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Perceptual disorders relating to hearing, smell, somatosensation, taste, touch, and vision commonly impair stroke survivors' ability to interpret sensory information, impacting on their ability to interact with the world. We aimed to identify and summarize the existing evidence for perceptual disorder interventions poststroke and identify evidence gaps. We searched 13 electronic databases including MEDLINE and Embase and Grey literature and performed citation tracking. Two authors independently applied a priori-defined selection criteria; studies involving stroke survivors with perceptual impairments and interventions addressing those impairments were included. We extracted data on study design, population, perceptual disorders, interventions, and outcomes. Data were tabulated and synthesized narratively. Stroke survivors, carers, and clinicians were involved in agreeing definitions and organizing and interpreting data. From 91 869 records, 80 studies were identified (888 adults and 5 children); participant numbers were small (median, 3.5; range, 1-80), with a broad range of stroke types and time points. Primarily focused on vision (34/80, 42.5%) and somatosensation (28/80; 35.0%), included studies were often case reports (36/80; 45.0%) or randomized controlled trials (22/80; 27.5%). Rehabilitation approaches (78/93; 83.9%), primarily aimed to restore function, and were delivered by clinicians (30/78; 38.5%) or technology (28/78; 35.9%; including robotic interventions for somatosensory disorders). Pharmacological (6/93; 6.5%) and noninvasive brain stimulation (7/93; 7.5%) approaches were also evident. Intervention delivery was poorly reported, but most were delivered in hospital settings (56/93; 60.2%). Study outcomes failed to assess the transfer of training to daily life. Interventions for stroke-related perceptual disorders are underresearched, particularly for pediatric populations. Evidence gaps include interventions for disorders of hearing, taste, touch, and smell perception. Future studies must involve key stakeholders and report this fully. Optimization of intervention design, evaluation, and reporting is required, to support the development of effective, acceptable, and implementable interventions. Registration: URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42019160270.
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Transtornos da Percepção , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Adulto , Cuidadores , Criança , Humanos , Transtornos da Percepção/epidemiologia , Transtornos da Percepção/etiologia , Transtornos da Percepção/terapia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/terapia , SobreviventesRESUMO
Interactions with objects involve simultaneous contact with multiple, not necessarily adjacent, skin regions. Although advances have been made in understanding the capacity to selectively attend to a single tactile element among distracting stimulations, here, we examine how multiple stimulus elements are explicitly integrated into an overall tactile percept. Across four experiments, participants averaged the direction of two simultaneous tactile motion trajectories of varying discrepancy delivered to different fingerpads. Averaging performance differed between within- and between-hands conditions in terms of sensitivity and precision but was unaffected by somatotopic proximity between stimulated fingers. First, precision was greater in between-hand compared with within-hand conditions, demonstrating a bimanual perceptual advantage in multi-touch integration. Second, sensitivity to the average direction was influenced by the discrepancy between individual motion signals, but only for within-hand conditions. Overall, our experiments identify key factors that influence perception of simultaneous tactile events. In particular, we show that multi-touch integration is constrained by hand-specific rather than digit-specific mechanisms.NEW & NOTEWORTHY Object manipulation involves encoding spatially and temporally extended tactile signals, yet most studies emphasize minimal units of tactile perception (e.g., selectivity). Instead, we asked participants to average two tactile motion trajectories delivered simultaneously to two different fingerpads. Our results show strong integration between multiple tactile inputs, but subject to limitations for inputs delivered within a hand. As such, the present study establishes a paradigm for studying unified experience of touch despite distinct stimulus elements.
