Browsing by Author "Huang, Qiyin"

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    Comparison of Manual and Robotic Proprioceptive Acuity Systems
    (2022-04-30) Fall, Nicole; Sertic, Jacquelyn; Huang, Qiyin; Konczak, Jürgen
    Awareness of the spatial position of our body and limbs, known as proprioception, is important for bodily function and motor operation. Particularly at the ankle joint, motor skills such as balance, walking, and coordination rely on intact ankle proprioception. Without a fully-functional proprioceptive system, quality of life declines as individuals find greater difficulty completing simple and coordinated, everyday physical tasks and actions. A number of different factors can lead to proprioceptive impairment, including brain injury, developmental disorder, and neurological diseases. These include stroke, cerebral palsy, diabetic neuropathy, and Parkinson’s disease. Many ways to measure proprioceptive acuity exist and can vary based on measurement outcomes, study aims, and participant demographics. Our study constructed two ankle proprioceptive acuity systems (APAS), one manual and one robotic. This was done to examine whether the same participant would demonstrate similar ankle position sense values when applying the same psychophysical paradigms across two different devices. We hypothesized that within subjects, ankle position sense acuity would not vary significantly between the two systems. A sample of 14 healthy, neurologically unimpaired individuals (age range 19-27 years) were recruited. Participants’ right ankles were tested for ankle position sense acuity using the two systems. This allowed for identification of the just noticeable difference (JND) threshold, defined as the angle for which the participant had a 75% correct answer response rate. Participants were also measured regarding their precision, or the area of uncertainty one has about the JND threshold. Results revealed that the JND threshold was statistically significantly different (p < 0.001) between the manual and robotic APAS systems. However, precision was not statistically significantly different between the two devices (p = 0.95). Given the significant difference in JND threshold outcomes, we recommend one system be used uniformly in future studies. Using both manual and robotic APAS systems simultaneously in a single study may result in confounding measurement error. With a control population collected and a strong understanding of the differences between the two APAS systems, we are prepared to continue research studies that further our understanding of the proprioceptive sense.
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    Differential Effects Of Explicit Verbal And Visual Feedback On Proprioceptive Learning: Examining Position Sense Acuity Of The Forearm During Active And Passive Displacement
    (2020-04) Huang, Qiyin
    Both intrinsic feedback derived from proprioceptive and tactile mechanoreceptors, and extrinsic visual or auditory feedback play an important role in sensorimotor learning. However, the interaction between intrinsic and extrinsic forms of feedback and the effect of extrinsic feedback on proprioceptive function during sensorimotor learning are only incompletely understood. The purpose of this study was to compare the differential effects of intrinsic and extrinsic verbal and visual feedback on proprioceptive learning. Specifically, this study investigated how the acuity of the forearm position sense changes during sensorimotor learning under different conditions of feedback. Methods: Thirty healthy young adult participants underwent a sensorimotor training program delivered in two training sessions in a single day. Using a forearm manipulandum, participants performed forearm flexion movements and learnt to actively match a previously experienced forearm position. After the matching movement, participants received either proprioceptive only or a combination of intrinsic and extrinsic feedback (proprioceptive + visual or proprioceptive + verbal feedback) about the final forearm position error. Vision was blocked for the proprioceptive only and proprioceptive + verbal feedback conditions. All participants received 150 training trials. Retention was tested 24 hours after training. Proprioceptive acuity was evaluated: Just-noticeable difference (JND) position sense thresholds served as a measure of passive elbow proprioceptive acuity. Absolute joint position matching error (JPME) represented a measure of active proprioceptive acuity. Results: First, none of feedback conditions led to a significant decrease in JND after training (p > 0.05). Second, all three feedback conditions induced a statistically significant reduction in JPME after training (p < 0.05) with both the proprioceptive only (Cohen’s d = 1.62) and proprioceptive + verbal (Cohen’s d = 1.57) feedback conditions showing the very large effect sizes. However, change in JPME with training was not significantly different between the three feedback conditions (p > 0.05). Third, the observed reduction in JPME at post-test had vanished 24 hours after training. Discussion: I found no evidence that providing additional extrinsic feedback in a proprioceptive learning task can boost joint position sense accuracy. Proprioceptive training relying solely on proprioceptive signals is sufficient to induce measurable improvements of active position sense. However, such learning was not retained after 24 hours.
