Effect of unilateral sensory impairment of the sole of the foot on postural control in man: Implications for the role of mechanoreception in postural control

doi:10.1016/0167-9457(92)90015-4

Human Movement Science

Volume 11, Issue 5, October 1992, Pages 549-561

https://doi.org/10.1016/0167-9457(92)90015-4 Get rights and content

Abstract

Body sway was measured in normal subjects and in patients with impaired mechanical sensitivity in limited areas of one or the other sole due to microvascular free flap reconstruction for a traumatic defect. This approach was used for evaluating the role of mechanoreception of the soles in postural control, and for determining the extent to which the sensitivity decrement affected the ability of these patients to control their posture. Mechanical sensibility was determined with vibratory stimuli of different frequencies which preferentially activate receptors of different types in the skin. Body sway was measured with a force platform technique with the eyes open and also closed. In both controls and patients the total extent of sway was larger when the eyes were kept closed. With the eyes open, the patients showed a normal extent of sway, but with the eyes closed the sway increased more than in the controls. The amount of sway increased both with the severity of the sensory impairment, and with the size of the affected skin region.

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Cited by (12)

Subliminal electrical and mechanical stimulation does not improve foot sensitivity in healthy elderly subjects
2018, Clinical Neurophysiology Practice
Citation Excerpt :
In several studies, Kavounoudias et al. (1998, 1999, 2001) demonstrated that vibration-induced sensory messages from mechanoreceptors in the sole of the foot are related to the regulation of upright body posture. Furthermore, Hämäläinen et al. (1992) found a positive correlation between quasi-static balance tasks and vibration sensitivity at 20 Hz in patients with unilateral sensory impairment. A recent study simulated the effects of reduced plantar sensitivity by cooling the sole of the foot (Germano et al., 2018).
Deterioration of cutaneous perception may be one reason for the increased rate of falling in the elderly. The stochastic resonance phenomenon may compensate this loss of information by improving the capability to detect and transfer weak signals. In the present study, we hypothesize that subliminal electrical and mechanical noise applied to the sole of the foot of healthy elderly subjects improves vibration perception thresholds (VPT).
VPTs of 99 healthy elderly subjects were measured at 30 Hz at the heel and first metatarsal head (MET I). Participants were randomly assigned to one of five groups: vibration (Vi-G), current (Cu-G), control (Co-G), placebo-vibration (Pl-Vi), and placebo-current (Pl-Cu). Vi-G and Cu-G were stimulated using 90% (subliminal) of their individual perception thresholds for five minutes in a standing position. Co-G received no stimulation. The placebo groups were treated with mock stimulation. VPTs were measured twice before the intervention (baseline (BASE) and pre-measurement (PRE)), and once after the intervention (post-measurement (POST)).
Significant differences were found between measurement conditions comparing BASE and POST, and PRE and POST. VPTs between groups within each measurement condition showed no significant differences. Vi-G was the only group that showed significantly higher VPTs in POST compared to BASE and PRE, which contradicts previous studies.
We analyzed increased VPTs after subliminal mechanical stimulation. The pressure load of standing for five minutes combined with subliminal stimulation may have shifted the initial level of mechanoreceptor sensitivity, which may lead to a deterioration of the VPT. The subliminal electrical stimulation had no effect on VPT.
Based on our results, we cannot confirm positive effects of subliminal electrical or mechanical stimulation on the sole of the foot.
Selective weighting of cutaneous receptor feedback and associated balance impairments following short duration space flight
2015, Neuroscience Letters
Citation Excerpt :
When cutaneous feedback is reduced experimentally through cooling [9] anesthetic [10] or via normal aging [11], COP variables have been shown to increase; however little is known about the contributions of the different tactile channels. Slow adapting (SA) skin afferents from the soles of the feet signal information about pressure, verticality and the boundaries of the BOS [12], and are suggested to be important in the maintenance of upright stance [13]. In contrast, fast adapting (FA) afferents are sensitive to dynamic stimuli, such as slips and high frequency vibration.