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Percepção de Movimento , Percepção do Tato , Dedos , Mãos , Humanos , Movimento (Física) , TatoRESUMO
INTRODUCTION: To characterise somatosensory discrimination impairment of the upper-limb across domains of tactile discrimination, limb position sense and haptic object recognition using the sense_assess© kids and examine associations with upper-limb motor performance in children with hemiplegic cerebral palsy (CP). METHODS: The sense_assess© kids was administered at one timepoint to 28 children, aged 6-15.5 years (M = 10.1, SD = 2.4), with hemiplegic CP (right hemiplegia n = 15) and Manual Ability Classification System Levels I (n = 11) and II (n = 17). Unimanual motor performance was quantified using the Box and Block Test. RESULTS: Tactile discrimination was impaired in 18, limb position sense in 20, and haptic object recognition was impaired in 21 of 28 children. Over 80% (23/28) of children had impaired somatosensory discrimination in one or more domains. Low to moderate correlations were observed between each measure of somatosensory discrimination and motor performance. Manual ability classification was associated with limb position sense and haptic object recognition. A moderate inverse correlation (r = -.57, p < .01) exists between the number of somatosensory domains impaired and motor performance. CONCLUSION: The frequency of somatosensory impairment in the upper limb of children in our sample was high and associated with manual ability, suggesting a need for routine assessment of somatosensation in this population.
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Paralisia Cerebral , Terapia Ocupacional , Criança , Hemiplegia , Humanos , Propriocepção , Extremidade SuperiorRESUMO
Objective: The aim was to examine oral mechanical and gustatory sensitivities in adult smokers and to estimate salivary levels of cotinine by tobacco consumption. A total of 54 adults (20-45 years old; 28 males/26 females) were divided into two sex-paired groups: smoker group (n = 27), tobacco consumers with no other chronic disease/use of chronic medication, and a control non-smoker non-exposed group with similar age (n = 27).Materials and Methods: 24 h-Recall was used to gather information about tobacco consumption, date of onset and duration of the habit. Oral mechanical evaluation comprised touch detection threshold (MDT) of upper and lower lips and tongue tip and two-point discrimination (TPD) assessments. Taste sensitivities for sweet, salty, sour and bitter were evaluated in four concentrations. Salivary cotinine was determined by high performance liquid chromatography. Statistical analysis comprised Mann-Whitney, Two-way ANOVA test and regression analysis.Results: The mean smoking time was 13.6 years (mean 8.4 mg/day; 13 cigarettes/day). A sex-effect was observed on MDT of tongue tip (higher sensitivity in females), while group-effect was observed on TPD of lower lip, showing a smaller sensitivity among smokers (p < .05; moderate effect: Eta partial2 = 0.076). Although the total score of gustatory sensitivity did not differ between groups, smokers exhibited an irregular pattern of correctly identified tastants among the different concentrations of salty, sour and bitter. The predictive model showed that salivary cotinine was dependent on "nicotine consumption on the day before" (R2 = 49%).Conclusion: A difference in tactile sensitivity of the lower lip and qualitative changes in taste sensitivity were observed in smokers.
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Cotinina/metabolismo , Mastigação/fisiologia , Nicotiana/química , Saliva/química , Salivação/fisiologia , Fumar/metabolismo , Fumar/fisiopatologia , Percepção Gustatória/fisiologia , Adulto , Cotinina/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca/fisiologia , Saliva/metabolismo , Fumantes , Produtos do Tabaco , Adulto JovemRESUMO
Touch is a crucial factor of physiological and psychological health in humans. A lack of touch in contrast is associated with adverse implications on mental health. A new "Longing for Interpersonal Touch Picture Questionnaire (LITPQ)" was developed and tested for its concurrent, predictive, discriminant and face validity as well as its relation to psychological distress. Six different types of touch were depicted and touch frequency and touch wish concerning different interaction partners assessed. A sample of 110 participants aged 18-56 years completed the LITPQ as well as an existing touch deprivation questionnaire and a questionnaire on mental health. Frequency and wish for touch were higher for close interaction partners than for strangers. For 72.7% of the participants, their touch wish exceeded the reported touch frequency. The LITPQ correlated moderately with the existing questionnaire for touch deprivation and was independent of relationship status or gender but positively correlated with depressiveness, anxiety and somatization. Measuring longing for touch is a very complex task considering the many aspects of subjective touch perception and confounds in the method of self-report of touch. In our view, the LITPQ provides promising insights into this matter.
