No neglect for anosognosia.
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Functional Laterality↗
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Results for “Kinesthesis”
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Posture control in Pusher syndrome: influence of lateral semicircular canals.
UNLABELLED: Pusher syndrome is an interesting disorder of balance in patients with encephalic lesions characterized by the peculiar behavior of actively pushing away from the non-hemiparetic side and resisting against passive correction, with a tendency to fall toward the paralyzed side. The role of vestibular system on the pushing behavior is not clear. AIM: To evaluate horizontal semicircular canal function in patients with Pusher syndrome, using caloric and rotation tests. STUDY DESIGN: Observational prospective. MATERIAL AND METHOD: We evaluated 9 inpatients with stroke and Pusher syndrome at the neurological unit of HCFMRP-USP. We applied neurological and neuropsychological exams, NIHSS, Scale for contraversive pushing (SCP), caloric and rotation tests. RESULTS: We evaluated 9 patients (5 men) with mean age of 71.8 +/- 5.9 and mean NIHSS of 18.33. Three patients presented contralateral directional preponderance on caloric test and we found four patients with directional preponderance on analysis of the slow phase velocity of rotation test response. CONCLUSION: Our findings indicate that a dysfunction of semicircular canals does not seem to be relevant for the clinical manifestations of the Pusher syndrome.
Aged↗
Kinaesthetic acuity in adolescent boys: a longitudinal study.
The Kinaesthetic Sensitivity Test (KST) was used to measure the development of kinaesthetic acuity in adolescent boys. Thirty boys were tested longitudinally, at intervals of 6 months, between the ages of 11 1/2 and 14 years. A second group of 20 boys was tested at the ages of 14 and 16 1/2 years. The findings were compared with existing normative data on 5- to 12-year-old children and young adults, and they indicated improvement in kinaesthetic acuity with age. Although the age effect is statistically significant only in the older group, confidence intervals show that the rate of improvement in both groups is comparable to improvement between the ages of 5 and 12 years. The reliability of the test is rather poor. The conclusion is that kinaesthetic development continues throughout adolescence. Further, development is quite robust and detectable even with a fairly unreliable measurement instrument. However, individual assessments should be interpreted with caution.
Adolescent↗
Kinaesthetic judgements and refinement of striking action.
Little is known about the developmental course of striking action. This cross-sectional study explored the refinement of striking in 28 children aged between 4 and 12 years and investigated how well they could use kinaesthesis to gauge the length of an unseen bat. The kinematic data (including smoothness of movement) showed quantitative differences between the age groups. In contrast, no differences were found in the children's ability to judge the length of the unseen bat: within three strikes all of the children had made a clean hit, indicating that they had successfully judged bat length. The children then appeared to memorize the bat with which they had accurately hit the target and made: (1) minimal errors when using this bat in later trials and (2) predictable errors when using two other bats of different sizes. The results show that the striking action becomes optimized over childhood, with smoothness of movement providing an index of this refinement. The findings also suggest that young children have a higher level of kinaesthetic sensitivity than has been assumed previously on the basis of static limb positioning tasks. The results suggest that the striking task used in this study might be a useful tool for investigating the development of movement skills in children with developmental disorders.
Age Factors↗
Motor coordination and kinaesthesis in boys with attention deficit-hyperactivity disorder.
In the current study, movement ability and underlying kinaesthetic processes of boys with attention deficit-hyperactivity disorder (ADHD) were compared with a group of control children. Two groups of 16 boys with either predominantly inattentive subtype ADHD (ADHD-PI) or combined subtype ADHD (ADHD-C) were compared with 16 control boys matched on age and verbal IQ. The findings demonstrated that the children with ADHD had significantly poorer movement ability than the control children. A high percentage of children with ADHD displayed movement difficulties consistent with developmental coordination disorder. In addition, the current study found that the type and degree of movement difficulty differed between subtypes. Children with ADHD-PI had significantly poorer fine motor skill while children with ADHD-C were found to experience significantly greater difficulty with gross motor skill. The severity of the children's inattentive symptomatology was found to be a significant predictor of motor coordination difficulties. Kinaesthetic sensitivity was not found to differ significantly between the groups.
Attention Deficit Disorder with Hyperactivity↗
Balance through the ages of man.
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Aging↗
Visual recognition through kinaesthetic mediation.
A case is reported in which mercury intoxication produced visual symptoms with an unusual compensation. The similarity of this patient to Schn., a much reported neuropsychiatric case, was striking and prompted correlation of the two cases. Experimental psychological studies performed on the present case provide a basis for an understanding of both cases.
