaluated.

Heating the Skin Over the Knee Improves Kinesthesia During Knee Extension.

To determine how heating affects dynamic joint position sense at the knee, participants (n = 11; F = 6) were seated in a HUMAC NORM dynamometer. The leg was passively moved through extension and flexion, and participants indicated when the 90° reference position was perceived, both at baseline (28.74 ± 2.43 °C) and heated (38.05 ± 0.16 °C) skin temperatures. Day 2 of testing reduced knee skin feedback with lidocaine. Directional error (actual leg angle-target angle) and absolute error (AE) were calculated. Heating reduced extension AE (baseline AE = 5.46 ± 2.39°, heat AE = 4.10 ± 1.97°), but not flexion. Lidocaine did not significantly affect flexion AE or extension AE. Overall, increased anterior knee-skin temperature improves dynamic joint position sense during passive knee extension, where baseline matching is poorer. Limited application of lidocaine to the anterior thigh, reducing some skin input, did not influence dynamic joint position sense, suggesting cutaneous receptors may play only a secondary role to spindle information during kinesthetic tasks. Importantly, cutaneous input from adjacent thigh regions cannot be ruled out as a contributor.

Dataset with Tactile and Kinesthetic Information from a Human Forearm and Its Application to Deep Learning.

There are physical Human-Robot Interaction (pHRI) applications where the robot has to grab the human body, such as rescue or assistive robotics. Being able to precisely estimate the grasping location when grabbing a human limb is crucial to perform a safe manipulation of the human. Computer vision methods provide pre-grasp information with strong constraints imposed by the field environments. Force-based compliant control, after grasping, limits the amount of applied strength. On the other hand, valuable tactile and proprioceptive information can be obtained from the pHRI gripper, which can be used to better know the features of the human and the contact state between the human and the robot. This paper presents a novel dataset of tactile and kinesthetic data obtained from a robot gripper that grabs a human forearm. The dataset is collected with a three-fingered gripper with two underactuated fingers and a fixed finger with a high-resolution tactile sensor. A palpation procedure is performed to record the shape of the forearm and to recognize the bones and muscles in different sections. Moreover, an application for the use of the database is included. In particular, a fusion approach is used to estimate the actual grasped forearm section using both kinesthetic and tactile information on a regression deep-learning neural network. First, tactile and kinesthetic data are trained separately with Long Short-Term Memory (LSTM) neural networks, considering the data are sequential. Then, the outputs are fed to a Fusion neural network to enhance the estimation. The experiments conducted show good results in training both sources separately, with superior performance when the fusion approach is considered.

Consistent under-reporting of task details in motor imagery research.

Motor Imagery is a subject of longstanding scientific interest. However, critical details of motor imagery protocols are not always reported in full, hampering direct replication and translation of this work. The present review provides a quantitative assessment of the prevalence of under-reporting in the recent motor imagery literature. Publications from the years 2018-2020 were examined, with 695 meeting the inclusion criteria for further examination. Of these studies, 64% (445/695) did not provide information about the modality of motor imagery (i.e., kinesthetic, visual, or a mixture of both) used in the study. When visual or mixed imagery was specified, the details of the visual perspective to be used (i.e., first person, third person, or combinations of both) were not reported in 24% (25/103) of studies. Further analysis indicated that studies using questionnaires to assess motor imagery reported more information than those that did not. We conclude that studies using motor imagery consistently under-report key details of their protocols, which poses a significant problem for understanding, replicating, and translating motor imagery effects.

Reliability and validity of the Japanese movement imagery questionnaire-revised second version.

