A history of distal radius fracture disturbs processing of sensory feedback without influencing neuromuscular control in the wrist joint

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Abstract

A distal radius fracture (DRF) is one of the most common fractures, especially in older women. Previous research shows that a DRF disturbs sensorimotor functions even eight weeks after finished treatment, which could influence neuromuscular control. The neuromuscular system exists of a sensory, motor and integration part, which all interact with each other as a closed-loop system. This study researches if a history of DRF disturbs neuromuscular control and if so, which part of the neuromuscular control system is the origin of this impairment. Nine healthy participants and eleven participants with a DRF history (who finished their treatment 0.2 – 4 years ago) executed posture tasks and reproduction tasks with a wrist perturbator. A posture task with force perturbations was done to test neuromuscular control. Changed environmental dynamics were applied to test the adaptation of the participants during the posture task. A position and force reproduction task were executed to test sensory position and force feedback. To test the motor part of the neuromuscular system, muscle activity was measured during the tasks with electromyography. The responses to the posture task did not differ between the groups. The position reproduction task was found to be significantly different between the two groups. Moreover, people with a DRF did not adapt to changed environmental dynamics while control participants did. This implies that processing of sensory position feedback does not work properly in people with a DRF history while neuromuscular control during a posture task with small deviations is still intact. A possible explanation for these results is that different neural networks are used during reproduction tasks and posture tasks. It is concluded that sensory feedback which is used in cortical processes is disturbed in people with a history of DRF while peripheral reflexes are still intact.