Design principles and application of a wearable vibration device for individuals with proprioception deficiency
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Proprioception deteriorates as a result of both healthy aging and injuries to the nervous system. Effective and efficient limb control requires accurate feedback from the moving limbs, thus any change in proprioception has a direct impact on movement performance. In recent years muscle tendon vibration has emerged as a complementary treatment option for improving motor performance in individuals with stroke or older adults. However, it is not clear how vibration of antagonist muscle groups will affect performance of upper limb tasks and how adaptable the sensorimotor system is to such afferent input. The current thesis explored the role of proprioception on motor control processes with the goal of developing a wearable sensory assistive device. This thesis includes 5 studies: the first two being fundamental studies focused on the role of using visual versus proprioceptive inputs in the motor control of the upper limb when one or both inputs are modified. The third study, a systematic review with meta-analysis, determined the characteristics of effective muscle tendon vibration for improving upper limb movements in individuals with stroke. The fourth study reports the design considerations and development of a novel assistive device that used muscle-tendon vibration for upper limb rehabilitation. The fifth study is a proof-of-concept study on the performance of an upper limb aiming task with muscle-tendon vibration applied at the wrist of young adults. The results of the five studies are organized in a manuscript-style thesis. The results of the first two fundamental studies found and confirmed the significant role of proprioceptive input in online control of movements, even in the presence of visual input. A prototype of the muscle-tendon vibration device was designed based on the results of the systematic review and meta-analysis. Finally, the behavioural study using muscle tendon vibration provides proof-of-concept for future clinical trials using this novel assistive device. Based on the current findings, future research will focus on the effectiveness of the muscle-tendon vibration band for rehabilitation in individuals with stroke and older adults.