Improving human ankle joint position sense using an artificial tongue-placed tactile biofeedback

Proprioception is comprised of sensory input from several sources including muscle spindles, joint capsule, ligaments and skin. The purpose of the present experiment was to investigate whether the central nervous system was able to integrate an artificial biofeedback delivered through electrotactile stimulation of the tongue to improve proprioceptive acuity at the ankle joint. To address this objective, nine young healthy adults were asked to perform an active ankle-matching task with and without biofeedback. The underlying principle of the biofeedback consisted of supplying subjects with supplementary information about the position of their matching ankle position relative to their reference ankle position through a tongue-placed tactile output device (Tongue Display Unit). Measures of the overall accuracy and the variability of the positioning were determined using the absolute error and the variable error, respectively. Results showed more accurate and more consistent matching performances with than without biofeedback, as indicated by decreased absolute and variable errors, respectively. These findings suggested that the central nervous system was able to take advantage of an artificial tongue-placed tactile biofeedback to improve the position sense at the ankle joint.     

Controlling posture using a plantar pressure-based,tongue-placed tactile biofeedback system

The present paper introduces an original biofeedback system for improving human balance control, whose underlying principle consists in providing additional sensory information related to foot sole pressure distribution to the user through a tongue-placed tactile output device. To assess the effect of this biofeedback system on postural control during quiet standing, ten young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements were recorded using a force platform. Results showed reduced CoP displacements in the Biofeedback relative to the No-biofeedback condition. The present findings evidenced the ability of the central nervous system to efficiently integrate an artificial plantar-based, tongue-placed tactile biofeedback for controlling control posture during quiet standing.     

Inter-individual variability in sensory weighting of a plantar pressure-based, tongue-placed tactile biofeedback for controlling posture

The purpose of the present experiment was to investigate whether the sensory weighting of a plantar pressure-based, tongue-placed tactile biofeedback for controlling posture could be subject to inter-individual variability. To achieve this goal, 60 young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements were recorded using a force platform. Overall, results showed reduced CoP displacements in the Biofeedback relative to the No-biofeedback condition, evidencing the ability of the central nervous system to efficiently integrate an artificial plantar-based, tongue-placed tactile biofeedback for controlling posture during quiet standing. Results further showed a significant positive correlation between the CoP displacements measured in the No-biofeedback condition and the decrease in the CoP displacements induced by the use of the biofeedback. In other words, the degree of postural stabilization appeared to depend on each subject's balance control capabilities, the biofeedback yielding a greater stabilizing effect in subjects exhibiting the largest CoP displacements when standing in the No-biofeedback condition. On the whole, by evidencing a significant inter-individual variability in sensory weighting of an additional tactile information related to foot sole pressure distribution for controlling posture, the present findings underscore the need and the necessity to address the issue of inter-individual variability in the field of neuroscience.     

Can a plantar pressure–based tongue-placed electrotactile biofeedback improve postural control under altered vestibular and neck proprioceptive conditions?

We investigated the effects of a plantar pressure-based tongue-placed electrotactile biofeedback on postural control during quiet standing under normal and altered vestibular and neck proprioceptive conditions. To achieve this goal, 14 young healthy adults were asked to stand upright as immobile as possible with their eyes closed in two Neutral and Extended head postures and two conditions of No-biofeedback and Biofeedback. The underlying principle of the biofeedback consisted of providing supplementary information related to foot sole pressure distribution through a wireless embedded tongue-placed tactile output device. Center of foot pressure (CoP) displacements were recorded using a plantar pressure data acquisition system. Results showed that (1) the Extended head posture yielded increased CoP displacements relative to the Neutral head posture in the No-biofeedback condition, with a greater effect along the anteroposterior than mediolateral axis, whereas (2) no significant difference between the two Neutral and Extended head postures was observed in the Biofeedback condition. The present findings suggested that the availability of the plantar pressure-based tongue-placed electrotactile biofeedback allowed the subjects to suppress the destabilizing effect induced by the disruption of vestibular and neck proprioceptive inputs associated with the head extended posture. These results are discussed according to the sensory re-weighting hypothesis, whereby the CNS would dynamically and selectively adjust the relative contributions of sensory inputs (i.e. the sensory weights) to maintain upright stance depending on the sensory contexts and the neuromuscular constraints acting on the subject.     

