Effects on posture by different neuromuscular afferent stimulations and proprioceptive insoles

Dankerl, Peter; Keller, Andrea; Häberle, Lothar; Stumptner, Thomas; Pfaff, G.; Uder, Michael; Forst, Raimund

doi:10.1177/0309364614554031

Cited by 13 publications

(12 citation statements)

References 14 publications

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“…The long-term use of somatosensory orthoses would both stimulate and preserve somatosensory receptors and thus develop and consolidate the neural network, supporting a more balanced sensory-motor strategy. Lastly, unlike previous studies which found no effect for PI and CG, our study suggested their efficacy on postural stability in hEDS patients (Hijmans et al, 2009; Dankerl et al, 2016). Indeed, in healthy controls, it is possible that the improved somatosensory input provided by CG actuate more information than needed to control their posture.…”

Section: Discussioncontrasting

confidence: 94%

“…Hence, the wearing of CG may induce noise in the somatosensory input in healthy subjects, whereas it helps adjust the somatosensory threshold in hEDS patients (Hijmans et al, 2009). Likewise, PI did not induce any effect on postural stability in healthy subjects, probably because no proprioceptive enhancement was required (Dankerl et al, 2016). …”

Section: Discussionmentioning

confidence: 99%

“…Along with these observations, previous studies have demonstrated that CG induced an improvement in knee proprioception, and PI decreased the attentional demand for gait (Clark et al, 2014; Ghai et al, 2016). Conversely, these two ortheses showed no impact in healthy young subjects, and CG appeared to induce a deterioration of postural stability in elderly subjects (Hijmans et al, 2009; Dankerl et al, 2016). In the light of these conflicting observations, we aimed to quantify the impact of these somatosensory orthoses on postural stability in a population with a specific impairment of the somatosensory system.…”

Section: Introductionmentioning

confidence: 99%

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Ehlers-Danlos Syndrome, Hypermobility Type: Impact of Somatosensory Orthoses on Postural Control (A Pilot Study)

Dupuy

Leconte

Vlamynck

et al. 2017

Front. Hum. Neurosci.

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Elhers-Danlos syndrome (EDS) is the clinical manifestation of connective tissue disorders, and comprises several clinical forms with no specific symptoms and selective medical examinations which result in a delay in diagnosis of about 10 years. The EDS hypermobility type (hEDS) is characterized by generalized joint hypermobility, variable skin hyperextensibility and impaired proprioception. Since somatosensory processing and multisensory integration are crucial for both perception and action, we put forth the hypothesis that somatosensory deficits in hEDS patients may lead, among other clinical symptoms, to misperception of verticality and postural instability. Therefore, the purpose of this study was twofold: (i) to assess the impact of somatosensory deficit on subjective visual vertical (SVV) and postural stability; and (ii) to quantify the effect of wearing somatosensory orthoses (i.e., compressive garments and insoles) on postural stability. Six hEDS patients and six age- and gender-matched controls underwent a SVV (sitting, standing, lying on the right side) evaluation and a postural control evaluation on a force platform (Synapsys), with or without visual information (eyes open (EO)/eyes closed (EC)). These two latter conditions performed either without orthoses, or with compression garments (CG), or insoles, or both. Results showed that patients did not exhibit a substantial perceived tilt of the visual vertical in the direction of the body tilt (Aubert effect) as did the control subjects. Interestingly, such differential effects were only apparent when the rod was initially positioned to the left of the vertical axis (opposite the longitudinal body axis). In addition, patients showed greater postural instability (sway area) than the controls. The removal of vision exacerbated this instability, especially in the mediolateral (ML) direction. The wearing of orthoses improved postural stability, especially in the eyes-closed condition, with a particularly marked effect in the anteroposterior (AP) direction. Hence, this study suggests that hEDS is associated with changes in the relative contributions of somatosensory and vestibular inputs to verticality perception. Moreover, postural control impairment was offset, at least partially, by wearing somatosensory orthoses.

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Section: Discussioncontrasting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ehlers-Danlos Syndrome, Hypermobility Type: Impact of Somatosensory Orthoses on Postural Control (A Pilot Study)

Dupuy

Leconte

Vlamynck

et al. 2017

Front. Hum. Neurosci.