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Percepção do Tato/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
Aim: This study aimed to evaluate differences in tactile acuity (TA) in people with non-specific persistent low back pain (NSPLBP) with and without predominant central sensitisation (CS).Method: An analytical cross-sectional study was conducted with 45 participants divided into three groups: (i) subjects with NSPLBP with predominant CS (n = 14), (ii) subjects with NSPLBP without predominant CS (n = 16) and (iii) subjects without low back pain (n = 15). Using an analogue calliper, TA was measured using the two-point discrimination threshold (TPD) in the three groups, both horizontally and vertically in the painful region. The analysis was based on the comparison of median discrimination thresholds between groups using the Kruskal-Wallis test.Result: A higher median TPD value was observed in the group with NSPLBP with predominant CS (vertical measurement 37.5 mm; horizontal measurement 52.5 mm) compared to the group with NSPLBP without predominant CS (vertical measurement 32.5 mm; horizontal measurement 33.8 mm) and the group without low back pain (vertical measurement 30 mm; horizontal measurement 27.5 mm) (p < 0.0001), both in vertical and horizontal measurement.Conclusion: The findings found in this study highlight the need to differentiate patients with NSPLBP with predominant CS when considering therapeutic evaluation as an indirect mechanism for assessing the perceptual function of the primary somatosensory cortex.
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Sensibilização do Sistema Nervoso Central/fisiologia , Discriminação Psicológica/fisiologia , Dor Lombar/fisiopatologia , Limiar Sensorial/fisiologia , Percepção do Tato/fisiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: The purpose of this study was to examine clinicians' ability to modulate spinal manipulation (SM) thrust characteristics based on their tactile perception of pressure and volitional intensity. METHODS: In a cross-sectional, within-participants design, 13 doctors of chiropractic delivered SM thrusts of perceived least, appropriate, or greatest intensity of their perceived safe output level for an SM thrust on low-fidelity thoracic spine models of 4 different pressure levels. The participants performed SM over the course of 96 trials in a randomized order on combinations of thrust intensity and pressure. Dependent variables included normalized preload force, thrust force, thrust duration, peak acceleration, time to peak acceleration, and displacement. For all dependent measures, 2-factor within-participants analysis of variance models with repeated measures on both factors were performed. RESULTS: Preload force increased with intensity (F2,24 = 9.72; P < .001) and model pressure (F3,36 = 4.27; P = .011). Participants modulated thrust force and displacement as each also increased with intensity escalation (F2,24 = 22.53, P < .001; F2,18 = 45.20, P < .001). The highest accelerations were observed during the greatest intensity. Increased thrust force was delivered at higher model pressures (F3,36 = 6.43; P < .001). A significant interaction demonstrated that as volitional thrust intensity increased, greater displacement was attained, particularly on low pressure models (F6,54 = 11.06; P < .001). Thrust duration and time to peak acceleration yielded no significant differences. CONCLUSION: Spinal manipulation thrust dosage was modulated by the chiropractors' tactile perception of pressure and volitional intensity.