Sensory supplementation system based on electrotactile tongue biofeedback of head position for balance control

The present study aimed at investigating the effects of an artificial head position-based tongue-placed electrotactile biofeedback on postural control during quiet standing under different somatosensory conditions from the support surface. Eight young healthy adults were asked to stand as immobile as possible with their eyes closed on two Firm and Foam support surface conditions executed in two conditions of No-biofeedback and Biofeedback. In the Foam condition, a 6-cm thick foam support surface was placed under the subjects' feet to alter the quality and/or quantity of somatosensory information at the plantar sole and the ankle. The underlying principle of the biofeedback consisted of providing supplementary information about the head orientation with respect to gravitational vertical through electrical stimulation of the tongue. Centre of foot pressure (CoP) displacements were recorded using a force platform. Larger CoP displacements were observed in the Foam than Firm conditions in the two conditions of No-biofeedback and Biofeedback. Interestingly, this destabilizing effect was less accentuated in the Biofeedback than No-biofeedback condition. In accordance with the sensory re-weighting hypothesis for balance control, the present findings evidence that the availability of the central nervous system to integrate an artificial head orientation information delivered through electrical stimulation of the tongue to limit the postural perturbation induced by alteration of somatosensory input from the support surface.     

Sensory supplementation system based on electrotactile tongue biofeedback of head position for balance control

The present study aimed at investigating the effects of an artificial head position-based tongue-placed electrotactile biofeedback on postural control during quiet standing under different somatosensory conditions from the support surface. Eight young healthy adults were asked to stand as immobile as possible with their eyes closed on two Firm and Foam support surface conditions executed in two conditions of No-biofeedback and Biofeedback. In the Foam condition, a 6-cm thick foam support surface was placed under the subjects’ feet to alter the quality and/or quantity of somatosensory information at the plantar sole and the ankle. The underlying principle of the biofeedback consisted of providing supplementary information about the head orientation with respect to gravitational vertical through electrical stimulation of the tongue. Centre of foot pressure (CoP) displacements were recorded using a force platform. Larger CoP displacements were observed in the Foam than Firm conditions in the two conditions of No-biofeedback and Biofeedback. Interestingly, this destabilizing effect was less accentuated in the Biofeedback than No-biofeedback condition. In accordance with the sensory re-weighting hypothesis for balance control, the present findings evidence that the availability of the central nervous system to integrate an artificial head orientation information delivered through electrical stimulation of the tongue to limit the postural perturbation induced by alteration of somatosensory input from the support surface.     

Postural destabilization induced by trunk extensor muscles fatigue is suppressed by use of a plantar pressure-based electro-tactile biofeedback

Separate studies have reported that postural control during quiet standing could be (1) impaired with muscle fatigue localized at the lower back, and (2) improved through the use of plantar pressure-based electro-tactile biofeedback, under normal neuromuscular state. The aim of this experiment was to investigate whether this biofeedback could reduce postural destabilization induced by trunk extensor muscles. Ten healthy adults were asked to stand as immobile as possible in four experimental conditions: (1) no fatigue/no biofeedback, (2) no fatigue/biofeedback, (3) fatigue/no biofeedback and (4) fatigue/biofeedback. Muscular fatigue was achieved by performing trunk repetitive extensions until maximal exhaustion. The underlying principle of the biofeedback consisted of providing supplementary information related to foot sole pressure distribution through electro-tactile stimulation of the tongue. Centre of foot pressure (CoP) displacements were recorded using a force platform. Results showed (1) increased CoP displacements along the antero-posterior axis in the fatigue than no fatigue condition in the absence of biofeedback and (2) no significant difference between the no fatigue and fatigue conditions in the presence of biofeedback. This suggests that subjects were able to efficiently integrate an artificial plantar pressure information delivered through electro-tactile stimulation of the tongue that allowed them to suppress the destabilizing effect induced by trunk extensor muscles fatigue.     

