How does a motor or cognitive dual-task affect our sense of upper limb proprioception?

Data Availability: The authors have no reservation with publicly sharing the data that supports our results. Accession numbers and/or DOIs will be made available upon acceptance of this manuscript. Researchers seeking to have access to our data may also contact the "Commissie Voor Medische Ethiek" Medical Ethics Committee from Ghent University, Belgian Registration Number of this study: 8670201940272. To contact the ethical committee: [email protected], or the lead investigation at [email protected] Daily upper limb activities require multitasking and our division of attention. How we allocate our attention can be studied using dual-task interference (DTi). Given the vital role proprioception plays in movement planning and motor control, it is important to investigate how conscious upper limb proprioception is impacted by DTi through cognitive and motor interference. Purpose To examine how dual-task interference impacts conscious upper limb proprioception during active joint repositioning tasks (AJRT). Methods Forty-two healthy participants, aged between 18 and 35, took part in this cross-sectional study. Participants completed two AJRT during three conditions: baseline (single task), dual-cognitive task (serial subtractions), and dual-motor task (non-dominant hand movements). The proprioceptive error (PE; difference between their estimation and targeted position) was measured using an AJRT of 75% and 90% of maximum internal rotation using the Biodex System IIITM and the Upper Limb Proprioception Reaching Test (PRO-Reach). To determine if PEs differed during dual-task interference, interference change scores from baseline were used with one sample t-tests and analyses of variance. Results The overall mean PE with the Biodex was 4.1̊ ± 1.9 at baseline. Mean change scores from baseline reflect a mean improvement of 1.5̊ ± 1.0 (p < .001) during dual-cognitive task and of 1.5̊ ± 1.2 (p < .001) during dual-motor task. The overall mean PE with the PRO-Reach was 4.4cm ± 1.1 at baseline. Mean change scores from baseline reflect a mean worsening of 1.0cm ± 1.1 (p < .001) during dual-cognitive task and improvement of 0.8cm ± 0.6 (p < .001) during dual-motor task. Analysis of variance with the Biodex PEs revealed an interference effect (p < .001), with the cognitive condition causing greater PEs compared to the motor condition and a criterion position effect (p = .006), where 75% of maximum IR produced larger PEs during both interference conditions. An interference effect (p = .022) with the PRO-Reach PEs was found highlighting a difference between the cognitive and motor conditions, with decreased PEs during the contralateral motor task. Conclusion Interference tasks did impact proprioception. Cognitive interference produced mixed results, whereas improved proprioception was seen during motor interference. Individual task prioritization strategies are possible, where each person may choose their own attention strategy when faced with dual-task interference.The author(s) received no specific funding for this work

Measuring upper limb active joint position sense: Introducing a new clinical tool - The Upper Limb Proprioception Reaching Test

Availability of data materials: All authors consent to all data being openly public and accessible.Supplementary data are available online at: https://www.sciencedirect.com/science/article/pii/S2468781223001145?via%3Dihub#appsec1 .Background: Proprioception is our sense of body awareness, including the sub-category of active joint position sense (AJPS). AJPS is fundamental to joint stability and movement coordination. Despite its importance, there remain few confident ways to measure upper limb AJPS in a clinic. Objective: To assess a new AJPS clinical tool, the Upper Limb Proprioception Reaching Test (PRO-Reach; seven targets), for discriminant validity, intra-rater and absolute reliability. Design: Cross-sectional measurement study. Methods: Seventy-five healthy participants took part in a single session with 2 consecutive evaluations (E1 and E2) (within-day reliability). Twenty participants were randomly selected to perform a dominant shoulder fatigue protocol (discriminant validity), whereafter a third evaluation was repeated (E3). The PRO-Reach was analyzed with paired t tests (discriminant validity), intra-class correlation coefficients (ICCs) and minimal detectable change [MDC]) (intra-rater: within-day and between-trial relative and absolute reliability). Results: The PRO-Reach supports moderate (mostly superior targets) to excellent (mostly inferior targets) reliability. Between-trial ICCs (T1/T2/T3) varied between 0.72 and 0.90, and within-day (E1/E2) ICCs between 0.45 and 0.72, with associated MDC95 values (3.9–5.0 cm). The overall scores (seven targets) supported the strongest within-day reliability (ICC = 0.77). The inferior targets demonstrated the highest between-trial and within-day reliability (ICCs = 0.90 and 0.72). A fatigue effect was found with the superior and superior-lateral targets (P <.05). Conclusions: The inferior targets and overall scores demonstrate the strongest reliability. The use of the PRO-Reach tool may be suitable for clinical use upon further psychometric testing amongst pathological populations. Level of evidence: Level III cross-sectional study.Financial support was provided by the Centre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris) and Université Laval in Québec City, Canada in the form of a student bursary

Can a conservative rehabilitation strategy improve shoulder proprioception? A systematic review

