Acute Effects of Neuromuscular-Training with Handheld-Vibration on Elbow Joint Position Sense

Context: Clinicians use exercises in rehabilitation to enhance sensorimotor-function, however evidence supporting their use is scarce. Objective: To evaluate acute effects of handheld-vibration on joint position sense (JPS). Design: A repeated-measure, randomized, counter-balanced 3-condition design. Setting: Sports Medicine and Science Research Laboratory. Patients or Other Participants: 31 healthy college-aged volunteers (16-males, 15-females; age=23+3y, mass=76+14kg, height=173+8cm). Interventions: We measured elbow JPS and monitored training using the Flock-of-Birds system (Ascension Technology, Burlington, VT) and MotionMonitor software (Innsport, Chicago, IL), accurate to 0.5°. For each condition (15,5,0Hz vibration), subjects completed three 15-s bouts holding a 2.55kg Mini-VibraFlex dumbbell (Orthometric, New York, NY), and used software-generated audio/visual biofeedback to locate the target. Participants performed separate pre- and post-test JPS measures for each condition. For JPS testing, subjects held a non-vibrating dumbbell, identified the target (90°flexion) using biofeedback, and relaxed 3-5s. We removed feedback and subjects recreated the target and pressed a trigger. We used SPSS 14.0 (SPSS Inc., Chicago, IL) to perform separate ANOVAs (p<0.05) for each protocol and calculated effect sizes using standard-mean differences. Main Outcome Measures: Dependent variables were absolute and variable error between target and reproduced angles, pre-post vibration training. Results: 0Hz (F1,61=1.310,p=0.3) and 5Hz (F1,61=2.625,p=0.1) vibration did not affect accuracy. 15Hz vibration enhanced accuracy (6.5±0.6 to 5.0±0.5°) (F1,61=8.681,p=0.005,ES=0.3). 0Hz did not affect variability (F1,61=0.007,p=0.9). 5Hz vibration decreased variability (3.0±1.8 to 2.3±1.3°) (F1,61=7.250,p=0.009), as did 15Hz (2.8±1.8 to 1.8±1.2°) (F1,61=24.027, p<0.001). Conclusions: Our results support using handheld-vibration to improve sensorimotor-function. Future research should include injured subjects, functional multi-joint/multi-planar measures, and long-term effects of similar training.

Neuromuscular Changes in Older Adults during the Lateral Step Task

Older adults may have trouble when performing activities of daily living due to decrease in physical strength and degradation of neuromotor and musculoskeletal function. Motor activation patterns during Lateral Step Down and Step Up from 4-inch and 8-inch step heights was assessed in younger (n=8, 24.4 years) and older adults (n=8, 58.9 years) using joint angle kinematics and electromyography of lower extremity muscles. Ground reaction forces were used to ascertain the loading, stabilization and unloading phases of the tasks. Older adults had an altered muscle activation sequence and significantly longer muscle bursts during loading for the tibialis anterior, gastrocnemius, vastus medialis, bicep femoris, gluteus medius and gluteus maximus muscles of the stationary leg. They also demonstrated a significantly larger swing time (579.1 ms vs. 444.8 ms) during the step down task for the moving leg. The novel data suggests presence of age-related differences in motor coordination during lateral stepping.