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Manipulação da Coluna/métodos , Percepção do Tato , Fenômenos Biomecânicos , Estudos Transversais , Retroalimentação , Humanos , Modelos Biológicos , PressãoRESUMO
C-tactile (CT) afferent fibers are optimally stimulated by slow gentle stroking, and an inverted U-shaped relationship exists between stroking velocity and pleasantness ratings of this type of touch. This study investigated whether an additional and potentially important variable, touch avoidance, interacts with this relationship. While a typical U-shaped velocity-pleasantness relationship was expected, those high in touch avoidance were expected to rate CT-targeted touch (1-10 cm/s) as less pleasant than those low in touch avoidance. Thirty-five participants rated the pleasantness of a brush stroked across their forearm at five velocities (0.3, 1, 3, 10, 30 cm/s) administered by a custom-built touch stimulator ("the touch device"). Participants also completed two self-report measures of touch avoidance. There was an inverted U-shaped relationship between velocity and pleasantness ratings, and high touch avoidance resulted in a downward shift of this curve. The downward shift was across all velocities, including those that do not maximally engage CT afferents. It appears that touch avoidance reduces the pleasantness of all kinds of touch in a similar way, and it is unlikely to be specifically related to CT afferent functioning. Other potential mechanisms leading to touch avoidance are discussed.
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OBJECTIVES: The aim of this study was to investigate if there were differences in the two-point discrimination (2-PD) of fingers among students at different stages of a chiropractic program. METHODS: This study measured 2-PD thresholds for the dominant and nondominant index finger and dominant and nondominant forearm in groups of students in a 4-year chiropractic program at the International Medical University in Kuala Lumpur, Malaysia. Measurements were made using digital calipers mounted on a modified weighing scale. Group comparisons were made among students for each year of the program (years 1, 2, 3, and 4). Analysis of the 2-PD threshold for differences among the year groups was performed with analysis of variance. RESULTS: The mean 2-PD threshold of the index finger was higher in the students who were in the higher year groups. Dominant-hand mean values for year 1 were 2.93 ± 0.04 mm and 1.69 ± 0.02 mm in year 4. There were significant differences at finger sites (P < .05) among all year groups compared with year 1. There were no significant differences measured at the dominant forearm between any year groups (P = .08). The nondominant fingers of the year groups 1, 2, and 4 showed better 2-PD compared with the dominant finger. There was a significant difference (P = .005) between the nondominant (1.93 ± 1.15) and dominant (2.27 ± 1.14) fingers when all groups were combined (n = 104). CONCLUSIONS: The results of this study demonstrated that the finger 2-PD of the chiropractic students later in the program was more precise than that of students in the earlier program.
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Quiroprática/educação , Competência Clínica , Limiar Sensorial , Tato/fisiologia , Limiar Diferencial , Dedos/fisiologia , Humanos , Malásia , Masculino , Palpação/métodos , Estudantes de Ciências da Saúde , Adulto JovemRESUMO
Introduction: The Ten Test (TT) is a touch threshold test that quantifies sensory discrimination by comparing an injured area with a contralateral uninjured area. It's quick, simple, equipment-free and repeatable. However, as a subjective measure, the TT's reliability and applicability need further investigation. This review aimed to investigate if the TT has superior inter- and intra-examiner reliability compared to the widely accepted Weinstein Enhanced Sensory Test (WEST) in a human population of all ages. Methods: A systematic search was conducted on major databases from January 1997 to September 2023 and adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. Outcomes were assessed with a narrative approach. The included articles were critically appraised according to the Quality Assessment of Diagnostic Accuracy Studies two tool. Results: This review included five articles. High inter-examiner reliability was demonstrated with intraclass correlation coefficient (ICC) values of 0.91 and 0.95, alongside a kappa statistic of 1, as reported by three distinct studies. Intra-examiner reliability displayed some variance, with one study reporting a significant ICC value in four out of six instances. Two studies corroborated that the TT results corresponded with the findings of WEST, each presenting a Spearman rank coefficient of -0.71. Conclusion: Our findings underscore the TT's high inter-examiner reliability, though its intra-examiner reliability exhibited some inconsistencies. Interestingly, certain studies claimed its superiority over the WEST. To validate the TT's use in the clinical setting, more rigorous studies, particularly those comparing pre-operative TT outcomes with intraoperative nerve damage evaluations, are essential.