Effect of exercise-induced fatigue on position sense of the knee in the elderly

Previously, data on the effects of muscle fatigue on joint position sense (JPS) have been provided. However, to our knowledge, no studies have been conducted so far to assess the effects of local muscle fatigue on elderly proprioception. Thus, the purpose of the present study was to determine the effects of local muscle fatigue on knee JPS in old-age-subjects. Sixteen male volunteers (mean age ± SD: 69.81 ± 3.92 years) participated in this study. Each subject completed all of the data collection in one morning session; JPS measures were obtained prior to and immediately after the fatigue protocol. JPS was evaluated by the technique of open-kinetic chain and active knee positioning, and was reported using absolute, relative and variable angular errors. The fatigue protocol applied to the lower extremity consisted of 30 maximum concentric repetitions of the knee extensors and flexors muscles on an isokinetic dynamometer at an angular velocity of 120 s⁻¹ (2.09 rad s⁻¹). The results showed that peak torque of knee extensor and flexor muscles was significantly decreased from rest to post exercise-induced fatigue. After local load to the knee muscles, a significant increase of absolute angular error was observed (2.56°). The relative error showed the directional bias in the extension movement. However, the reliability and accuracy of estimating knee angles as showed by the variable error is similar at both times. It can be concluded that exercise-induced local muscle fatigue alters knee JPS in old age adults.     

Ascending spinal axons that signal the position of the hindlimbs under static conditions: Location and receptor input

Summary Psychophysical experiments have shown that signals from slowly adapting subcutaneous receptors are used to sense limb position under static conditions (i.e., when the joints are stationary). The ascending collaterals of the slowly adapting primary sensory neurons supplying the deep tissues of the hindlimb do not project to the brain via the fasciculus gracilis. In experiments on cats, we have found a population of axons in the lateral fasciculus that signal the position of the ipsilateral hindlimb with a slowly adapting discharge. In the lower thoracic cord these fibers lie between the spinocervical tract and the ventral roots. Although plentiful in the lower thoracic cord, they are sparse or absent below L₃. In addition, a few position signaling axons with crossed input were found in the ventral part of the lateral white matter and in the ventral columns. Since the clinical evidence suggests that the spinal pathway for position sense is uncrossed, we propose that information used for conscious judgments of limb position when the joints are stationary initially ascends via the dorsal columns and then relays to the lateral fasciculus on the same side. These slowly adapting signals also may be used to judge limb position when the joints are moving. To determine whether this slowly adapting discharge originates from muscle or joint receptors, the tendons crossing the ankle joint were exposed but left in continuity and then pulled on while the joint was stationary. In this way individual lateral fascicular axons that signaled ankle flexion, extension, abduction or adduction could be shown to receive a strong excitatory input from muscle receptors. After the muscle tendons crossing the ankle joint were cut, tract fibers signaling ankle flexion, extension, abduction or adduction could no longer be found in this portion of the spinal white matter. Axons signaling clockwise or counterclock-wise twist of the ankle were reduced in number but a few were still present. These results suggest that muscle receptors provide the predominant signal used to sense ankle flexion, extension, abduction and adduction and that receptors in articular tissues may signal ankle twist.     

How a plantar pressure-based,tongue-placed tactile biofeedback modifies postural control mechanisms during quiet standing

The purpose of the present study was to determine the effects of a plantar pressure-based, tongue-placed tactile biofeedback on postural control mechanisms during quiet standing. To this aim, 16 young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements, recorded using a force platform, were used to compute the horizontal displacements of the vertical projection of the centre of gravity (CoG _v ) and those of the difference between the CoP and the vertical projection of the CoG (CoP-CoG _v ). Analysis of the CoP-CoG _v displacements showed larger root mean square (RMS) and mean power frequencies (MPF) in the Biofeedback than in the No-biofeedback condition. Stabilogram-diffusion analysis further showed a concomitant increased spatial and reduced temporal transition point co-ordinates at which the corrective processes were initiated and an increased persistent behaviour of the CoP-CoG _v displacements over the short-term region. Analysis of the CoG _v displacements showed decreased RMS and increased MPF in the Biofeedback relative to the No-biofeedback condition. Stabilogram-diffusion analysis further indicated that these effects mainly stem from reduced spatio-temporal transition point co-ordinates at which the corrective process involving CoG _v displacements is initiated and an increased anti-persistent behaviour of the CoG _v displacements over the long-term region. Altogether, the present findings suggest that the main way the plantar pressure-based, tongue-placed tactile biofeedback improves postural control during quiet standing is via both a reduction of the correction thresholds and an increased efficiency of the corrective mechanism involving the CoG _v displacements.     

