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Effect of target presentation mode and movement extent on correlations of ipsilateral position-matching test outcomes
Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences.
Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences.
(English)Manuscript (Other (popular science, discussion, etc.))
Identifiers
URN: urn:nbn:se:umu:diva-3144OAI: oai:DiVA.org:umu-3144DiVA: diva2:141627
Available from: 2008-05-02 Created: 2008-05-02 Last updated: 2010-01-14Bibliographically approved
In thesis
1. Position-matching and goal-directed reaching acuity of the upper limb in chronic neck pain: associations to self-rated characteristics
Open this publication in new window or tab >>Position-matching and goal-directed reaching acuity of the upper limb in chronic neck pain: associations to self-rated characteristics
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Neck-shoulder pain is common in the general population and causes individual suffering as well as large costs for the society. Despite substantial efforts, there is still a shortage of methods for objective diagnosis and effective rehabilitation of such disorders. Thus, there is a great need to develop and evaluate new methods for these purposes. From clinical observations and recent research it has become evident that sensorimotor control can be impaired in people with neck-shoulder pain and may play a role in the pathogenesis of these disorders. In this thesis, precision of goal-directed arm movements, a previously unstudied class of movements in neck-shoulder pain, was studied.

The main aim of the thesis was to investigate if people with chronic neck-shoulder pain have a reduced acuity of goal-directed movements of the upper extremity. A second aim was to study associations between reduced movement acuity and symptoms and self-rated characteristics.

Upper limb repositioning acuity was assessed in blindfolded subjects performing tests of active, ipsilateral position-matching of two target positions (long and short) in movements constrained to horizontal-adduction of the shoulder. Reduced repositioning acuity, suggesting impaired shoulder proprioception, was found for both subjects with whiplash associated disorders (WAD) and non-specific neck-shoulder pain (NS). The degree of reduced acuity was shown to correlate with self-ratings of various health concepts, functioning and pain. A conspicuous finding was that there was lack of correlation between short and long target errors, along with the fact that associations between repositioning acuity and symptoms and self-rated characteristics was primarily found for the short target position.

To further investigate the possible mechanisms underlying the disassociation between long and short target movement control, the association pattern between the outcome of several variants of ipsilateral position matching and velocity-discrimination tests, were studied. It was found that the perception of limb position in position-matching of short target locations appears to be predominantly based on movement velocity, whereas perception of limb position in movements to longer target locations may rely on a location-based perception mechanism.

To extend the research on reduced upper extremity proprioception in neck-shoulder pain to a more natural movement situation, acuity of goal-directed pointing including full vision and 3D multi-joint movements was investigated in WAD, NS and healthy controls subjects. The results revealed a reduced acuity for both neck-pain groups. Moreover, distinct associations between end-point acuity and neck movement problems, limitations of some physical functions and, in WAD; some aspects of pain, were revealed.

The findings demonstrate that the precision of upper limb movements can be reduced in chronic neck-shoulder pain. Substantial associations with symptoms and self-rated functioning suggest a clinical relevance of acuity measures of goal-directed arm movements. The findings indicate that tests of sensorimotor control can provide objective measures that may be useful in biopsychosocial profiling and characterization of subgroups of patients with chronic neck-shoulder pain, and that training target control of goal-directed movements should be considered in rehabilitation programs of people with these disorders.

Place, publisher, year, edition, pages
Umeå: Kirurgisk och perioperativ vetenskap, 2008. 93 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1182
Keyword
Neck pain, whiplash injuries, shoulder, proprioception, kinesthesis, vision, psychophysiology, somatosensory disorders, psychomotor performance, self assessment
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-1635 (URN)978-91-7264-569-1 (ISBN)
Public defence
2008-05-22, Stora hörsalen, entréplan fd. Arbetslivsinstitutet, Johan Bures väg 5, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2008-05-02 Created: 2008-05-02 Last updated: 2010-01-18Bibliographically approved
2. Perception and control of upper limb movement: Insights gained by analysis of sensory and motor variability
Open this publication in new window or tab >>Perception and control of upper limb movement: Insights gained by analysis of sensory and motor variability
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Chronic neck-shoulder pain is associated with impairments of proprioception and motor control. Thus, assessment of proprioceptive and motor function may be powerful tools both for research and clinical practice. However, insufficient knowledge of certain features of human sensorimotor control hampers both development and interpretation of results of clinically relevant tests. For example, evidence is lacking which proprioception submodalities are reflected in common tests of proprioception. For testing motor function, a better understanding of the control of goal directed arm movements is needed. The purpose of the thesis was to gain further insights into the sensorimotor control of the upper limb in healthy subjects, with implications for clinical testing. The main aims were: (1) to study relationships of outcomes of different tests of shoulder proprioception and (2) to study control strategies in bimanual pointing tasks by analysis of the structure of joint angle variability with the Uncontrolled Manifold (UCM) method. Correlations between proprioceptive acuity in different variants of ipsilateral position-matching and velocity-discrimination were studied. The main finding was that two uncorrelated mechanisms based either on perception of position or movement might underlie perception of limb location in ipsilateral position-matching. The results provided important information for interpretation of common and development of novel tests of shoulder proprioception. The structure of joint angle variance was computed with respect to several task variables during bimanual pointing. Joint angle variability was decomposed in variance affecting and not affecting a task variable. The results showed that the variance in joint space was structured according to the predictions of the UCM hypothesis. It was also shown that the arms were united into one synergy to significantly larger degree than joints within each arm were united into single-arm synergies. It was concluded that the UCM approach might quantify components of motor variability during repetitive motor tasks.

Place, publisher, year, edition, pages
Umeå: Kirurgisk och perioperativ vetenskap, 2005. 51 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 953
Keyword
Medicine, proprioception, kinaesthesia, position sense, movement sense, position-matching, velocity-discrimination, correlation, uncontrolled manifold, variability, synergy, upper limb, motor control, Medicin
National Category
Sport and Fitness Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:umu:diva-485 (URN)91-7305-850-5 (ISBN)
Public defence
2005-04-12, Stora salen, Arbetslivsinstitutet / Belastningsskadecentrum, Petrus Lästadius väg, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2005-03-31 Created: 2005-03-31 Last updated: 2015-01-21Bibliographically approved

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