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Introduction: Nurses use physical touch to interact with patients and address their needs. Human touch benefits social development, stress/anxiety reduction, and rapport building. Touch has been a part of nursing care for centuries, however nurses' perceptions of expressive touch are not easily ascertained from the literature. Literature currently offers one review on the perceptions of various medical professionals regarding touch of all kinds. No reviews specific to the nurses' perception of expressive touch exist. This integrative review provides a greater understanding of nurses' perceptions of expressive touch. Methods: Using Cooper's steps for integrative review, CINAHL, Medline, Academic Search Premier, and Complimentary Index were searched from 2000-2022; using search term expressive touch or caring touch or compassionate touch and nurse/nurses/nursing and perception or perspective. Results: Of 283 articles identified, 22 articles remained for full-text review after duplicate removal and application of inclusion/exclusion criteria. Five topics on nurses' perceptions of expressive touch were identified: Comfort with touch and job satisfaction, expressive touch as an essential part of nursing practice, expressive touch as a form of compassion and/or communication, the impact of expressive touch on the humanization of patients in the nurses' perception, and nurse discomfort with expressive touch. Conclusion: This integrative review provides findings that assist in understanding nurses' perceptions of expressive touch. Further research should examine the impact of gender, education, and experiences on nurses' perceptions as they use expressive touch in nursing practice.
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We present the open-source design and fabrication of a compliant multimodal tactile sensing module. The sensing module design presented here enables robotic end-effectors to sense contact properties like pressure and vibration and estimate a quaternion that represents the deformation due to contact. We elaborated the module's compliant structure fabrication process to use only 3D printed molds and a vacuum chamber, making it accessible to a broad range of roboticists. The process also allows production batches of up to five modules and easy deployment to robotic hands. The repository associated contains packages that support the Robot Operating System (ROS) to perform data collection and visualization. All hardware Computer-Aided Design (CAD) files and software source codes have been released and can be easily assembled and modified. The sensing module proposed in this paper uses off-the-shelf Microelectromechanical (MEMs) barometers and Magnetic, Angular Rate and Gravity (MARG) systems. Those components may be replaced by alternatives depending on the sensor's availability, constraints related to the module's size, or robotic application without prejudice to sensor functionality.
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Many perceptual studies focus on the brain's capacity to discriminate between stimuli. However, our normal experience of the world also involves integrating multiple stimuli into a single perceptual event. Neural mechanisms such as lateral inhibition are believed to enhance local differences between sensory inputs from nearby regions of the receptor surface. However, this mechanism would seem dysfunctional when sensory inputs need to be combined rather than contrasted. Here, we investigated whether the brain can strategically regulate the strength of suppressive interactions that underlie lateral inhibition between finger representations in human somatosensory processing. To do this, we compared sensory processing between conditions that required either comparing or combining information. We delivered two simultaneous tactile motion trajectories to index and middle fingertips of the right hand. Participants had to either compare the directions of the two stimuli, or to combine them to form their average direction. To reveal preparatory tuning of somatosensory cortex, we used an established event-related potential design to measure the interaction between cortical representations evoked by digital nerve shocks immediately before each tactile stimulus. Consistent with previous studies, we found a clear suppression between cortical activations when participants were instructed to compare the tactile motion directions. Importantly, this suppression was significantly reduced when participants had to combine the same stimuli. These findings suggest that the brain can strategically switch between a comparative and a combinative mode of somatosensory processing, according to the perceptual goal, by preparatorily adjusting the strength of a process akin to lateral inhibition.
