Deliberately Light Interpersonal Touch as an Aid to Balance Control in Neurologic Conditions

Johannsen, L.; McKenzie, Evelyn; Brown, Melanie; Redfern, Mark S.; Wing, Alan M.

doi:10.1002/rnj.197

Cited by 19 publications

(12 citation statements)

References 29 publications

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“…12,13 IPT reduces sway in patients with chronic stroke as well as Parkinson's disease. 14 More rostral IPT (at shoulder level) reduces sway to a greater amount than more caudal (low back) locations, 14 which is analogous to single-person effects of light touch on body sway. 15,16 The observation that more cranial IPT results in more reduced sway could be caused by a clearer signal due to greater sway amplitude at the contact point.…”

Section: Discussionmentioning

confidence: 99%

Deliberately Light Interpersonal Contact Affects the Control of Head Stability During Walking in Children and Adolescents With Cerebral Palsy

Schulleri

Burfeind

Höß-Zenker³

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Section: Discussionmentioning

confidence: 99%

Deliberately Light Interpersonal Contact Affects the Control of Head Stability During Walking in Children and Adolescents With Cerebral Palsy

Schulleri

Burfeind

Höß-Zenker³

et al. 2017

Archives of Physical Medicine and Rehabilitation

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“…The touch stabilization paradigm has been extended by Wing and Johanssen in a number of very imaginative ways of potential use for rehabilitation and fall prevention. They have shown that interpersonal touch at very low force levels can be helpful in stabilizing older people's posture and gait (25)(26)(27)(28)(29). Sawers and Ting have shown how small inter-person forces can be used to communicate goals and actions between individuals but also how they can be incorporated in the design of rehabilitation robots (30,31).…”

Section: Alternative Interpretationsmentioning

confidence: 99%

The Importance of Being in Touch

Lackner

2021

Front. Neurol.

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This paper describes a series of studies resulting from the finding that when free floating in weightless conditions with eyes closed, all sense of one's spatial orientation with respect to the aircraft can be lost. But, a touch of the hand to the enclosure restores the sense of spatial anchoring within the environment. This observation led to the exploration of how light touch of the hand can stabilize postural control on Earth even in individuals lacking vestibular function, and can override the effect of otherwise destabilizing tonic vibration reflexes in leg muscles. Such haptic stabilization appears to represent a long loop cortical reflex with contact cues at the hand phase leading EMG activity in leg muscles, which change the center of pressure at the feet to counteract body sway. Experiments on dynamic control of balance in a device programmed to exhibit inverted pendulum behavior about different axes and planes of rotation revealed that the direction of gravity not the direction of balance influences the perceived upright. Active control does not improve the accuracy of indicating the upright vs. passive exposure. In the absence of position dependent gravity shear forces on the otolith organs and body surface, drifting and loss of control soon result and subjects are unaware of their ongoing spatial position. There is a failure of dynamic path integration of the semicircular canal signals, such as occurs in weightless conditions.

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“…For example during balance exercises, this can lead to an allocation of sub-tasks, such as provision of haptic balance support by a therapist and reception by the client involved in the balancing task [9].…”

Section: Significancementioning

confidence: 99%

“…Johannsen et al [9] assessed "passive" IPT in neurological patients as well as chronic stroke and reported sway reductions between 15%-26%. In stroke patients, passive, trunk-based IPT [9], nevertheless, seemed more beneficial than fingertip IPT [16].…”

Section: Significancementioning

confidence: 99%

Interpersonal interactions for haptic guidance during balance exercises

et al. 2018

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Word count abstract: 296Word count manuscript: 2984 Figures: 5 Study Highlights passive support mode demonstrated its advantages in increased strength of the IPC  active support mode decreased the postural sway to a greater extent. more partnership based methods should be considered for balance rehabilitation  postural control can be responsive to social factors Abstract BackgroundCaregiver-patient interaction relies on interpersonal coordination during support provided by a therapist to a patient with impaired control of body balance. Research questionThe purpose of this study was to investigate in a therapeutic context active and passive participant involvement during interpersonal support in balancing tasks of increasing sensorimotor difficulty. MethodsTen older adults stood in semi-tandem stance and received support from a physical therapist (PT) in two support conditions: 1) physical support provided by the PT to the participant's back via an instrumented handle affixed to a harness worn by the participant ("passive" interpersonal touch; IPT) or 2) support by PT and participant jointly holding a handle instrumented with a force-torque transducer while facing each other ("active" IPT). The postural stability of both support conditions was measured using the root-mean-square (RMS) of the Centre-of-Pressure velocity (RMS dCOP) in the antero-posterior (AP) and medio-lateral (ML) directions. Interpersonal postural coordination (IPC) was characterized in terms of crosscorrelations between both individuals' sway fluctuations as well as the measured interaction forces. ResultsActive involvement of the participant decreased the participant's postural variability to a greater extent, especially under challenging stance conditions, than receiving support passively. In the passive support condition, however, stronger in-phase IPC between both partners was observed in the antero-posterior direction, possibly caused by a more critical (visual or tactile) observation of participants' body sway dynamics by the therapist. In-phase crosscorrelation time lags indicated that the therapist tended to respond to participants' body sway fluctuations in a reactive follower mode, which could indicate visual dominance affecting the therapist during the provision of haptic support. SignificanceOur paradigm implies that in balance rehabilitation more partnership-based methods promote greater postural steadiness. The implications of this finding with regard to motor learning and rehabilitation need to be investigated.

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Deliberately Light Interpersonal Touch as an Aid to Balance Control in Neurologic Conditions

Abstract: Deliberately light IPT resembles a manual handling strategy, which minimizes load imposed on healthcare professionals when providing balance support, while it facilitates patients' own sensorimotor control of body balance during standing.

Cited by 19 publications

References 29 publications

Deliberately Light Interpersonal Contact Affects the Control of Head Stability During Walking in Children and Adolescents With Cerebral Palsy

Deliberately Light Interpersonal Contact Affects the Control of Head Stability During Walking in Children and Adolescents With Cerebral Palsy

The Importance of Being in Touch

Interpersonal interactions for haptic guidance during balance exercises

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