Adult↗
Clinical perception of phantom limb sensation in patients with brachial plexus block.
BACKGROUND AND OBJECTIVE: Patients' perception of limb position during regional anaesthesia is frequently incorrect. The incidence and nature of this phenomenon has not yet been completely described. The aim of this prospective study was to assess phantom sensation in patients undergoing a brachial plexus block. METHODS: Axillary block was performed in 81 patients with the aid of a peripheral nerve stimulator. Immediately after the block, patients were allocated randomly to two groups (Group 1, n = 40; Group 2, n = 41) to have the blocked limb placed either on their thorax or in abduction. Fifteen minutes later, when the block was complete, the position of the limb was changed, without the knowledge of the patient, to a new position of abduction and flexion of the forearm. Patients were questioned about the new limb position. Fifteen minutes later, the limb was then transiently shown to the patient and further placed 'blindly' to another position. Patients were once more questioned about this new position. RESULTS: Correct perception was more frequently observed in both groups following the first interview. Thirty-two and 34 patients gave at least one erroneous response about their limb position when it was initially placed on the thorax or in abduction respectively. Transient visualization of the limb position did not improve the rate of correct response. CONCLUSIONS: Patients' perception of the position of the limb after axillary block in the majority of instances was probably due to persisting sensory inputs from the shoulder joint, which is not involved in this block. This is in contrast to supraclavicular or interscalene blocks. A significant number of patients experienced phantom limb sensation. They reported an arm position in fact related to the position of their arm before the axillary block.
Adolescent↗
Dual dorsal columns: a review.
Recent evidence indicates that Wall (1970) may have been premature in concluding that dorsal column lesions produce no discernable sensory defects. Much of the negative evidence Wall presented to support this view is inconclusive. In addition several studies have reported significant sensory deficits in animals with severed dorsal columns. On the other hand, the literature strongly supports Wall's view that dorsal column lesions cause motor disturbances. A review of the anatomical and electrophysiological literature reveals growing evidence for the dissociation of two major subsystems relaying in the dorsal column nuclei. The possible functions of these two systems are discussed.
Animals↗
Visual distance estimation in static compared to moving virtual scenes.
Visual motion is used to control direction and speed of self-motion and time-to-contact with an obstacle. In earlier work, we found that human subjects can discriminate between the distances of different visually simulated self-motions in a virtual scene. Distance indication in terms of an exocentric interval adjustment task, however, revealed linear correlation between perceived and indicated distances but with a profound distance underestimation. One possible explanation for this underestimation is the perception of visual space in virtual environments. Humans perceive visual space in natural scenes as curved, and distances are increasingly underestimated with increasing distance from the observer. Such spatial compression may also exist in our virtual environment. We therefore surveyed perceived visual space in a static virtual scene. We asked observers to compare two horizontal depth intervals, similar to experiments performed in natural space. Subjects had to indicate the size of one depth interval relative to a second interval. Our observers perceived visual space in the virtual environment as compressed, similar to the perception found in natural scenes. However, the nonlinear depth function we found can not explain the observed distance underestimation of visual simulated self-motions in the same environment.
Adult↗
Limb and hemispatial hypometria.
In a previous study, we demonstrated that unilateral cerebral lesions produce hypometric limb movements of the contralateral arm and hemispatial (i.e., directional) hypometria for movements towards contralateral hemispace. In the present study, we investigated 10 patients with right cerebral lesions and 25 healthy controls using a task to uncouple deficits in sensory perceptual systems and motor-action output systems on directional hypometria. This task required participants, with their eyes closed, to reproduce lateral and medial horizontal displacements (15-27 cm) with each arm. Each participant was seated at a waist high table and had their hand placed at an origin point aligned with the axillary fold on the same side. Their hand was moved by the investigator from the origin point to a target point and brought back to the point of origin (input displacement). The participant was then asked to return their hand to either the same target point or to an equidistant target point in the opposite direction. Healthy dextral participants were significantly more hypometric with their right arm, but patients with right cerebral lesions exhibited an opposite pattern with overall left arm hypometria. In addition, patients were significantly more hypometric for movements when output displacements were toward left hemispace. No effect was found for direction of sensory input. The results suggest that the directional hypometria is predominantly produced by hemispatial output deficits.
Adolescent↗
Brief report: postural reactivity to fast visual motion differentiates autistic from children with Asperger syndrome.