The present study investigated the perception of low frequency (3 Hz) vibration on the foot sole and its relationship to standing balance following short duration space flight in nine astronauts. Both 3 Hz vibration perception threshold (VPT) and standing balance measures increased on landing day compared to pre-flight. Contrary to our hypothesis, a positive linear relationship between these measures was not observed; however astronauts with the most sensitive skin (lowest 3 Hz VPT) were found to have the largest sway on landing day. While the change in foot sole sensitivity does not appear to directly relate to standing balance control, an exploratory strategy may be employed by astronauts whose threshold to pressure information is lower. Understanding sensory adaptations and balance control has implications to improve balance control strategies following space flight and in sensory impaired populations on earth.
Quantifying a relationship between tactile and vibration sensitivity of the human foot with plantar pressure distributions during gait
1999, Clinical Biomechanics
Objective. To quantify the relationship between the tactile and vibration sensitivity thresholds of the sole of the human foot with plantar pressure distribution while walking and running.
Design. Cross-sectional study performed in a laboratory setting.
Background. Results of previous studies of human locomotion have identified potentially dangerous variations in locomotion patterns. A common approach to manage these variations is with the use of orthotics. Individual responses to differences in the construction and shape of orthotics cannot be fully explained with a mechanical model. It has been suggested that sensory feedback from the receptors in the feet may play an important role in regulating gait patterns.
Methods. Fifteen subjects were recruited for this study. Pressure (tactile) and vibration thresholds were determined from each subject. Plantar pressure distributions were obtained while walking at 1.5 m s⁻¹ and running at 3.5 m s⁻¹. Sensitivity measurements were correlated to pressure measurements under the foot.
Results. Significant negative correlation exists between the vibration threshold of the hallux at 125 Hz and peak pressures under the hallux while walking (P=0.02) and running (P=0.01). A significant negative relationship was shown between the foot mean vibration threshold at 125 Hz with peak force during running (P=0.038). A similar trend was seen at the heel, lateral arch and first metatarsal head.
Conclusions. The results from this study support recent hypotheses that suggest that the body can detect and respond to external stimuli. The relationship between plantar sensitivity and peak pressures at the hallux, and the relationship between sensitivity to higher frequency vibrations and peak force during running suggests that neurological feedback should be incorporated in to any model that attempts to explain gait patterns.
Relevance
It is suggested that the body is able to detect small biomechanical changes in the external environment and alter gait patterns as a defensive mechanism. Understanding the relationship between neural feedback and gait patterns will help in the development of criteria for the proper application of inserts, and the prevention of lower extremity injuries.
Losing touch: Age-related changes in plantar skin sensitivity, lower limb cutaneous reflex strength, and postural stability in older adults
2016, Journal of Neurophysiology
The Complexity of Standing Postural Control in Older Adults: A Modified Detrended Fluctuation Analysis Based upon the Empirical Mode Decomposition Algorithm
2013, PLoS ONE
The Role of Textured Material in Supporting Perceptual-Motor Functions
2013, PLoS ONE

View all citing articles on Scopus

^☆: This study was supported by the Academy of Finland (Dr. Hämäläinen) and the Paulo Foundation (Dr. Rautio). The skillful technical assistance by the Staff of the Clinical Neurosciences is greatly acknowledged. We also wish to thank Mrs. Jean Margaret Perttunen for correcting the language.

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Effect of unilateral sensory impairment of the sole of the foot on postural control in man: Implications for the role of mechanoreception in postural control☆

Abstract

American Journal of Otolaryngology

Brain Research

Brain Research

Brain Research

The Lancet

Brain Research

British Journal of Plastic Surgery

The basis of sensation

Changes of posture during transient perturbations in microgravity

Aviation, Space, and Environmental Medicine

Use and limits of visual vestibular interaction in the control of posture. Are there two modes of sensorimotor control?

Sensibility and cutaneous reinnervation in free flaps

Plastic and Reconstructive Surgery

Study of human standing ability

Agressologie