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The Kinesthetic Senses

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  • Ref The Kinesthetic Senses

    Gandevia shows no signs of slowing down - thank goodness.
    Also, thanks to a tweet from BodyinMind, this presented itself to my eyeballs - free access paper, The Kinesthetic Senses.

    Of note: "Peripheral receptors which contribute to kinaesthesia are muscle spindles and skin stretch receptors. Joint receptors do not appear to play a major role at most joints."

    :clap2::clap2::clap2:

    So happy to know that I was on the right track, preferring to stretch skin instead of wiggle or pop joints.
    Diane
    www.dermoneuromodulation.com
    SensibleSolutionsPhysiotherapy
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    @dfjpt
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    "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

    “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

    “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

    "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

    "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

  • #2
    This paper came to my attention yesterday: The kinesthetic senses by Uwe Proske and Simon Gandevia, in Australia. By some refreshing turn of events, it is open access. It provides an historical backdrop to nearly everything we as physical therapists are about. We are all about restoring this function, kinesthesia, to people in whom it would seem to have gone missing. We always have been. Without good kinesthesia, motor control goes offline. When motor control goes off line, so does maximal function.

    The paper begins with a brief intro to kinesthesia. It states at the outset that muscle and skin receptors account for most of the receptor input that helps the brain make motor choices. It specifically states,

    "Peripheral receptors which contribute to kinaesthesia are muscle spindles and skin stretch receptors. Joint receptors do not appear to play a major role at most joints."

    Wow. Right there, we can see a huge erosion under the sea shore of one of the defining organizational principles of orthopaedic manual therapy, which is that getting to and wiggling or popping the right joint in the right way will jumpstart a better motor output. Orthopaedic manaual therapy (and chiro) have used this idea to build themselves and have perpetuated it for decades, for a century. It's just not valid. It was a false hypothesis, and finally research has begun to trickle out that suggests this is the case.

    After a brief description of the contribution of muscle spindle receptors to the kinesthetic senses, Proske and Gandevia begin to discuss receptors found in skin. Let's take a look at some things they say in the paper:

    1.
    "Concerning the possible contribution to kinaesthesia from other receptor types, the summary view is that while a good case has been made for some cutaneous receptors, the evidence is less convincing for joint receptors."
    Both have been studied and cutaneous receptors are found to be more contributory.


    2.
    "The cutaneous receptor most likely to subserve a kinaesthetic role is the skin stretch receptor, the slowly adapting Type II receptor served by Ruffini endings (Chambers et al. 1972; Edin, 1992)."
    I could kiss these guys. :clap2:
    Reading this I suddenly felt like I had emerged from an echo chamber in which I'd been talking only to myself for years. It's nice to see outside confirmation that I've been on the right track about Ruffinis. It's nice to see Ruffinis mentioned out loud in a paper about the kinesthesic senses' role in movement.

    3.
    For kinaesthesia at the forearm, stretch of skin over the elbow during elbow flexion can provide information about both position and movement. Movement illusions generated by stretch of skin of the hand and over more proximal joints, when combined with muscle vibration were greater than when either stimulus was applied on its own (Collins et al. 2005).
    Here is a link to the paper.

    4.
    "The authors made the point that this was not just a matter of skin input facilitating the muscle input and that cutaneous input generated by skin stretch contributed to kinaesthesia in its own right. More recent observations have shown that skin input can also have an occluding action. Signals from local, rapidly adapting receptors evoked by low-amplitude, high frequency vibration can impede movement detection (Weerakkody et al. 2007)."
    Sounds to me, from this, that skin is able to complain and mess up movement. Hmn...
    Suggests to me that messing around therapeutically at a skin level just might help the brain sort out misinformation from it, give it time to do so.

    5.
    While joint receptors were first thought to be all-important in kinaesthesia, the present-day view is that their contribution at most joints is likely to be minor. Typically they respond to joint movement, but often with response peaks at both limits of the range of joint motion (Burgess & Clark, 1969). They are now thought of as limit detectors. However, there are examples in the literature of responses across the full range of joint movement (Burke et al. 1988) and here joint receptors may play a role under circumstances in which input from muscle and skin is not available (Ferrell et al. 1987). "
    This makes sense - why would joints have any other function in that they are in the middle of movement operations? They are the last to move, not the first, in any human action. There has to be tensioning of cables before the actual hinges or wheels turn or levers lift, e.g., on a crane. And of course the brain would want to have maximal feedback prior to joints actually moving.