踝关节本体感觉的测量方法研究与应用

背景：踝关节本体感觉能力的降低可能是踝关节容易反复损伤的一个重要原因,而对于踝关节本体感觉的定量评定方法一直没有一个标准化的测试方法。 目的：通过查阅大量资料并进行分析总结,对踝关节本体感觉的测量方法的研究现状进行综述。 方法：由作者检索PubMed数据库及维普数据库的相关文章。英文检索词为“joint position sense,muscle force sense;balance capacity;proprioception;ankle joint”;中文检索词为“本体感觉,平衡能力,踝关节”。共入选53篇文献进行归纳总结。 结果与结论：踝关节本体感觉的测量方法包括关节位置觉、肌肉力觉、侦测被动运动变化阈值、关节运动觉、平衡能力等,在实际应用中应根据实际情况需要来确定选用哪种方法作为踝关节本体感觉的测量方法。     

Microneurographically recorded Ia discharge from the tibial nerve mainly transmits the angular velocity of the ankle joint in humans

Investigations of the Ia afferent discharge in clarifying problems in disused and malused skeletal muscles have been carried out mainly in muscles of the upper extremities. However, such problems actually occur more frequently in the antigravity muscles of the lower extremities, such as the triceps surae muscle. An analysis of microneurographically recorded Ia discharges from the tibial nerve innervating the triceps surae muscle during dynamic movement of the ankle joint indicated that they mainly transmitted information on the angular velocity of the joint. However, the information on the position sense of the joint was not as well transmitted through Ia discharges. There was no correlation between the joint angle and the static response. However, the dynamic response of a Ia afferent was well correlated to the angular velocity. It is concluded that the human proprioception of the triceps surae muscle was not dependent on the position of the ankle joint, but largely on its movement by the stretching of the muscle.     

老年人膝关节和踝关节位置觉的重测信度

背景：目前国内外关节位置觉的研究主要以青年人为对象,而老年人在不同角度关节位置重现的重测信度研究比较缺乏。 目的：观察老年人膝关节和踝关节在不同角度关节复位测试的重测信度。 方法：在Biodex system 3等速系统上用被动复位测试法测试28名健康老年人的膝、踝关节本体感觉,以被动复位绝对误差角度作为个体位置觉能力优劣的代表。重测信度评价指标为组内相关系数(ICC)。 结果与结论：左右两侧膝关节位置觉测试在不同角度都具有良好的重测信度,ICC值为0.851~0.973;左右两侧踝关节位置觉测试在跖屈与背伸位具有中等以上的重测信度,ICC值为0.742~0.964;左侧踝关节复位的绝对误差角度小于右侧踝关节(P < 0.05),且左侧(ICC为0.870~0.964)踝关节重测的相关系数高于右侧(ICC为0.742~0.944)。提示老年人膝关节和踝关节位置觉重测的相关性良好,并且左侧踝关节的相关性高于右侧。     

Lumbar extensor fatigue and circumferential ankle pressure impair ankle joint motion sense

Fatigue of the lumbar extensor muscles has been associated with a degradation of balance, but the mechanism is not well understood. The ankle plays a major role in upright standing, and loss of proprioceptive acuity at the ankle could contribute to a degradation of balance. Therefore, the first objective of this study was to investigate the effect of lumbar extensor fatigue on ankle proprioceptive acuity. The second objective was to investigate the effect of circumferential ankle pressure (CAP) on ankle proprioceptive acuity to evaluate CAP as a potential intervention to mitigate any loss of proprioceptive acuity at the ankle with lumbar extensor fatigue. To address these objectives, ankle joint motion sense was evaluated with and without CAP, both before and after the lumbar extensors were fatigued. Results showed an impairment in joint motion sense with both fatigue and CAP. These results indicate that lumbar extensor fatigue impairs ankle proprioceptive acuity, which may help explain observed increases in postural sway subsequent to lumbar extensor fatigue.     

Factors Contributing to Chronic Ankle Instability: Kinesthesia and Joint Position Sense

OBJECTIVE: To present a comprehensive review of the influence of altered kinesthesia and joint position sense on chronic ankle instability and to present a model connecting deficits in ankle position sense with the increased risk of sustaining lateral ankle sprains. DATA SOURCES: I searched MEDLINE for the years 1966-2001 using the key words ankle and kinesthesia or position sense and books on proprioception. DATA SYNTHESIS: Study findings suggest a risk for unprovoked lateral ankle sprains when the lateral border of the foot accidentally catches the ground surface during the late swing phase of normal locomotion. In normal situations, the lateral border of the foot clears the ground by only 5 mm, and a small increase in ankle-position error may substantially increase the risk of a collision. Findings of affected kinesthesia and joint position sense in subjects with chronically unstable ankles dominate over studies showing nonsignificant results, but the answer is far from clear. CONCLUSIONS/RECOMMENDATIONS: Changes in joint position sense and kinesthesia of a magnitude found in subjects with chronically unstable ankles can lead to an increased risk of sustaining lateral ankle sprains. Results from a small number of studies suggest that balance and coordination training can restore the increased uncertainty of joint positioning to normal levels.     

