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1 University of Newcastle
2 Prince of Wales Hospital
3 Monash University
4 Prince of Wales Medical Research Institute
* To whom correspondence should be addressed. E-mail: s.gandevia.jap{at}unsw.edu.au.
Joint position sense is believed to be mediated by muscle afferent signals. Because a 'phantom' hand produced by a sensory and motor nerve block appears to move in the direction of voluntary effort, signals of 'motor command' or 'effort' can influence perceived joint position. To determine whether this occurs when sensory signals are available, 3 studies assessed position sense when motor command and afferent signals were available, but joint movement was prevented. First, the hand was positioned to stop movement at the proximal joint of the middle finger and movement at the distal joint was impossible because the muscles had been 'disengaged'. Voluntary efforts produced illusory position changes in the direction of the effort (12.6° ± 2.0° distal joint; 12.3° ± 2.3° proximal joint for efforts at 30% maximum; mean ± SD). Second, when subjects attempted to move the index finger under isometric conditions, the index finger appeared to move 7.4° ± 1.2° in the direction of efforts. These illusions graded with the level of effort (10% or 30% maximum) and far exceeded any real joint movement. Finally, because changes in muscle afferent feedback might have accompanied the voluntary efforts, all forearm and hand muscles were completely paralysed by locally infused rocuronium. During paralysis, passive wrist position was signalled accurately, but, during attempted efforts (30% maximum), perceived wrist position changed by 9.7° ± 4.9°s. Before paralysis, isometric efforts changed it by 6.7±3.6°. Thus, all studies concur: when joint movement is prevented, signals of motor command contribute to joint position sense.
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