Matching Items (3)

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Upper limb proprioceptive sensitivity in three-dimensional space: effects of direction, posture, and exogenous neuromodulation

Description

Proprioception is the sense of body position, movement, force, and effort. Loss of proprioception can affect planning and control of limb and body movements, negatively impacting activities of daily living

Proprioception is the sense of body position, movement, force, and effort. Loss of proprioception can affect planning and control of limb and body movements, negatively impacting activities of daily living and quality of life. Assessments employing planar robots have shown that proprioceptive sensitivity is directionally dependent within the horizontal plane however, few studies have looked at proprioceptive sensitivity in 3d space. In addition, the extent to which proprioceptive sensitivity is modifiable by factors such as exogenous neuromodulation is unclear. To investigate proprioceptive sensitivity in 3d we developed a novel experimental paradigm employing a 7-DoF robot arm, which enables reliable testing of arm proprioception along arbitrary paths in 3d space, including vertical motion which has previously been neglected. A participant’s right arm was coupled to a trough held by the robot that stabilized the wrist and forearm, allowing for changes in configuration only at the elbow and shoulder. Sensitivity to imposed displacements of the endpoint of the arm were evaluated using a “same/different” task, where participant’s hands were moved 1-4 cm from a previously visited reference position. A measure of sensitivity (d’) was compared across 6 movement directions and between 2 postures. For all directions, sensitivity increased monotonically as the distance from the reference location increased. Sensitivity was also shown to be anisotropic (directionally dependent) which has implications for our understanding of the planning and control of reaching movements in 3d space.

The effect of neuromodulation on proprioceptive sensitivity was assessed using transcutaneous electrical nerve stimulation (TENS), which has been shown to have beneficial effects on human cognitive and sensorimotor performance in other contexts. In this pilot study the effects of two frequencies (30hz and 300hz) and three electrode configurations were examined. No effect of electrode configuration was found, however sensitivity with 30hz stimulation was significantly lower than with 300hz stimulation (which was similar to sensitivity without stimulation). Although TENS was shown to modulate proprioceptive sensitivity, additional experiments are required to determine if TENS can produce enhancement rather than depression of sensitivity which would have positive implications for rehabilitation of proprioceptive deficits arising from stroke and other disorders.

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Date Created
  • 2018

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The Effects of Cervical Nerve Stimulation (CNS) on Fall Risk

Description

Every year, 3 million older people are treated for fall injuries, and nearly 800,000 are hospitalized, many of which due to head injuries or hip fractures. In 2015 alone, Medicare

Every year, 3 million older people are treated for fall injuries, and nearly 800,000 are hospitalized, many of which due to head injuries or hip fractures. In 2015 alone, Medicare and Medicaid paid nearly 75% of the $50 Billion in medical costs generated by falls. As the US population continues to age, more adults are beginning to deal with movement related disorders, and the need to be able to detect and mitigate these risks is becoming more necessary. Classical metrics of fall risk can capture static stability, but recent advancements have yielded new metrics to analyze balance and stability during movement, such as the Maximum Lyapunov Exponent (MLE). Much work has been devoted to characterizing gait, but little has explored novel way to reduce fall risk with interventional therapy. Targeting certain cranial nerves using electrical stimulation has shown potential for treatment of movement disorders such as Parkinson’s Disease (PD) in certain animal models. For human models, based on ease of access, connection to afferents leading to the lower lumber region and key brain regions, as well as general parasympathetic response, targeting the cervical nerves may have a more significant effect on balance and posture. This project explored the effects of transcutaneous Cervical Nerve Stimulation (CNS) on posture stability and gait with the practical application of ultimately applying this treatment to fall risk populations. Data was collected on each of the 31 healthy adults (22.3 ± 6.3 yrs) both pre and post stimulation for metrics representative of fall risk such as postural stability both eyes open and closed, Timed-Up-and-Go (TUG) time, gait velocity, and MLE. Significant differences manifested in the postural stability sub-metric of sway area with subject eyes open in the active stimulation group. The additional 8 metrics and sub-metrics did not show statistically significant differences among the active or sham groups. It is reasonable to conclude that transcutaneous CNS does not significantly affect fall risk metrics in healthy adults. This can potentially be attributed to either the stimulation method chosen, internal brain control mechanisms of posture and balance, analysis methods, and the Yerkes-Dodson law of optimal arousal. However, no adverse events were reported in the active group and thus is a safe therapy option for future experimentation.

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Date Created
  • 2019

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Effects of Transdermal Electrical Nerve Stimulation on Sleep and Mood

Description

Sleep is an essential human function. Modern day society has made it so that sleep is prioritized less and less. Professionals in critical positions such as doctors, nurses, and emergency

Sleep is an essential human function. Modern day society has made it so that sleep is prioritized less and less. Professionals in critical positions such as doctors, nurses, and emergency medical technicians can often have hectic schedules that are unforgiving toward sleep due to the increase in shift work that dominates these fields. Sleep deficits can have detrimental effects on one’s psyche and mood. Depression and anxiety both have high comorbidity rates with insomnia because of sleeping deficits. Transdermal Electrical Nerve Stimulation (TENS) offers a potential solution to improving sleep quality and mood by modulating the ascending reticular activating system (RAS). This system starts in the anterior portion of the head with trigeminal nerve branches and is stimulated using a 500-550 Hz waveform.

In this experiment Positive Affect and Negative Affect Schedule (PANAS) scores are recorded daily to monitor mood differences between pre and post treatment (TENS vs Sham). PANAS scores were found to be insignificant between groups. Pittsburgh Sleep Quality Index (PSQI), and Fitbit were chosen to study perceived sleep, and objective sleep. Both PSQI, and Fitbit found insignificant differences between TENS and Sham. Finally, the Beck Depression and Beck Anxiety Inventories were administered weekly to determine if there are immediate changes to depressive and anxiety symptom, after a week of treatment (TENS vs Sham). A significant difference was found between the pre and post of the TENS treatment group. The TENS group was not found to be significantly different from Sham, potentially the result of a placebo effect. These results were found with n=10 participants in the TENS treatment group and n=6 in the sham group.

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Date Created
  • 2018