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Your brain senses every single move you make. It accepts information coming in from different senses including vision, touch and spatial awareness of the limbs (proprioception). The pattern of brain signals arriving from the body is fundamentally important to fine-tune our muscles. It guides us to make precise and accurate movements. The brain’s plasticity is remarkable. When one system fails, another one can take over. This explains why a blind person can enter a room and find his or her way out again. Unable to rely on sight, the brain uses spatial awareness to figure out the layout of a room and remember the exit, it’s a 6th sense.

The nerves that generate spatial awareness are embedded deep in the muscles and joints and sense muscle tension. In familial dysautonomia the faulty gene prevents these nerves from functioning properly, so the brain lacks incoming information from the muscles. It is this lack of spatial awareness that affects balance and coordination. It’s impossible to imagine life without spatial awareness, because we are constantly receiving this steady stream of background information and the brain’s ability to use spatial awareness to fine-tune movement occurs automatically.

Without the sense of spatial awareness, moving around becomes a major problem. It goes beyond just being a little unsteady or clumsy. Patients with familial dysautonomia have less control over their limbs. Their movements are inaccurate, causing them to veer into walls, trip up and fall often. Overtime their sensory ataxia can worsen, leaving them dependent on a walker or wheelchair.

 

A new paper by the Dysautonomia Center Research Team describes a simple remedy that can be used to improve spatial awareness in patients with familial dysautonomia. By placing stretchy athletic tape (find it here) across the front and back of the knees, researchers were able to show that patients improved their spatial awareness and could more accurately position their legs.

This skin-based input system is now being used by patients to feels their limbs and fine-tune movement. Some say that tricking the brain into relying on their skin to coordinate their movements helps improve their walking.

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Read more: Macefield VG, Norcliffe-Kaufmann L, Goulding N, Palma JA, Fuente Mora C, Kaufmann H. Increasing cutaneous afferent feedback improves proprioceptive accuracy at the knee in patients with sensory ataxia. J Neurophysiol. 2015  doi: 10.1152/jn.00148.2015. [Epub ahead of print] PMID: 26655817

This work was supported by the Dysautonomia Foundation, a non-profit organization dedicated to supporting research and treatment in familial dysautonomia.