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    Proprioceptive training is effective in improving movement and motor dysfunction: A Systematic Review
    (2022) Winter, Viola; Huang, Qiyin; Sertic, Jacquelyn; Konczak, Jürgen
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    Robot-Aided Assessment of Ankle Motion Sense and Associated Lesion-Symptom Mapping Analysis in Chronic Stroke
    (2023-06) Huang, Qiyin
    Background: Compromised ankle proprioception is a strong predictor of balance dysfunction in chronic stroke. However, objective, accurate methods for testing ankle proprioceptive function in clinical settings are not established. Only sparse data on ankle position sense and no systematic data on ankle motion sense dysfunction in stroke are available. Moreover, the lesion sites underlying impaired ankle proprioception have not been comprehensively delineated.Objectives: To address these knowledge gaps, this study aimed: 1) To examine the feasibility and test-retest reliability of a newly developed robotic technology that uses an adaptive psychophysical forced-choice method to obtain quantitative data on ankle position and motion sense acuity in healthy young adults. 2) To determine the extent and magnitude of ankle motion sense impairment observed in adults with chronic stroke and how such impairment coincides with position sense dysfunction using the robotic system. 3) To identify the brain lesions associated with ankle position and motion sense dysfunction. Methods: To verify aim 1, experiments 1 and 2 were conducted successively. Forty healthy adults (20 in each experiment, mean ± SD age 24 ± 3.9 years, F: 17) were recruited. The feasibility and test-retest reliability of the system were determined in Experiment 1. Experiment 2 was conducted to improve the motion sense test paradigm that controlled for confounding factors (time and position) that a person might use as motion cues to make a perceptual judgment of ankle joint motion. To verify aim 2 and 3, twelve stroke survivors (mean ± SD age, 54 ± 10.9 years, on average 6 years post-stroke, 10 ischemic, 2 hemorrhagic lesions), and 13 neurotypical adults participated. During the testing, the robot passively plantarflexed a participant’s ankle to two distinct positions or at two distinct velocities. Participants subsequently indicated which of the two movements was further/faster. Based on the stimulus-response data, a psychometric function was obtained, and just-noticeable-difference (JND) thresholds, as a measure of bias, and intervals of uncertainty (IU), as a measure of precision were derived. For adults with stroke (n = 11), lesion-symptom analyses identified the brain lesions associated with observed proprioceptive deficits in adults with stroke. Results: For aim 1, objective data on position sense acuity (JND threshold: 0.80° ± 0.10°, IU: 0.84° ± 0.41°) and motion sense acuity (JND threshold: 0.73°/s ± 0.11°/s, IU: 0.60°/s ± 0.29°/s) were obtained in experiment 1. Additionally, moderate-to-excellent test-retest reliability of the system has been established based on the JND threshold for position sense (average intraclass correlation coefficient (ICC) = 0.86 [0.50 - 0.98], standard error of measurement (SEM) = 0.0173°) and motion sense (average ICC = 0.88, SEM = 0.0197°/s). In experiment 2, the results showed that the mean JND motion sense threshold increased almost linearly from 0.53°/s at the 10°/s reference to 1.6°/s at 20°/s (p < 0.0001). Perceptual uncertainty increased similarly (median IU = 0.33°/s at 10°/s and 0.97°/s at 20°/s; p < 0.0001). Both measures were strongly correlated (rs = 0.70). For aim 2, 83% of adults with stroke exhibited abnormalities in either position or motion sense, or both. JND and IU measures were significantly elevated compared to the control group (JNDPosition: +77%, p = 0.03; JNDMotion: +153%, IUPosition: +148%, and IUMotion: +78%, all p < 0.01). The JND and IU values of both senses were strongly positively correlated (rs = 0.56-0.62). For aim 3, lesions in the primary somatosensory, posterior parietal, motor cortices, insula, and temporoparietal regions (supramarginal, superior temporal, Heschl's gyri) were associated with deficits in both senses. Meanwhile, lesions in the medial/lateral occipital cortex were linked to impaired position sense, and temporal pole lesions were associated with impaired motion sense. Moreover, temporal pole lesions were significantly related to motion sense deficit (z-score = 3.26). Conclusion: This research demonstrated that the proposed robot-aided test produces quantitative data on human ankle position and motion sense acuity. It yields two distinct measures of proprioceptive acuity (i.e., bias and precision) as part of a comprehensive analysis of proprioceptive function. Using the robot-aided assessment, this study documented the initial data on the magnitude and prevalence of ankle position and motion sense impairment in adults with chronic stroke. Proprioceptive dysfunction was characterized by elevated JND thresholds and increased uncertainty in perceiving ankle position/motion. Associated cortical lesions for both proprioceptive senses were largely overlapping, but temporal pole lesions were independently linked to motion sense dysfunction.