Role of intramuscular receptors in the awareness of limb position

We studied proprioception with the ankle joint and the metacarpophalangeal (MCP) joint of the index finger of humans by use of a method that could distinguish a position sense from a movement sense. The test measured how subjects' ability to detect a fixed displacement of a joint varied with the rate of joint rotation. A position sense should not depend on the speed of joint placement; therefore slow rates of movement should not degrade subjects' ability to sense joint displacements. However, in the absence of a position sense, subjects would presumably rely on movement signals that do depend on the rate of rotation, and their ability to detect displacements should decrease when rate decreases. Subjects could sense small displacements of the ankle (+/- 3.5 degrees) and the MCP joint (+/- 2.5 degrees lateral excursions) with no decrement in performance at speeds as low as 0.25 degrees/min for the ankle and 0.5 degrees/min for the MCP joint (the slowest tested thus far). The findings confirm the existence of a position sense with these joints. Block of the ulnar nerve at the wrist, which paralyzes the interosseous muscles that adduct and abduct the MCP joint but presumably leaves skin and joint mechanisms unaffected, substantially impaired subjects' ability to detect the lateral excursions at slow speeds. Performance fell sharply at speeds less than 128 degrees/min and leveled off at approximately 20% detections at speeds less than 4 degrees/min. Increasing displacement to +/- 7 degrees did not improve performance. Block of the common peroneal nerve at the knee, which paralyzes the ankle dorsiflexor muscles, substantially impaired subjects' ability to detect the +/- 3.5 degrees displacements at slow speeds when the foot was positioned to slacken the plantarflexion muscles (which were not affected by the block). Performance fell sharply at speeds less than 256 degrees/min and approached zero at speeds less than 16 degrees/min. However, positioning the foot to stretch the plantarflexor muscles restored subjects' performance to near normal. Local anesthetic injected into the MCP joint space produced no observable effect on the ability to detect either slow or fast excursions. The joint anesthesia went unnoticed by the subject. We conclude that independent and separable senses exist for limb position and limb movement and that normal position sense requires sensory inputs from the muscles.     

Selection and coordination of human locomotor forms following cerebellar damage

We have previously shown that control subjects use two distinct temporal strategies when stepping on an inclined surface during walking: one for level and 10 degrees surfaces and another for 20 and 30 degrees surfaces. These two temporal strategies were characterized by systematic shifts in the timing of muscle activity and peak joint angles. We examined whether cerebellar subjects with mild to moderate gait ataxia were impaired in their ability to select these two temporal strategies, adjust peak joint angle amplitudes, and/or adjust one joint appropriately with respect to movements and constraints at another joint. Subjects walked on a level surface and on different wedges (10, 20, and 30 degrees ) presented in the context of level walking. In a single trial, a subject walked on a level surface in approach to a wedge, took a single step on the wedge, and continued walking on an elevated level surface beyond the wedge. Cerebellar subjects used two temporal strategies, one for the level and 10 degrees surfaces and another for 20 and 30 degrees surfaces. Cerebellar strategies were similar to those used by controls except for the timing of ankle-joint movement on the steeper wedges. Cerebellar subjects adjusted the peak amplitudes of individual joint angles normally, with the exception of peak ankle plantarflexion. However, they exhibited greater trial-to-trial variability of peak hip and knee joint angles that increased as a function of wedge inclination. The most substantial deficit noted in the cerebellar group was in the relative movement of multiple joints. Cerebellar subjects demonstrated multijoint coordination deficits in all conditions, although these deficits were most pronounced during stance on the steeper wedges. On the 30 degrees wedge, cerebellar subjects showed abnormal relative movement of hip, knee, and ankle joints and the most substantial decomposition of movement. We speculate that to simplify multijoint control, cerebellar subjects decomposed their movement by fixing the ankle joint in a dorsiflexed position on the steepest wedges. Our results suggest that the cerebellum may not be critical in selecting the basic motor patterns for the two temporal strategies because cerebellar subjects produced appropriate timing shifts at most joints. Instead, our data suggest that the cerebellum is most critical for adjusting the relative movement of multiple joints, especially to accommodate external constraints.     