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Potenciais Somatossensoriais Evocados , Tato , Potenciais Somatossensoriais Evocados/fisiologia , Dedos/fisiologia , Humanos , Córtex Somatossensorial/fisiologia , Tato/fisiologiaRESUMO
OBJECTIVE: To assess the anatomical and tactile quality of 3D printed models derived from medical printers for application in orthognathic surgery. METHODS: A CBCT-scan of an 18 years old female patient was acquired with NewTom VGi evo (NewTom, Verona, Italy). Thereafter, mandibular bone was segmented and isolated from the scan using Mimics inPrint 2.0 software (Materialise NV, Leuven, Belgium). Six printers with different technologies were utilized for printing skeletal models, which included stereolithography (ProX800, 3D Systems, Rock Hill, SC, USA), digital light processing (Perfactory 4 mini XL, Envisiontec, Dearborn, MI, USA), fused deposition modeling (uPrint SE, Stratasys, Eden Prairie, MI, US), colorjet (ProJet CJP 660Pro, 3D Systems, Rock Hill, SC, USA), multijet (Objet Connex 350, Stratasys, Eden Prairie, MN, USA) and selective laser sintering (EOSINT P700, EOS GmbH, Munich, Germany). A questionnaire was designed, where 22 maxillofacial residents scored whether the printed models were able to mimic bone color, texture and anatomy. Five maxillofacial surgeons performed bone cutting with screw insertion/removal to assess the tactile perceptibility. RESULTS: In relation to texture and cortical and medullary anatomy replication, Perfactory 4 mini XL printer showed the highest mean score, whereas, Objet Connex 350 scored highest for color replication. The haptic feedback for cutting and screw insertion/removal varied for each printer, however, overall it was found to be highest for ProX800, whereas, EOSINT P700 was found to be least favorable. CONCLUSIONS: The digital light processing based Perfactory 4 mini XL printer offered the most acceptable anatomical model, whereas, deficiencies existed for the replication of haptic feedback to that of real bone with each printer. CLINICAL SIGNIFICANCE: The study outcomes provide pearls and pitfalls of 3D printed models utilizing various printers and technologies. There is a need for research on multi-material printing as such to improve the haptic feedback of skeletal models and render the models more human bone-like to improve surgical planning and clinical training.
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Cirurgia Ortognática , Adolescente , Bélgica , Feminino , Alemanha , Humanos , Itália , Modelos Anatômicos , Impressão TridimensionalRESUMO
BACKGROUND: Reduced tactile acuity has been observed in several chronic pain conditions and has been proposed as a clinical indicator of somatosensory impairments related to the condition. As some interventions targeting these impairments have resulted in pain reduction, assessing tactile acuity may have significant clinical potential. While two-point discrimination threshold (TPDT) is a popular method of assessing tactile acuity, large measurement error has been observed (impeding responsiveness) and its validity has been questioned. The recently developed semi-automated 'imprint Tactile Acuity Device' (iTAD) may improve tactile acuity assessment, but clinimetric properties of its scores (accuracy score, response time and rate correct score) need further examination. AIMS: Experiment 1: To determine inter-rater reliability and measurement error of TPDT and iTAD assessments. Experiment 2: To determine internal consistencies and floor or ceiling effects of iTAD scores, and investigate effects of age, sex, and anthropometry on performance. METHODS: Experiment 1: To assess inter-rater reliability (ICC(2,1)) and measurement error (coefficient of variation (CoV)), three assessors each performed TPDT and iTAD assessments at the neck in forty healthy participants. Experiment 2: To assess internal consistency (ICC(2,k)) and floor or ceiling effects (skewness z-scores), one hundred healthy participants performed the iTAD's localisation and orientation tests. Balanced for sex, participants were equally divided over five age brackets (18-30, 31-40, 41-50, 51-60 and 61-70). Age, sex, body mass index (BMI) and neck surface area were assessed to examine their direct (using multiple linear regression analysis) and indirect (using sequential mediation analysis) relationship with iTAD scores. RESULTS: Mean ICC(2,1) was moderate for TPDT (0.70) and moderate-to-good for the various iTAD scores (0.65-0.86). The CoV was 25.3% for TPDT and ranged from 6.1% to 16.5% for iTAD scores. Internal consistency was high for both iTAD accuracy scores (ICC(2,6) = 0.84; ICC(2,4) = 0.86). No overt floor or ceiling effects were detected (all skewness z-scores < 3.29). Accuracy scores were only directly related to age (decreasing with increasing age) and sex (higher for men). DISCUSSION: Although reliability was similar, iTAD scores demonstrated less measurement error than TPDT indicating a potential for better responsiveness to treatment effects. Further, unlike previously reported for TPDT, iTAD scores appeared independent of anthropometry, which simplifies interpretation. Additionally, the iTAD assesses multiple aspects of tactile processing which may provide a more comprehensive evaluation of tactile acuity. Taken together, the iTAD shows promise in measuring tactile acuity, but patient studies are needed to verify clinical relevance.
