Department of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands.
Hand and Wrist Center, Hand and Wrist Rehabilitation, The Hague, The Netherlands.
J Hand Ther. 2021 Oct-Dec;34(4):567-576. doi: 10.1016/j.jht.2020.07.002. Epub 2020 Jul 29.
Sensorimotor control can be disturbed because of pain and trauma. There is scarce comprehension about which component of the sensorimotor system would benefit the most from treatment in distal radius fracture (DRF).
The purpose of this study was to determine whether the sensorimotor control of subjects with a history of DRF impaired compared with healthy subjects. If so, which component of the sensorimotor system is most affected.
Nine healthy participants and 11 participants with a DRF history executed posture and reproduction tasks in interaction with a robotic wrist manipulator. A posture task with force perturbations assess sensorimotor control. Position and force reproduction tasks assessed sensory feedback. Electromyography recorded the muscle activity to study the motor part of the sensorimotor system.
Cross-sectional case-control.
The results showed that the motor responses to the perturbations during the posture task did not differ significantly, whereas the position reproduction did significantly differ between the 2 groups. Moreover, participants with a DRF history did not adapt to the changed dynamics of the environment during the posture task, whereas the controls did.
The results of this study imply that processing of sensory position feedback is impaired in people with a DRF history while sensorimotor control during a posture task is unaffected. A possible explanation for these results is that different neural networks are involved during reproduction and posture tasks.
A history of DRF is related to disturbed processing of sensory feedback of the sensorimotor system, especially the Joint Position Sense, which leads to an impairment in detecting a changed environment and adapting to it. Impaired Joint Position Sense and thereby the inability to adapt adequately to a changing environment should be taken into account during the rehabilitation of patients with DRF.
由于疼痛和创伤，感觉运动控制可能会受到干扰。对于桡骨远端骨折（DRF）患者，哪个感觉运动系统的组成部分最受益于治疗，目前人们对此知之甚少。
本研究旨在确定 DRF 病史患者的感觉运动控制是否与健康受试者相比受损，如果是这样，哪个感觉运动系统的组成部分受影响最大。
9 名健康受试者和 11 名 DRF 病史受试者与机器人腕部操纵器交互执行姿势和再现任务。通过力扰动评估姿势任务，评估感觉运动控制。位置和力再现任务评估感觉反馈。肌电图记录肌肉活动，以研究感觉运动系统的运动部分。
横断面病例对照。
结果表明，在姿势任务中，对扰动的运动反应没有显著差异，而两组之间的位置再现差异显著。此外，DRF 病史的参与者在姿势任务中没有适应环境动力学的变化，而对照组则适应了。
本研究结果表明，DRF 病史患者的感觉运动系统的感觉位置反馈处理受损，而姿势任务中的感觉运动控制不受影响。这些结果的一个可能解释是，在再现和姿势任务中涉及不同的神经网络。
DRF 病史与感觉运动系统的感觉反馈处理受损有关，特别是关节位置感，这导致检测到变化的环境和适应它的能力受损。关节位置感受损，从而无法适应不断变化的环境，应在 DRF 患者的康复过程中加以考虑。
