Inter‐ and intrasensory modality matching in children with hand‐eye coordination problems: exploring the developmental lag hypothesis
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This study set out to explore the suggestion that the problems experienced by 8-year-old children diagnosed as clumsy in the area of hand-eye coordination (HECP) might be attributed to a developmental lag. The performances of this group of HECP children were compared with those of groups of 5-year-old and 8-year-old controls without such deficits, when required to carry out a task involving pointing, without vision, to targets located, visually, visually/proprioceptively, or proprioceptively, the dependent variable being the distance error score from the centre of the target. The performances of the HECP children, when vision or vision/proprioception was used to locate the targets, were shown to be inferior to those of the two control groups of children thereby supporting a visual deficit hypothesis. When the targets had to be located proprioceptively, the performance of the HECP children was shown to be similar to that of the 5-year-olds, while both groups were inferior to the 8-year-olds, thereby supporting a developmental lag hypothesis in proprioceptive terms. However, when the scores for the preferred and non-preferred hands were analysed separately a marked deterioration in the performances of both the 5-year-old controls and the HECP children was observed while the 8-year-old controls were unaffected. While this finding supports a developmental lag explanation of the inferior performances of the HECP children, it was necessary to qualify such an explanation when the within-group performances using the preferred and non-preferred hands were compared. Only the HECP children, under the visual/proprioceptive or proprioceptive conditions, showed significant performance differences, in favour of the preferred hand. This finding was taken as a suggestion that the developmental lag exhibited by the HECP children might have pathological overtones possibly related to the development of the corpus callosum.Keywords:
Proprioception
Eye–hand coordination
Typically developing
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Current methods of measurement of proprioceptive function depend on the ability to detect passive movement (kinaesthesia) or the awareness of joint position (joint position sense, JPS). However, reports of proprioceptive function in healthy and pathological joints are quite variable, which may be due to the different methods used. We have compared the validity of several frequently used methods to quantify proprioception. Thirty healthy subjects aged between 24 and 72 years underwent five established tests of proprioception. Two tests were used for the measurement of kinaesthesia (KT1 and KT2). Three tests were used for the measurement of JPS, a passive reproduction test (JPS1), a relative reproduction test (JPS2) and a visual estimation test (JPS3). There was no correlation between the tests for kinaesthesia and JPS or between the different JPS tests. There was, however, a significant correlation between the tests for kinaesthesia (r = 0.86). We conclude therefore that a subject with a given result in one test will not automatically obtain a similar result in another test for proprioception. Since they describe different functional proprioceptive attributes, proprioceptive ability cannot be inferred from independent tests of either kinaesthesia or JPS.
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We assessed proprioception in the knee using the angle reproduction test in 20 healthy volunteers, ten patients with acute anterior instability and 20 patients with chronic anterior instability after reconstruction of the anterior cruciate ligament (ACL). In addition, the Lysholm-knee score, ligament laxity and patient satisfaction were determined. Acute trauma causes extensive damage to proprioception which is not restored by rehabilitation alone. Three months after operation, there remained a slight decrease in proprioception compared with the preoperative recordings, but six months after reconstruction, restoration of proprioception was seen near full extension and full flexion. In the mid-range position, proprioception was not restored. At follow-up, 3.7 ± 0.3 years after reconstruction, there was further improvement of proprioception in the mid-range position. There was no difference between open and arthroscopic techniques. The highest correlation was found between proprioception and patient satisfaction. After reconstruction of the ACL reduced proprioception may explain the poor functional outcome in some patients, despite restoration of mechanical stability.
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We explored the effects of random whole-body vibration on leg proprioception in Parkinson's disease (PD). In earlier studies it was found that this treatment leads to improved postural control in these patients. Thus, one could speculate that these effects result from modified proprioceptive capabilities. Twenty-eight PD patients were subdivided in one experimental and one control group. Proprioceptive performance was analyzed using a tracking task basing on knee extension and flexion movements. Treatment consisted of 5 series of random whole-body vibration taking 60 seconds each. Control subjects had a rest period instead. Prominent over- and undershooting errors were found in both groups representing proprioceptive impairments. No significant differences became evident, however, either between pre- and post-tests or between experimental and control group. One might therefore conclude that spontaneous improvements in postural control are not directly connected with proprioceptive changes. Nevertheless, one also should keep in mind the general aspects and difficulties of analyzing proprioception.
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Eye–hand coordination is a visuomotor task that enables one to look, localize, and touch objects. Eye–hand coordination is known to be poor in children with developmental delay. In this study, we assessed the feasibility of measuring eye–hand coordination task in children with developmental delay using Sanet Vision Integrator (SVI), a commercially available device. Children (age: 3–16 years) with developmental delay and their age-similar typically developing peers were enrolled. White circles (5.5°) on a black background were presented on the SVI touch screen monitor. Participants popped these circles by touching it. Reaction time, accuracy, and an overall performance score were computed. Participants could perform the task from 4 years of age and with visual acuity 20/400 (6/120) or better. This resulted in 85% (17/20) of children with developmental delay and 95% (19/20) of typically developing children completing the task. Children with developmental delay were significantly ( p < .001) less accurate (56%) and took longer (2.63 s) to complete the task when compared with their peers (accuracy = 93%, reaction time = 1.46 s). The overall performance score of children with developmental delay was also lower than their peers by a factor of 3.3. Eye–hand coordination performance can be measured and quantified with SVI. The quantification of speed and accuracy is possible and a unitary measure combining speed-accuracy can be computed. The task can be performed both by typically developing children and by children with developmental delay. Thus, it is feasible to measure eye–hand coordination using SVI. Such quantification will be useful for children undergoing interdisciplinary therapies for their medical conditions.
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Proprioceptive deficits have been demonstrated following anterior cruciate ligament (ACL) disruption, but little research exists evaluating proprioception in the posterior cruciate ligament (PCL)-deficient and/or -reconstructed knee. We have studied proprioception in PCL-deficient and PCL-reconstructed knees. The following summarizes our protocol and results of proprioceptive testing of kinesthesia and joint position sense in participants with isolated PCL injuries and those who underwent PCL reconstruction. We studied 18 participants with isolated raptures of the PCL and 10 participants who underwent PCL reconstruction. Proprioception was evaluated by two tests: the threshold to detect passive motion (TTDPM) and the ability to passively reproduce passive positioning (RPP). These assess kinesthesia and joint position sense, respectively. We have shown that isolated PCL deficiency in the human knee does result in reduced kinesthesia and enhanced joint position sense. Thus, the proprioceptive mechanoreceptors in the PCL do appear to have some function. We further found that PCL reconstruction significantly improved kinesthesia at 45° of knee flexion, while 110° was not significantly different between the involved and uninvolved knee in both studies.
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