OBJECTIVE: Developing a Japanese version of the Movement Imagery Questionnaire-Revised Second Version (MIQ-RS) is essential for widespread evaluation and treatment based on motor imagery in physically disabled persons and patients in rehabilitation. This study aimed to investigate the reliability and validity of the Movement Imagery Questionnaire-Revised Second Version (MIQ-RS), which assesses motor imagery ability, by translating it into Japanese. RESULTS: This study enrolled twenty healthy participants (10 men and 10 women, mean age 21.17 ± 1.10 years). Reliability was examined for internal consistency using Cronbach's alpha coefficient. Spearman's rank correlation coefficient was used to examine the criterion-related validity of the MIQ-RS and the Kinesthetic and Visual Imagery Questionnaire (KVIQ-20). Results showed that Cronbach's alpha coefficients for the MIQ-RS were 0.81 and 0.82 for visual and kinesthetic imagery, respectively. Significant positive correlations were found between each visual and kinesthetic imagery score, and each total on the MIQ-RS and KVIQ-20 scores (r = 0.73, p < 0.01; r = 0.84, p < 0.01; r = 0.80, p < 0.01, respectively). This study suggests that the Japanese version of the MIQ-RS is a reliable and valid method of assessing motor imagery ability.

Neural Activity During Imagery Supports Three Imagery Abilities as Measured by the Movement Imagery Questionnaire-3.

Self-report and neural data were examined in 14 right-handed college-age males screened from a pool of 200 to verify neural activity during imagery and that the neural activity (area of brain) varies as a function of the imagery type. Functional magnetic resonance imaging data collected during real-time imagery of the three Movement Imagery Questionnaire-3 abilities indicated frontal areas, motor areas, and cerebellum active during kinesthetic imagery, motor areas, and superior parietal lobule during internal visual imagery, and parietal lobule and occipital cortex during external visual imagery. Central and imagery-specific neural patterns were found providing further biological validation of kinesthetic, internal visual, and external visual complementing results on females. Next, research should (a) compare neural activity between male participants screened by self-reported imagery abilities to determine if good imagers have more efficient neural networks than poor imagers and (b) determine if there is a statistical link between participants' neural activity during imagery and self-report Movement Imagery Questionnaire-3 scores.

A Study on Artificial Kinesthesia Generation by Simultaneous Stimulation of Mechanical Vibration and Mechanical Skin Stretch.

Artificially controlled kinesthesia can be applied to many situations because kinesthesia is essential to recognizing body movements. It could be used to generate artificial kinesthesia in rehabilitation or daily motion assist to improve self-efficacy of the robot user. Moreover, the controlled artificial kinesthesia could make people feel as if they are performing the actions of the robotic limbs with their own limbs. Mechanical vibration stimulation is one of the candidates to artificially control kinesthesia. It is known that mechanical vibration stimulation on human muscles or tendons from skin surface evokes an illusion of movement as if the stimulated muscles are extended. That effect of artificial kinesthesia is called Kinesthetic Illusion (KI). In this paper, a method to increase the amount of KI without changing the frequency of the vibration stimulation is investigated by applying mechanical skin stretch stimulation at the same time with the mechanical vibration stimulation. The experiment was conducted by generating KI for flexion motion of the elbow joint on a horizontal plane to evaluate the proposed approach. In the experiments, three out of five subjects showed obvious increase in the amount of KI when skin stretch stimulation was applied at the same time with the mechanical vibration stimulation. The results of this study provide a first step toward artificial kinesthesia control using a wearable robotic device using the mechanical vibration stimulation.

Decoding of Motor Imagery Involving Whole-body Coordination.

The present study investigated whether different types of motor imageries can be classified based on the location of the activation peaks or the multivariate pattern analysis (MVPA) of functional magnetic resonance imaging (fMRI) and compared the difference between visual motor imagery (VI) and kinesthetic motor imagery (KI). During fMRI scanning sessions, 25 participants imagined four movements included in the Motor Imagery Questionnaire-Revised (MIQ-R): knee lift, jump, arm movement, and waist bend. These four imagined movements were then classified based on the peak location or the patterns of fMRI signal values. We divided the participants into two groups based on whether they found it easier to generate VI (VI group, n = 10) or KI (KI group, n = 15). Our results show that the imagined movements can be classified using both the location of the activation peak and the spatial activation patterns within the sensorimotor cortex, and MVPA performs better than the activation peak classification. Furthermore, our result reveals that the KI group achieved a higher MVPA decoding accuracy within the left primary somatosensory cortex than the VI group, suggesting that the modality of motor imagery differently affects the classification performance in distinct brain regions.