Cutaneous mechanisms of isometric ankle force control

The sense of force is critical in the control of movement and posture. Multiple factors influence our perception of exerted force, including inputs from cutaneous afferents, muscle afferents and central commands. Here, we studied the influence of cutaneous feedback on the control of ankle force output. We used repetitive electrical stimulation of the superficial peroneal (foot dorsum) and medial plantar nerves (foot sole) to disrupt cutaneous afferent input in 8 healthy subjects. We measured the effects of repetitive nerve stimulation on (1) tactile thresholds, (2) performance in an ankle force-matching and (3) an ankle position-matching task. Additional force-matching experiments were done to compare the effects of transient versus continuous stimulation in 6 subjects and to determine the effects of foot anesthesia using lidocaine in another 6 subjects. The results showed that stimulation decreased cutaneous sensory function as evidenced by increased touch threshold. Absolute dorsiflexion force error increased without visual feedback during peroneal nerve stimulation. This was not a general effect of stimulation because force error did not increase during plantar nerve stimulation. The effects of transient stimulation on force error were greater when compared to continuous stimulation and lidocaine injection. Position-matching performance was unaffected by peroneal nerve or plantar nerve stimulation. Our results show that cutaneous feedback plays a role in the control of force output at the ankle joint. Understanding how the nervous system normally uses cutaneous feedback in motor control will help us identify which functional aspects are impaired in aging and neurological diseases.     

Prior experience and current goals affect muscle-spindle and tactile integration

We previously have shown that reports of illusory elbow extension from biceps vibration can be attenuated by touching a stationary cue-surface with the index fingertip of a vibrated arm. However, this was not the case if the subject had previously felt genuine motion of the cue-surface without biceps vibration. Two potential explanations for this are that the sense of elbow orientation results from tactile and muscle stretch cues that are integrated based on (1) an awareness of the tactile cue’s mobility or (2) specific patterns of tactile and muscle spindle activity resembling the elbow motion during previous interactions with the tactile cue. We tested these hypotheses by comparing how touching the cue-surface attenuated the reports of arm movement during biceps vibration after a demonstration of the cue- surface mobility without involving any elbow motion versus simultaneously touching the cue-surface as it moved and extending the elbow to correspond exactly to the elbow extension illusion during vibration. Touching the cue-surface stopped attenuating the reports of elbow extension during biceps vibration only after experiencing actual cue-surface motion while moving the elbow . This supports the second hypothesis that tactile and muscle stretch feedback that are integrated based on specific patterns of tactile and muscle spindle activity recalled from previous interactions with the tactile cue. We also tested the influence of motor set on the sense of elbow position in this paradigm. We found that even after touching the stationary cue-surface had ceased to attenuate illusory elbow motion during biceps vibration, illusory elbow motion during vibration still could be attenuated. This was possible if the subjects intended to actively use their wrists rather than the elbow to maintain fingertip contact. We conclude that muscle stretch and tactile cues are integrated to locate the arm within a highly specific context associated with tactile and proprioceptive feedback from prior experience and current movement goals.     

Contributions of skin and muscle afferent input to movement sense in the human hand

In the stationary hand, static joint-position sense originates from multimodal somatosensory input (e.g., joint, skin, and muscle). In the moving hand, however, it is uncertain how movement sense arises from these different submodalities of proprioceptors. In contrast to static-position sense, movement sense includes multiple parameters such as motion detection, direction, joint angle, and velocity. Because movement sense is both multimodal and multiparametric, it is not known how different movement parameters are represented by different afferent submodalities. In theory, each submodality could redundantly represent all movement parameters, or, alternatively, different afferent submodalities could be tuned to distinctly different movement parameters. The study described in this paper investigated how skin input and muscle input each contributes to movement sense of the hand, in particular, to the movement parameters dynamic position and velocity. Healthy adult subjects were instructed to indicate with the left hand when they sensed the unseen fingers of the right hand being passively flexed at the metacarpophalangeal (MCP) joint through a previously learned target angle. The experimental approach was to suppress input from skin and/or muscle: skin input by anesthetizing the hand, and muscle input by unexpectedly extending the wrist to prevent MCP flexion from stretching the finger extensor muscle. Input from joint afferents was assumed not to play a significant role because the task was carried out with the MCP joints near their neutral positions. We found that, during passive finger movement near the neutral position in healthy adult humans, both skin and muscle receptors contribute to movement sense but qualitatively differently. Whereas skin input contributes to both dynamic position and velocity sense, muscle input may contribute only to velocity sense.