View full text Add to dashboard Cite

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“…In our clinical sample of complex patients, we were unable to determine whether the CG modulated basic functioning, as we found concomitant improvements in gross motor skills, postural sway, and challenging behaviors. These findings may mirror the observation that the CG might contribute to the acquisition of better motor patterns, either by reducing a primary deficit or strengthening the input in people who rely on proprioception for motor learning [93,94], leading to better behavioral outcomes [95]. Furthermore, we do not know if CGs work only as a sensorial substitution or if they also contribute to an extensive modification of internal models of action.…”

Section: Implications For Future Researchmentioning

confidence: 78%

Compressive Garments in Individuals with Autism and Severe Proprioceptive Dysfunction: A Retrospective Exploratory Case Series

et al. 2020

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(1) Background: Compression garments (CGs) are an adjuvant treatment for generalized joint hypermobility (GJH), including the Ehlers–Danlos syndrome/hypermobility types. The effects of CGs are likely to be related to better proprioceptive control. We aimed to explore the use of CGs in individuals with autism and severe proprioceptive dysfunction (SPD), including individuals with GJH, to control posture and challenging behaviors. (2) Methods: We retrospectively described 14 patients with autism and SPD, including seven with comorbid GJH, who were hospitalized for major challenging behaviors with remaining behavioral symptomatology after the implementation of multidisciplinary approaches, including medication, treatment of organic comorbidities, and behavioral restructuring. Each patient received a CG to wear for at least 1 h (but most often longer) per day for six weeks. We assessed challenging behaviors in these participants with the Aberrant Behavior Checklist (ABC), sensory integration with the Dunn questionnaire, and postural sway and motor performance using a self-designed motricity path at baseline, two weeks, and six weeks. (3) Results: We observed a significant effect on most ABC rating scores at two weeks, which persisted at six weeks (total score, p = 0.004; irritability, p = 0.007; hyperactivity, p = 0.001; lethargy, p = 0.001). Postural control in dorsal and profile positions was significantly improved between before and after wearing the CGs (p = 0.006 and 0.007, respectively). Motor performance was also significantly improved. However, we did not observe a significant change in Dunn sensory scores. During the six-week duration, the treatment was generally well-tolerated. A comorbid GJH diagnosis was not associated with a better outcome. (4) Conclusions: CGs appear to be a promising adjuvant treatment for both behavioral and postural impairments in individuals with autism and SPD.

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“…Moreover, it has been reported in previous work that using the standard deviation of intraindividual lumbar dimple distance was an accurate parameter for evaluating positional variation. 33 A 3D image was reviewed after each acquisition; a repeat was done if required. The validity of the Diers system has been previous established in a number of clinical studies.…”

Section: Protocolmentioning

confidence: 99%

Video rasterstereography of the spine and pelvis in eight erect positions: A reliability study

et al. 2020

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Introduction: To investigate the reliability and variability of Video Rasterstereography (VR) measurements of the spine and pelvis, for eight proposed standing postures, in order to help define an optimal standing position for erect pelvis radiography. Methods: Surface topography data were collected using the formetic 4D dynamic modelling (Diers) system. 61 healthy participants were recruited; each participant performed eight different standing positions. Four positions were performed with the feet shoulder width apart and parallel, and four positions were performed with the feet shoulder width apart and internally rotated. For the upper extremity, each of the (two sets of) four positions were performed with different arm positions (arms by the sides, arms crossed over the chest, arms 30 flexed and touching the medial end of the clavicle, arms 30 flexed with the hands holding a support). Three sets of surface topography were collected in the eight positions (n ¼ 24). The variability was assessed by calculating standard error of the measurement (SEm) and the coefficient of variation (CV). Reliability was assessed using intra-class correlation coefficients (ICC ± 95% CI). Results: No significant differences in the SEm were found between the three paired measurements for all standing positions (P > 0.05). ICC values demonstrated excellent reliability for all measurements across the eight standing positions (range 0.879e1.00 [95% CI 0.813e1.00]). Conclusion: Evaluating eight standing positions radiographically would be unethical as it would involve repeat radiation exposures. Using the formetic 4D dynamic modelling (Diers) system, provides an alternative and has shown that there was only a minimal, non-statistically significant, differences between the eight different standing positions. Implication for practice: Different standing positions were proposed for erect pelvis radiography.

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Effects on posture by different neuromuscular afferent stimulations and proprioceptive insoles

Cited by 13 publications

References 14 publications

Ehlers-Danlos Syndrome, Hypermobility Type: Impact of Somatosensory Orthoses on Postural Control (A Pilot Study)

Ehlers-Danlos Syndrome, Hypermobility Type: Impact of Somatosensory Orthoses on Postural Control (A Pilot Study)

Compressive Garments in Individuals with Autism and Severe Proprioceptive Dysfunction: A Retrospective Exploratory Case Series

Video rasterstereography of the spine and pelvis in eight erect positions: A reliability study

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