Joint positioning sense, perceived force level and two-point discrimination tests of young and active elderly adults

Background: Changes in the proprioceptive system are associated with aging. Proprioception is important to maintaining and/or recovering balance and to reducing the risk of falls.Objective:To compare the performance of young and active elderly adults in three proprioceptive tests.Method:Twenty-one active elderly participants (66.9±5.5 years) and 21 healthy young participants (24.6±3.9 years) were evaluated in the following tests: perception of position of the ankle and hip joints, perceived force level of the ankle joint, and two-point discrimination of the sole of the foot.Results:No differences (p>0.05) were found between groups for the joint position and perceived force level. On the other hand, the elderly participants showed lower sensitivity in the two-point discrimination (higher threshold) when compared to the young participants (p < 0.01).Conclusion:Except for the cutaneous plantar sensitivity, the active elderly participants had maintained proprioception. Their physical activity status may explain similarities between groups for the joint position sense and perceived force level, however it may not be sufficient to prevent sensory degeneration with aging.

Reprodutibilidade intra-avaliador do teste de discriminação de dois pontos na sola dos pés em idosos e jovens assintomáticos / Intra-observer reproducibility of the feet soles two-point discrimination test in asymptomatic elderly and young individuals

CONTEXTUALIZAÇÃO: Os primeiros sinais de comprometimento sensorial plantar decorrente do envelhecimento e de neuropatias periféricas são manifestados na sola dos pés e podem resultar em déficits no controle postural e no equilíbrio. Os testes de sensibilidade cutânea visam a avaliar a densidade da inervação sensorial na pele e têm sido utilizados para avaliação de segmentos distais. Alguns estudos têm aplicado o teste de discriminação de dois pontos (DDP) na sola dos pés e diferenciado idosos com e sem históricos de quedas, porém sua reprodutibilidade ainda precisa ser determinada. OBJETIVO: Verificar a reprodutibilidade intra-avaliador do teste de DDP na sola dos pés em idosos e jovens assintomáticos. MÉTODO: Participaram do estudo 21 idosos ativos (67±5 anos; 1,56±0,08 m; 65,3±13,7 kg) e 21 jovens ativos (24±3 anos; 1,69±0,09 m; 54,5±9,5 kg). Os participantes realizaram duas sessões de testes com procedimentos experimentais idênticos, com intervalo de 48 horas. Foi avaliada a sensibilidade cutânea da sola do pé direito por meio do teste de DDP. Para avaliar a reprodutibilidade intra-avaliador, foi aplicado o teste de Bland-Altman. RESULTADOS: Idosos e jovens apresentaram variações de 0,71% e 1,53%, respectivamente. CONCLUSÕES: Esses valores não excedem dois desvios-padrão, e o teste de DDP foi considerado como uma medida reprodutível para a avaliação da sensibilidade cutânea da sola dos pés de jovens e idosos fisicamente ativos.

BACKGROUND: The first sign of plantar sensory impairment due to aging and peripheral neuropathies are manifested on the soles of the feet and can result in postural control and balance deficits. The aim of cutaneous sensitivity tests is to assess the skin sensory innervation density such as those of the distal segments. In some studies the two-point discrimination test (TPD) have been applied on the soles of the feet and have proven to accurately distinguish elderly with and without falls events. However, the reproducibility of the test still needs to be determined. OBJECTIVES: The aim of the present study was to verify the intra-observer reproducibility of the TPD test on the soles of feet in asymptomatic elderly and young individuals. METHOD: The sample was composed of 21 physically active elderly participants (67±5 years; 1:56±0.08 m, 65.3±13.7 kg) and 21 physically active young adults (24±3 years, 1.69±0.09 m, 54.5±9.5 kg). The participants attended two sessions with identical experimental procedures, with an interval of 48 hours between them. The skin sensitivity of the right foot sole was assessed using the TPD test. Intra-observer reproducibility was assessed using Bland-Altman plots. RESULTS: Elderly and young participants showed sensitivity variations of 0.71% and 1.53%, respectively. CONCLUSIONS: These values did not exceed two standard deviations and the TPD test was considered as a reproducible measure for the assessment of feet cutaneous sensitivity in asymptomatic and physically active young and elderly participants.