LOSS OF PROPRIOCEPTION PRODUCES DEFICITS IN INTERJOINT COORDINATION
LOSS OF PROPRIOCEPTION PRODUCES DEFICITS IN INTERJOINT COORDINATION
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DOI：
10.1152/jn.1993.70.5.2136
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发表时间：
1993-11-01
影响因子：
2.5
通讯作者：
GHEZ, C
中科院分区：
文献类型：
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作者：
SAINBURG, RL;POIZNER, H;GHEZ, C
1.我们分析了2例大纤维感觉神经病患者和11例对照受试者的简单手势的表现，以确定本体感觉传入阻滞如何破坏不受约束的多关节运动。两名患者的上肢关节位置、振动和辨别触觉几乎完全丧失。肌肉力量保持完好。受试者做了一个类似于切面包的手势。在这个手势中，手首先从身体向外移动，急剧反转方向，然后向身体移动。准确的表现需要在反向运动期间肩关节和肘关节之间的精确协调。在两种条件下进行运动：睁开眼睛和闭上眼睛。在WATSMART系统上记录肩、肘、腕和手的三维运动轨迹。当对照组受试者闭着眼睛做手势时，他们的手腕轨迹相对较直，每个运动周期都是平面的。运动方向急剧逆转，使得手腕路径的向外和向内部分紧密对齐。与此空间轮廓相对应，肩关节从屈曲到伸展的运动方向逆转和手肘关节从伸展到屈曲的运动方向逆转是同步的.相比之下，当传入神经阻滞的患者闭着眼睛做手势时，他们的手腕轨迹是高度弯曲的，个别周期是严重非平面的。当肘关节运动暂时锁定时，腕关节运动轨迹在运动方向逆转时表现出特征性异常。相应地，肩关节和肘关节的运动逆转在时间上严重延迟。当患者能够看到他们的肢体在执行这个手势有显着改善的线性和平面运动。然而，患者仍然无法同步肩关节和肘关节的运动，以产生空间精确的手腕路径。我们的结论是，本体感觉的损失破坏了关节间的协调和讨论的假设，这种关节间的协调赤字的结果，未能控制在多关节运动的肢体节段之间产生的相互作用力。
1. We analyzed the performance of a simple pantomimed gesture in 2 patients with large-fiber sensory neuropathy and 11 control subjects to determine how proprioceptive deafferentation disrupts unconstrained multijoint movements. Both patients had near-total loss of joint position, vibration, and discriminative touch sensation in the upper extremities. Muscle strength remained intact.2. Subjects performed a gesture similar to slicing a loaf of bread. In this gesture, the hand first moves outward from the body, reverses direction sharply, and then moves back toward the body. Accurate performance requires precise coordination between the shoulder and elbow joints during movement reversals. Movements were performed under two conditions: with eyes open and with eyes closed. Three dimensional shoulder, elbow, wrist, and hand trajectories were recorded on a WATSMART system.3. When control subjects performed the gesture with their eyes closed, their wrist trajectories were relatively straight and individual cycles of motion were planar. Movements reversed direction sharply, such that outward and inward portions of the wrist path were closely aligned. Corresponding to this spatial profile, the reversals in movement direction at the shoulder joint, from flexion to extension, and at the elbow joint, from extension to flexion, were synchronous.4. In contrast, when deafferented patients performed the gesture with their eyes closed, their wrist trajectories were highly curved and individual cycles were severely nonplanar. The wrist paths showed a characteristic anomaly during the reversal in movement direction, when elbow joint movement became transiently locked. Correspondingly, the movement reversals at the shoulder and elbow joints were severely temporally decoupled.5. When patients were able to view their limbs during performance of this gesture there was significant improvement in the linearity and planarity of movements. However, the patients remained unable to synchronize the movements at the shoulder and elbow joints to produce spatially precise wrist paths.6. We conclude that loss of proprioception disrupts interjoint coordination and discuss the hypothesis that this interjoint coordination deficit results from a failure to control the interaction forces that arise between limb segments during multijoint movements.