Context: Proprioception deficits contribute to persistent and recurring physical disability, particularly with shoulder disorders. Proprioceptive training is thus prescribed in clinical practice. It is unclear whether nonsurgical rehabilitation can optimize shoulder proprioception. Objectives: To summarize the available evidence of conservative rehabilitation (ie, nonsurgical) on proprioception among individuals with shoulder disorders. Evidence Acquisition: PubMed, Web of Science, and EBSCO were systematically searched, from inception until November 24, 2019. Selected articles were systematically assessed, and the methodological quality was established using the Dutch Cochrane Risk of Bias Tool and the Newcastle-Ottawa Quality Assessment Scale. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were utilized for this review. The conservative treatments were categorized as follows: (1) conventional therapy, (2) proprioceptive training, (3) elastic kinesiology tape, and (4) other passive therapies. Evidence Synthesis: Twelve articles were included, yielding 58 healthy control shoulders and 362 shoulders affected by impingement syndrome, glenohumeral dislocations, nonspecific shoulder pain, rotator cuff dysfunction, or subluxation poststroke. The level of agreement between the evaluators was excellent (84.9%), and the studies were evaluated to be of fair to excellent quality (risk of bias: 28.5%–100%). This review suggests, with moderate evidence, that proprioceptive training (upper-body wobble board or flexible foil training) can improve proprioception in the midterm. No decisive evidence exists to suggest that conventional therapy is of added value to enhance shoulder proprioception. Conflicting evidence was found for the improvement of proprioception with the application of elastic kinesiology tape, while moderate evidence suggests that passive modalities, such as microcurrent electrical stimulation and bracing, are not effective for proprioceptive rehabilitation of the shoulder. Conclusions: Proprioceptive training demonstrates the strongest evidence for the effective rehabilitation of individuals with a shoulder proprioceptive deficit. Elastic kinesiology tape does not appear to affect the sense of shoulder proprioception. This review suggests a possible specificity of training effect with shoulder proprioception.This project did not receive funding from any sources

Zelfsturing en organisatienetwerken in de publieke sector: Micro en macro

In deze bijdrage focussen de auteurs op de concepten zelfsturing en organisatienetwerken. Hierbij is zelfsturing een eerder interne dimensie op een meer microniveau, met name binnen een groep, zoals een team. Het organisatienetwerk gaat dan eerder over de externe dimensie, de manier waarop groepen en actoren in verbinding staan met elkaar. Zowel de aandacht voor zelfsturing als de aandacht voor organisatienetwerken kunnen we zien als reacties op eenzelfde fenomeen binnen de publieke sector. Meer specifiek gaat het over het zoeken naar nieuwe manieren om om te gaan met de groeiende maatschappelijke complexiteit en hoe een samenleving hierop een antwoord kan biede

Relationship between pain and proprioception among individuals with rotator cuff-related shoulder pain

Availability of data materials: All authors consent to all data being openly public and accessible.Supplementary material is available online at: https://www.sciencedirect.com/science/article/pii/S0894113023001680#sec0145 .Background: Individuals with rotator cuff-related shoulder pain (RCRSP) have altered proprioception. The relationship between shoulder pain and proprioception is not well understood. Purpose: This study aimed to investigate the relationship between shoulder pain and proprioception. Study design: This was a cross-sectional comparative study. Methods: Twenty-two participants with RCRSP (mean age 27.6 ± 4.8 years) and 22 matched pain-free participants (23.4 ± 2.5 years) performed two upper limb active joint position sense tests: (1) the Upper Limb Proprioception Reaching Test (PRO-Reach; reaching toward seven targets) in centimeters and (2) Biodex System at 90% of maximum internal rotation in degrees. Participants performed three memorization and three reproduction trials blindfolded. The proprioception error (PE) is the difference between the memorized and estimation trials. Pain levels were captured pre- and post-evaluation (11-point Likert Numerical Pain Rating Scale). Relationships between PE and pain were investigated using independent t-tests and Spearman rank correlations. Results: Overall, 22.7% RCRSP participants indicated an increase in pain following the PRO-Reach (X̅ increase of 1.4 ± 1.5 points), while 59% did so with the Biodex (X̅ increase of 2.3 ± 1.8 points), reflecting a clinically important increase in pain. Weak-to-moderate correlations between pain and PEs were found with the Biodex (r = 0.39-0.53) and weak correlations with the PRO-Reach (r = −0.26 to 0.38). Concerning PEs, no significant differences were found between groups with the Biodex (p = 0.32, effect size d = −0.31 [−0.90 to 0.29]). The RCRSP participants demonstrated lower PEs with the PRO-Reach in elevation compared to pain-free participants (global X̅ = 4.6 ± 1.2 cm vs 5.5 ± 1.5 cm; superior 3.8 ± 2.1 cm vs 5.7 ± 2.9 cm; superior-lateral nondominant targets 4.3 ± 2.2 cm vs 6.1 ± 2.8 cm; p = 0.02-0.05, effect size d = 0.72-0.74 [0.12-1.3]). Conclusions: Individuals with RCRSP demonstrated better upper limb proprioception in elevation, suggesting a change to interoception (sensory reweighting) in the presence of pain.Financial support was provided by Ghent University, Belgium, in the form of a student bursary

Conceptual design of a fretting fatigue testing device

Fretting fatigue occurs in contacting parts which are simultaneously subjected to fluctuating loadsand very small sliding movements. This phenomenon can significantly reduce the fatigue life ofcomponents. This paper focuses on the conceptual design of an advanced,Ghent University, Laboratory Soete, Belgiumespecially in functionality andhuman engineering,Keywords Fretting, fatigue, test rigtest rig for fretting fatigue experiments. Different designs of test rigs are evaluated byweighing their advantages and disadvantages.</jats:p