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BACKGROUND: The optimisation of learning has long been a focus of scientific research, particularly in relation to improving psychological treatment and recovery of brain function. Previously, partial N-methyl-D-aspartate agonists have been shown to augment reward learning, procedural learning and psychological therapy, but many studies also report no impact of these compounds on the same processes. AIMS: Here we investigate whether administration of an N-methyl-D-aspartate partial agonist (D-cycloserine) modulates a previously unexplored process - tactile perceptual learning. Further, we use a longitudinal design to investigate whether N-methyl-D-aspartate-related learning effects vary with time, thereby providing a potentially simple explanation for apparent mixed effects in previous research. METHODS: Thirty-four volunteers were randomised to receive one dose of 250 mg D-cycloserine or placebo 2 h before tactile sensitivity training. Tactile perception was measured using psychophysical methods before and after training, and 24/48 h later. RESULTS: The placebo group showed immediate within-day tactile perception gains, but no further improvements between-days. In contrast, tactile perception remained at baseline on day one in the D-cycloserine group (no within-day learning), but showed significant overnight gains on day two. Both groups were equivalent in tactile perception by the final testing - indicating N-methyl-D-aspartate effects changed the timing, but not the overall amount of tactile learning. CONCLUSIONS: In sum, we provide first evidence for modulation of perceptual learning by administration of a partial N-methyl-D-aspartate agonist. Resolving how the effects of such compounds become apparent over time will assist the optimisation of testing schedules, and may help resolve discrepancies across the learning and cognition domains.
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Ciclosserina/farmacologia , Aprendizagem/efeitos dos fármacos , Receptores de N-Metil-D-Aspartato/agonistas , Adolescente , Adulto , Cognição/efeitos dos fármacos , Método Duplo-Cego , Agonismo Parcial de Drogas , Feminino , Humanos , Estudos Longitudinais , Masculino , Receptores de N-Metil-D-Aspartato/metabolismo , Fatores de Tempo , Percepção do Tato/efeitos dos fármacos , Adulto JovemRESUMO
BACKGROUND: For visually impaired or blind patients, the experience of pregnancy sets them apart from nondisabled people for whom viewing of the first ultrasound has become a social and emotional milestone. OBJECTIVE: We proposed the use of 3D-printed models to allow the societal inclusion of visually impaired or blind expectant parents. PATIENT INVOLVEMENT: Visually impaired expectant parents were proposed to touch a 3D printed sensory vector of their prenatal classic ultrasonography. METHODS: After a classic ultrasound assessment was performed, selected volumes were processed and 3D-printed with acrylonitrile butadiene styrene. Patient satisfaction was recorded after they manipulated the models. RESULTS: A total of 42 prenatal 3D prints were for 12 expectant parents, used during 20 ultrasonographic sessions with visually impaired or blind expectant parents. During 13 of them (65%), it was the mother who was affected by a visual loss whereas the father was the parent affected by the disability during 7 sessions (35%). The parent affected by the disability was congenitally blind and Braille-reader in 9 ultrasonography sessions (45%). All expectant visually impaired or blind parents expressed very significant satisfaction with the use of 3D models for inclusive use. DISCUSSION: We have shown that acrylonitrile butadiene styrene-printed models improve the sonographic experience of visually impaired or blind expectant parents. They can thereby perform their own mental representation process by extrapolating sensory information obtained from the 3D tactile support. PRACTICAL VALUE: These low-cost 3D-printed models improve the inclusion of visually impaired or blind expectant parents, by offering them a sensory vector of information.