The aim of the present study was to search for a sensorimotor marker (i.e., visuopostural tuning) that could be correlated with the severity of motor impairments in children with autistic spectrum disorders. Given that autistic children were previously reported to be posturally hyporeactive to visually perceived environmental motion in comparison with normal control children (Gepner et al., 1995), we sought to determine whether children with Asperger syndrome (AS) would share the same postural hyporeactivity to visual motion. Three autistic children with mild to severe motor impairments, three AS children with soft motor signs, and nine normal control children were tested for overall postural instability and postural reactivity to environmental motion. Results indicate, first, that overall postural instability is significantly reduced in autistic children compared with both AS and normal children. Second, although postural oscillations in the fore-aft axis become more attuned to the oscillation frequency of an immersive dynamic visual display as visual speed is increased, in both control and AS subjects, this is not the case in autistic children. Despite the small number of subjects tested in this study, our data confirm the existence of a visuopostural detuning in autistic children. Third, they argue for a correlation between visuopostural tuning and severity of motor signs in children with autistic spectrum disorders. Finally, they suggest a differentiation between children with autism and children with AS with regard to postural reactivity to fast visual motion. Neurophysiological implications of these results are discussed. In particular, a visuocerebellar pathway deficit hypothesis in autism is proposed.
Asperger Syndrome↗
Method for studying the processes maintaining equilibrium at rest standing.
According to current concepts, two processes are responsible for the maintenance of body equilibrium: shifts of the reference point caused by changes in the posture and stabilization of oscillations of the center of mass relative to this point. Exact changes in these processes occurring at various forms of locomotor disorders remain unclear. We proposed an original mathematical method allowing separate evaluation of these two processes responsible for the maintenance of body equilibrium.
Biomechanical Phenomena↗
[Test construction, analysis and trial of the Heidelberg Sound Discrimination Test for measuring auditory-kinesthetic perceptual discrimination acuity].
The provisional trial was carried out in a sample of 133 second- and 139 fourth-graders from the Heidelberg area. The HD-LT was subjected to an item selection, test criteria were ascertained and temporary percentile norms for the second and fourth grades were established. High item difficulty resulted for both grades, i.e. the test was relatively easy. Test criteria were generally satisfactory. Significant correlations were found in both grades between the HD-LT and the children's spelling ability. The HD-LT accounted for 30% of the spelling variance among second-graders as compared to 10% of that among fourth-graders. This reflects the specific significance of phonetic discrimination ability in the first years of elementary school. Children with spelling difficulties were compared to those with good spelling abilities in respect to their ability to discriminate sound. Spelling-impaired children in both grades exhibited a significantly lower overall HD-LT score. No significant sex differences were found with regard to the auditory and kinesthetic phonetic discrimination ability. Since the HD-LT turns out to be well-suited to indicate a phonetic discrimination disability during the initial phases of acquisition of written language, its further development and extension of its application to the pre-school level are recommended.
Child↗
[Movement as interaction--systemic-constructivist approach to movement and consequences for nursing care]].
The article starts off by analysing the problem that practice of nursing care and its training primarily keep to a mechanistic understanding of movement which is based on the scientific stimulus-response-model. Following this understanding it is argued that subjective dimensions of movement are thus neglected, ignoring patients' needs and demands. In order to reach a complex understanding of movement systemic and constructivist perspectives are introduced. Hence consequences for nurses' development of motorical propositions are developed. Interventions focussed on movements are to be designed as movement dialogues in which patients and nurses must find a consensus. In this process nurses' propositions can be seen as suggestions while patients' responses can be taken as counter suggestions.
Communication↗
[Effects of kinesthetic mobilization in comparison with standard mobilization on respiratory function after coronary artery bypass and other relevant factors].