Involvement of visual signals in kinaesthesia: A virtual reality study.

Body movements are invariably accompanied by various proprioceptive, visual, tactile and/or motor signals. It is therefore difficult to completely dissociate these various signals from each other in order to study their specific involvement in the perception of movement (kinaesthesia). Here, we manipulated visual motion signals in a virtual reality display by using a humanoid avatar. The visual signals of movement could therefore be manipulated freely, relative to the participant's actual movement or lack of movement. After an embodiment phase in which the avatar's movements were coupled to the participant's voluntary movements, kinaesthetic illusions were evoked by moving the avatar's right forearm (flexion or extension) while the participant's right arm remained static. The avatar's left forearm was hidden from view. In parallel, somaesthetic signals could be masked by agonist-antagonist co-vibration or be amplified (by agonist vibration only or antagonist vibration only) so that the real impact of visual cues of movement in kinaesthesia could be studied. In a study of 24 participants, masking the somaesthetic signals (which otherwise provide signals indicating that the arm is static) was associated with a greater intensity and shorter latency of the visually evoked illusions. These results confirm the importance of carefully considering somaesthetic signals when assessing the contribution of vision to kinaesthesia. The use of a combination of virtual reality and somaesthetic signal manipulation might be of clinical value.

Relationship between Cervicocephalic Kinesthetic Sensibility Measured during Dynamic Unpredictable Head Movements and Eye Movement Control or Postural Balance in Neck Pain Patients.

Cervical afferent input is believed to affect postural balance and oculomotor control in neck pain patients, but its relationship to cervicocephalic kinesthesia, describing movement sense, has not yet been studied. The aim of this study was to analyze the relationship of two aspects of cervicocephalic kinesthesia to postural balance and oculomotor control in neck torsion positions. Forty-three idiopathic neck pain patients referred from orthopedic outpatient clinics and forty-two asymptomatic controls were enrolled in the study. A force plate was used to measure center-of-pressure movements during parallel stances under neutral and neck torsion maneuvers. Video-oculography was used to assess eye movements during smooth pursuit neck torsion test (SPNTT), while kinesthetic awareness was measured using the Butterfly test and head-to-neutral relocation test. Multiple regression was used to describe relationships between tests. Body sway in the anterior-posterior direction was related to Butterfly parameters but less to the head-to-neutral test. A medium relationship between Butterfly parameters and gain during SPNTT, with less SPNT-difference, was observed, but not for the head-to-neutral test. It can be concluded that specific aspect of neck kinesthetic functions (i.e., movement sense) importantly contributes towards oculomotor and balance control, which is more evident under neck torsion positions in neck pain patients, but is less pronounced in asymptomatic individuals.

Kinesthetic motor-imagery training improves performance on lexical-semantic access.

The objective of this study was to evaluate the effect of Motor Imagery (MI) training on language comprehension. In line with literature suggesting an intimate relationship between the language and the motor system, we proposed that a MI-training could improve language comprehension by facilitating lexico-semantic access. In two experiments, participants were assigned to a kinesthetic motor-imagery training (KMI) group, in which they had to imagine making upper-limb movements, or to a static visual imagery training (SVI) group, in which they had to mentally visualize pictures of landscapes. Differential impacts of both training protocols on two different language comprehension tasks (i.e., semantic categorization and sentence-picture matching task) were investigated. Experiment 1 showed that KMI training can induce better performance (shorter reaction times) than SVI training for the two language comprehension tasks, thus suggesting that a KMI-based motor activation can facilitate lexico-semantic access after only one training session. Experiment 2 aimed at replicating these results using a pre/post-training language assessment and a longer training period (four training sessions spread over four days). Although the improvement magnitude between pre- and post-training sessions was greater in the KMI group than in the SVI one on the semantic categorization task, the sentence-picture matching task tended to provide an opposite pattern of results. Overall, this series of experiments highlights for the first time that motor imagery can contribute to the improvement of lexical-semantic processing and could open new avenues on rehabilitation methods for language deficits.