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Pessoas com Deficiência Visual , Feminino , Humanos , Gravidez , Impressão Tridimensional , Tato , Ultrassonografia Pré-Natal , Transtornos da VisãoRESUMO
BACKGROUND: Clinical tools assessing tactile acuity in people with persistent pain have limitations. Therefore, a novel and semi-automated tool was developed: The Imprint Tactile Acuity Device (iTAD). AIM: To describe the iTAD prototype and present the psychometric properties of its tactile acuity assessments: the localisation test, the orientation test and the overall score (mean of both tests). METHOD: A test-retest design with fifty healthy participants was used to assess intra-rater reliability (ICC(2.1)), internal consistency (ICC(2.4)) and measurement error (SEM) of the three assessments (0-100% accuracy scores each) performed at the neck. Using a known-group comparison design, balanced by age and sex, scores of thirty individuals with persistent neck pain were compared to thirty healthy controls to determine construct validity. RESULTS: The ICC(2,1) and ICC(2,4) were 0.60 and 0.78 for the localisation test, 0.66 and 0.77 for the orientation test, and 0.73 and 0.84 for the overall score. The SEMs were 9.0%, 8.1% and 6.0%, respectively. No fixed or proportional bias, or signs of heteroscedasticity were observed. Overall, no between group differences were observed (p = 0.49). In the male subgroup, however, the overall score was lower for people with neck pain than for healthy participants (mean difference (SE); 7.6% (2.5); p = 0.008). DISCUSSION: The tactile acuity assessments of the iTAD demonstrate moderate reliability and good internal consistency. Measurement errors appear comparable to currently preferred methods. Clear construct validity was not established, but results may be biased by design issues of the prototype. Taken together, the iTAD shows promise but further fine-tuning is needed.
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Cervicalgia , Tato , Humanos , Masculino , Pescoço , Cervicalgia/diagnóstico , Psicometria , Reprodutibilidade dos TestesRESUMO
Intersensory interactions predicted by the sensory precision hypothesis have been infrequently examined by distorting the reliability of size perception by touch. Consequently, participants were asked to see one size and manually feel another unseen size either with bare fingers or with fingers sleeved in rigid tubes to decrease the precision of touch. Their subsequent visual estimates of the perceived size favored the more precise modality. Experiment 1 (N = 46) varied the intersensory discordance to examine whether the estimate arose from trivial response biases or from perceptual binding effects. Experiment 2 (N = 32) examined the presence of the perceptual effect in the absence of discordant sensory cues. Results favored a perceptual interpretation because the haptic and visual cues merged regardless of the discordance amount only when the stimulation arose from separate sources. The observed interaction between touch imprecision and visual bias is consistent with computational models of optimal perception.
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Percepção do Tato , Percepção Visual , Humanos , Reprodutibilidade dos Testes , Percepção de Tamanho , TatoRESUMO
Background: To successfully modify an intervention from an adult population for use with children with cerebral palsy, it is important to understand the components that support a child's motivation and engagement. Method: Ten children who had participated in the Sense© intervention (mean age = 11 years 2 m [SD = 2 years]; four males; Manual Ability Classification System level I = 1, II = 9) and their primary caregivers (N = 11, 10 females) were interviewed. Transcripts were analyzed using framework analysis. Results: Key themes were identified in the core domains of the Synthesis of Child, Occupational Performance and Environment in Time model. Child: children's somatosensory discrimination ability improved; Motivation: incorporating child's goals was essential, as were real-world gains; Environmental: parents were interested in having more involvement in the intervention. Conclusion: The most engaging elements of the intervention for children were the attainment of their self-selected goals. Opportunities to modify the intervention for improved partnership with parents were identified.