Presently no relevant nursing data exist in Germany on the effect of mobilization according to kinaesthetic principles on the physiological system, on locomotion and the sensory system. The effect of two different versions of mobilization was measured in a unicentric, open, randomized study with two parallel groups from December 1999 to October 2000 in the intermediate ICU for patients after heart surgery at Ulm University Hospital. The aim was, to show superiority of kinaesthetic mobilization, compared to empirically developed standard mobilization on patients after aortal coronary bypass surgery, with reference to respiratory function. The two protocols of mobilization were carefully coordinated with precise plans of action and timing. A total of 104 subjects were randomized to the two groups. In the kinaesthetic mobilization group (n = 52) median age was 67.5 years, ten (19.2%) were female and 42 (80.8%) were male. In the standard mobilization group (n = 52) median age was 69 years, eight (15.4%) were female and 44 (84.6%) were male. The main outcome variable was the respiratory minute volume 30 minutes after the second mobilization minus the respiratory minute volume prior to the second mobilization. The median change in respiratory minute volume was 0.4 ltr/min. (-5.1 to 3) in the group with kinaesthetic mobilization and median 0.3 ltr/min (-6.0 to +9.1) in the standard mobilization group. Superiority of kinaesthetic mobilization compared to standard mobilization could not be proven (p = 0.38). Also in the secondary outcome variables the kinaesthetic mobilization showed no superiority over standard mobilization. The respiratory minute volume data within points of measure show that subjects in the kinaesthetic group have less extreme results (> 12 ltr.). In the area < 5 ltr. there is a similar tendency. This may point out that regulation between movement of body, respiration and circulatory system occurs more continuous in kinaesthetic mobilization than the standard mobilization. A similar tendency was seen in the secondary outcomes variables. Subjectively nurses noted that kinaesthetic mobilization was less strenuous than standard mobilization, even though subjects in the kinaesthetic group showed more mobility restriction (37%) than in the standard group (15%). From before to after the first mobilization the percentage of subjects needing less pain medication was higher in the kinaesthetic group (35%), compared to the standard group (19%). There were no serious adverse events in either group. The concept of kinaesthetic mobilization showed no negative effect on subjects compared to empirically developed standard mobilization. There was no diagnosis of pneumonia and none of instabile sternum on any of the subjects in this study. Also, there was no negative effect on the sternum due to the light support arms gave to sitting up and rotating movements in the area of thorax and pelvis on subjects in the kinaesthetic group. The subjects early trust in their own varied movement and the possible effects of kinaesthetic mobilization in later phases of recuperation was not explored in this study.
Aged↗
[Experiences and results from standardised observations of conventional and kinaesthetic nursing in a nuclear and radio-therapeutic ward].
In the Clinic for Nuclear Medicine and Radiotherapy, City Hospital Triemli (Zurich, Switzerland), a controlled observational study was carried out. The investigation aimed at comparing conventional and kinaesthetic nursing interventions with respect to the agility and body orientation of the patients, and with respect to their interaction with the nurses. The observations were limited to the interventions washing, positioning, and mobilizing and lasted 20 to 60 minutes. During this time, an experienced nurse, who did not belong to the nursing team, completed a checklist. The checklist items comprise operationalized criteria of the kinaesthetic concept by Hatch and Maietta, as well as two questions directed to the patients. Body motion and orientation were judged by a 12-items scale, identical for observations prior to and immediately after the nursing intervention. The interaction between patients and nurses was judged by means of a 10-items scale. Group 1 (13 patients) was observed during conservative nursing; group 2 (another 13 patients) was observed almost half a year later during kinaesthetic nursing. All observations were recorded with the same instrument. There was a general positive effect of the nursing interventions. Kinaesthetic nursing, however, only showed a trend towards better effects on the patients' agility, body orientation or interaction abilities in comparison to conventional nursing. The results are discussed with respect to a recently published study on objective measurement of kinaesthetic nursing effects. There is a certain discrepancy between the well-known positive valuation of kinaesthetic nursing by the nurses themselves and the measurable effects of the method. This discrepancy cannot simply be explained by sample size, type of measurement, or the nurses'experience with the method.
Aged↗
[Movement support based on Kinaesthetics and the development and improvement of body perception, movement abilities and functional independency of elderly nursing home residents].
This case study examined whether the movement support based on Kinaesthetics furthers the body perception, movement abilities and functional independency of elderly nursing home residents with movement restrictions. Two elderly nursing home residents who showed a strong dependence (Barthel-Index II; 20-60 points) after a stroke and who were not previously cared based on Kinaesthetics took part in the study. A four months follow-up with pre-test, Kinaesthetics interventions, and monthly evaluations (n = 4) was carried out. The data was gathered by means of observation. Structured observation was used in order to assess the functional independence by means of Barthel-Index and unstructured observation was used for qualitative information by means of Kinaesthetics assessment from. In addition, the care personnel kept a diary over the development of the participants during the study. Both cases showed clear improvement of the information processing, body perception, and the movement abilities. However, Barthel-Index showed only a little increase in functional development in case A (from 30 to 40 points). Based on the Kinaesthetics concepts, case A however showed a higher level of functional development. The score of case B on the Barthel-Index increased cleary from 55 to 95 points. Movement support based on principles of Kinaesthetics if used consistently, continuously, and adapted to the situation of the assisted person can increase the body perception, movement abilities, and the functional independence of patients in old age. Barthel-Index is not sensitive enough to detect small development in functional status, whereas with Kinaesthetics assessment form it is possible. Besides of quantitative scales it is recommended to use qualitative measures that focus more on qualitative progress and on the way how the level of score is achieved.
Activities of Daily Living↗