Dissertation

The Effects of Proprioceptive Training and Dyad Practice to Improve Sensorimotor Function

Winter, Leoni Nina Viola

2025

Overview

Background: The overarching goal of this dissertation was to examine the effects of proprioceptive training and dyad practice on sensorimotor function. It is well established that the human motor and sensory systems are closely linked, such that changes in motor training affect proprioceptive performance and vice versa, and that it affects neural processing in both motor and somatosensory cortical areas. However, there remains uncertainty about what proprioceptive training modalities are most effective to yield meaningful changes in proprioceptive and motor function and which populations may be receptive to such interventions.There is now also convincing empirical evidence that observational practice of motor learning can positively affect proprioceptive performance. Dyad practice is a form of sensorimotor learning in which individuals train in pairs, alternating between physical and observational practice. It is a sensorimotor training regime that has received increasing interest in improving performance in complex motor tasks. Previous research shows that dyad practice can result in improved motor performance and faster learning than physical practice only in tasks including flight simulations, micro-surgery, cup stacking, and balance tasks. Despite these promising effects of dyad practice on motor results, its effects on proprioceptive performance are unknown.Objectives: The objectives of this dissertation are two-fold. Aim 1: To provide a systematic review of literature aimed: A. to document interventions that are used to improve proprioception and motor performance, B. to highlight the measures to quantify the effects on proprioceptive and motor performance due to proprioceptive training, and C. to examine the usefulness of proprioceptive training as a rehabilitation tool to improve motor function and performance in clinical and non-clinical populations. Aim 2: To examine the effects of dyad practice, a form of sensorimotor training, on motor and proprioceptive performance in healthy individuals in a wrist-robotic environment.Methods - Aim 1: Four major databases were searched, based on four inclusion criteria.Results - Aim 1: Of the 3297 articles identified by the database search, 70 studies met the inclusion criteria and were included for further review. Across studies, proprioceptive training led to comparable gains in both proprioceptive (+46%) and motor performance (+45%). The majority of studies (50/70) applied active movement interventions. Interventions applying somatosensory stimulation were most successful in clinical populations. Joint position sense error was the most commonly used proprioceptive measure and presents a reliable and feasible measure for clinical use.Methods - Aim 2: Forty-two healthy participants (18–35 years) were randomized into three groups (n = 14): Dyad practice, physical practice with rest, and physical practice without rest. Participants practiced a 2 degree-of-freedom gamified wrist movement task for 20 trials using a custom-made wrist robotic device. A motor performance score (MPS) that captured temporal and spatial time-series kinematics was computed at baseline, the end of training and 24 h later to assess retention. Wrist position sense acuity was assessed before (baseline) and 24 hours after the end of training (retention), using the Just-noticeable-difference (JND) threshold and Uncertainty.Results - Aim 2: MPS did not differ between groups at baseline. All groups revealed significant motor performance gains by the end of training. However, dyads outperformed the other groups at the end of training (p<0.001) and showed higher retention after 24 hours (p = 0.02). Median MPS improved by 46.5% in dyads, 25.3% in physical practice-rest, and 33.6% in physical practice-no rest at the end of training compared to baseline. Only the PP-no rest group exhibited significantly lower JND thresholds at retention compared to baseline (p = 0.03). There were no differences in position sense Uncertainty within or between groups, and there was no relationship between motor and proprioceptive gains.Conclusion: Proprioceptive training can lead to significant improvements in proprioceptive and motor function across a range of healthy and clinical populations. Those regimens requiring active movement of the trainee tended to be most successful in improving sensorimotor performance. Conclusive evidence on how long training gains are retained is still lacking. There is no solid evidence about the underlying long-term neuroplastic changes associated with proprioceptive training.Compared to physical practice alone, dyad practice leads to superior motor outcomes in a robot-assisted motor learning task. Dyads still outperformed their counterparts 24 hours after practice. However, the superior motor improvements did not translate into comparable gains in proprioceptive acuity. A possible explanation for these findings is that the recruitment of explicit motor learning mechanisms during dyad motor skill practice does not enhance the implicit learning mechanisms underlying proprioceptive learning.Taken together, these results underline the close relationship between somatosensory and sensorimotor function. Future research should assess the neurophysiological effects of proprioceptive training and dyad practice in particular, and aim to implement dyad practice in clinical populations.

• Publisher: ProQuest Dissertations & Theses
• Subject: Cognitive psychology / Exercise, kinesiology, and sport sciences / Kinesiology / Neurosciences / Physiological psychology
• ISBN: 9798293866762