    And of course it would want to have a signal of "that's far enough, thanks" from something. Of course it makes sense that the "that's enough, thanks" signals would come from the most deeply buried bits, i.e., joints. It's all so logical. :thumbs_up

    In a biological system with embedded sensors, it makes sense that the outside would have the most feedback capacity, because like the "crack the whip" game played on ice, the skater on the end of the line (the "outside") moves the furthest and at the greatest acceleration. Nature always tries to do more with less. So, put the feedback sensors on the outside of the biological organism you're building. That way they'll fire from movement generated from inside, and from anything touching the organism from the outside. Excellent economy.

    This paper is an important one for manual therapists who seek to understand how it is that "light" manual techniques seem to do as well to help patients' brains connect up in terms of improved, observable motor output, as heavy joint-based, manipulative or mobilizing ones.

    Now, let's see if we can help the "joint"-based manual therapies get over thinking themselves superior to nervous system "skin"-based manual therapies. :thumbs_up

    Let's see if we can get skin-based therapies on track with some decent nervous-system based information, get them to dismantle their false hypotheses.
    Diane
    www.dermoneuromodulation.com
    SensibleSolutionsPhysiotherapy
    HumanAntiGravitySuit blog
    Neurotonics PT Teamblog
    Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
    Canadian Physiotherapy Association Pain Science Division Facebook page
    @PainPhysiosCan
    WCPT PhysiotherapyPainNetwork on Facebook
    @WCPTPTPN
    Neuroscience and Pain Science for Manual PTs Facebook page

    @dfjpt
    SomaSimple on Facebook
    @somasimple

    "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

    “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

    “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

    "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

    "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

    Comment


    • #3
      Hi Diane,

      Your absolutely right. It all about the skin. :clap1:

      Sorry, I don't have an electronic copy but here's the ref:

      Mountcastle VB & Powell TPS (1959). Central nervous
      mechanisms subserving position sense and kinesthesis.
      Bull Johns Hopkins Hosp 105, 173–200.

      Inhibition of cortical neurons related to the joint by stimulationof the skin. pg. 186.


      ...we have observed, for nine neurons...in which stimulation of the skin serves to suppress both the spontaneous and the evoked activity of a cortical cell which is excited by joint rotation.
      Facts reguarding inhibitory receptive fields. (inhib. rec. flds) pg 187.

      1) Inhib rec flds phenomenon is from skin to deep and not the reverse
      2) Inhib rec flds is always quite often distal to the jt whose mov't drives the neuron
      (think about an arm pull for sh pain-fascia release. I don't think so).

      pg 192-
      It seems likely that...very lightest of mechanical stimuli of the body surface must activate...cortical rec of the skin but also those in the superficial and deep fascia as well.

      This is for Barrett

      whether the rec of the periosteum and their central connections are also concerned with touch-pressure is unknown, but their sensitivity to mechanical stimuli is almost equally great, especially at such bony prominences...pg 192
      Sincerely


      Mike S

      Comment


      • #4
        Thanks for those choice bits, Mike.
        Diane
        www.dermoneuromodulation.com
        SensibleSolutionsPhysiotherapy
        HumanAntiGravitySuit blog
        Neurotonics PT Teamblog
        Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
        Canadian Physiotherapy Association Pain Science Division Facebook page
        @PainPhysiosCan
        WCPT PhysiotherapyPainNetwork on Facebook
        @WCPTPTPN
        Neuroscience and Pain Science for Manual PTs Facebook page

        @dfjpt
        SomaSimple on Facebook
        @somasimple

        "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

        “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

        “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

        "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

        "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

        Comment


        • #5
          dear Diana,
          How´s the new life treating you?

          I am finally back and getting "into" the skin again.
          Could you help me with the above article? I cannot freeaccess it as you could.
          thanks

          Esther

          Comment


          • #6
            Well, it USED to be free access... Sorry about that Esther. :sad:

            Here is a link.
            Diane
            www.dermoneuromodulation.com
            SensibleSolutionsPhysiotherapy
            HumanAntiGravitySuit blog
            Neurotonics PT Teamblog
            Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
            Canadian Physiotherapy Association Pain Science Division Facebook page
            @PainPhysiosCan
            WCPT PhysiotherapyPainNetwork on Facebook
            @WCPTPTPN
            Neuroscience and Pain Science for Manual PTs Facebook page

            @dfjpt
            SomaSimple on Facebook
            @somasimple

            "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

            “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

            “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

            "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

            "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

            Comment


            • #7
              Diane,

              You may need to update your tag line: "Human Primate Social Groomer and Neuroplastician/kinesthetician." :thumbs_up
              John Ware, PT
              Fellow of the American Academy of Orthopedic Manual Physical Therapists
              "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
              “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
              be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

              Comment

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