Relationship of balance in static single-leg stance to muscle strength and position sense of ankle in individuals with functional ankle instability / 中国康复理论与实践

ObjectiveTo analyze the relationship of the static single-leg stance balance with ankle muscles strength and position sense in individuals with functional ankle instability (FAI). MethodsFrom March to May, 2023, 44 FAI individuals were recruited in Hebei Normal University, and the maximum isokinetic muscle strength (60°/s and 180°/s) and position sense as ankle flexion, extension, inversion and eversion were measured using isokinetic dynamometer; while the center of pressure (COP) sway distance and envelope area were measured as static single-leg stance with eyes open or closed using three-dimensional force plate. ResultsThe maximum isokinetic torque as ankle eversion at 180°/s correlated with the COP anterior-posterior sway distance with eyes closed (r = -0.378, P < 0.05). ConclusionExplosive ankle eversion strength is related with the balance in static single-leg stance, which may help to evaluate and intervent the ankle function of FAI individuals.

Profile of Ankle Isokinetic Strength and Proprioception in Elite Female Handball Players / Perfil de Fuerza Isokinética del Tobillo y Propiocepción en Jugadoras de Balonmano de Élite

SUMMARY: The evaluation of the invertor and evertor muscle strength and proprioception are important in terms of determining the risk of injury in handball players. The aim of this study was to determine the isokinetic strength and proprioception profile of the ankle invertor and evertor muscles of elite female handball players. Fifteen elite female handball players were included. Ankle invertor and evertor muscle strength and proprioception were evaluated using the isokinetic system. The isokinetic strength test was performed in concentric mode at 30°/s (5 repetitions) and 120°/s (10 repetitions). Proprioception sense was evaluated as active joint position sense. There was no statistically significant difference between the dominant and nondominant sides in terms of invertor and evertor muscle strength, evertor/invertor (Ever/Inver) ratio, and active joint position sense at both angular speeds (p>0.05). The Ever/Inver ratio on both sides was lower than normal values. It was concluded that the female handball players showed bilateral symmetry in the invertor and evertor muscles. However, the fact that the Ever/Inver strength ratio was lower than normal values on both sides suggested that caution should be exercised in terms of risks such as ankle sprain or chronic ankle instability. Pre-season evaluations should be made and it would be beneficial to add strengthening exercises to related muscle groups in training programs to normalize the unilateral ratios in these athletes.

La evaluación de la fuerza muscular inversora y eversora y la propiocepción son importantes para determinar el riesgo de lesión en los jugadores de balonmano. El objetivo de este estudio fue determinar la fuerza isocinética y el perfil de propiocepción de los músculos inversores y eversores del tobillo de jugadoras de balonmano de élite. Se incluyeron 15 jugadoras de élite de balonmano. La fuerza muscular inversora y eversora del tobillo y la propiocepción se evaluaron mediante el sistema isocinético. El test de fuerza isocinética se realizó en modo concéntrico a 30º/s (5 repeticiones) y 120º/s (10 repeticiones). El sentido de propiocepción se evaluó como sentido activo de posición articular. No hubo diferencias estadísticamente significativas entre los lados dominante y no dominante en términos de fuerza muscular inversora y eversora, relación eversor/inversor (Ever/ Inver) y sentido activo de la posición de la articulación en ambas velocidades angulares (p>0.05). La relación Ever/Inver en ambos lados fue inferior a los valores normales. Se concluyó que las jugadoras de balonmano presentaron simetría bilateral en los músculos inversores y eversores. Sin embargo, el hecho de que la relación de fuerza Ever/Inver fuera inferior a los valores normales en ambos lados sugirió que se debe tener precaución en términos de riesgos como el esguince de tobillo o la inestabilidad crónica de tobillo. Se deben realizar evaluaciones de pretemporada y sería beneficioso agregar ejercicios de fortalecimiento a los grupos musculares relacionados en los programas de entrenamiento para normalizar las proporciones unilaterales en estas atletas.

Recovery of proprioception after lateral ankle sprain / 中国康复理论与实践

ObjectiveTo observe the recovery of proprioception of the affected ankle over time after lateral ankle sprain accepting routine rehabilitation. MethodsFrom June, 2020 to June, 2022, 18 patients with lateral ankle sprain in Kunshan Rehabilitation Hospital underwent routine rehabilitation for twelve weeks. They were measured active and passive position sense of bilateral ankles using an isokinetic dynamometer before treatment, and four, eight and twelve weeks after treatment, respectively. ResultsThe active presentation difference of affected ankle reduced after treatment (F = 22.533, P < 0.001), but it was more than that of the healthy ankle at the same time (t > 4.419, P < 0.001). No significant improvement was found in passive presentation difference of affected ankle after treatment (F = 1.175, P > 0.05), and it was not significantly different from those of the healthy ankle at the same time (|t| < 0.646, P > 0.05). ConclusionProprioception of affected ankle has been impaired after lateral ankle sprain, and it can be recovered after rehabilitation, but cannot achieve the healthy level even after three months of training. Passive position sense as an index of proprioception needs more researches.

The reliability and validity of using a head-neck relocation test to assess cervical position sense / 中华物理医学与康复杂志

Objective:To observe the reliability and validity of using a head-neck relocation test (HRT) in assessing cervical position sense.Methods:A total of 62 subjects were recruited, including 32 with neck pain and 30 healthy subjects. All received two HRTs conducted by two independent assessors at a first session, and then they received another HRT 24 hours later administered by one of them. The joint position error (JPE) was measured in the four directions of cervical motion: flexion, extension, levorotation and dextrorotation. The intra- and inter-rater reliability was quantified in terms of intra-class correlation coefficients (ICCs) and the difference in JPE between the two groups was also determined for validity.Results:The intra- and inter-rater reliability for the HRT in the four directions had ICC values of 0.603-0.830 and 0.597-0.837 respectively. The corresponding standard error of measurement (SEM) values were 1.52-2.15cm and 1.69-2.09cm, while the minimal detectable change (MDC) values were 4.20-5.97cm and 4.69-5.79cm, respectively. The patients with neck pain had significantly larger JPE in cervical extension and right rotation compared to healthy individuals, on average. And their JPE for cervical extension had an area under the curve (AUC) of the receiver′s operating curve of 0.755.Conclusions:The HRT showed good intra- and inter-rater reliability in assessing cervical joint position sense. The JPE for cervical extension can be used to discriminate those with neck pain from healthy subjects.

Efectos del autoinjerto hueso-tendón patelar-hueso sobre la posición articular y la fuerza en pacientes con reconstrucción del ligamento cruzado anterior / Effects of bone-patellar tendon-bone autograft on joint position and strength in patients with anterior cruciate ligament reconstruction

RESUMEN: El objetivo del estudio fue comparar el déficit propioceptivo a través del Joint position sense (JPS) y Force steadiness en pacientes con reconstrucción del ligamento cruzado anterior (LCA) injerto hueso-tendón patelar-hueso (HTH) 6 a 12 meses postcirugía. Participaron 15 pacientes (13 hombres y 2 mujeres, 25,5 ± 1,3 años) con reconstrucción de LCA con autoinjerto HTH y 20 personas sin lesión del LCA (19 hombres y 1 mujer, 24,1 ± 0,8 años). Para evaluar la sensación de posición de la articulación de la rodilla se midió la Joint position sense (JPS) en tres rangos: 0°-30°, 31°-60° y 61°-90° y la sensación de fuerza del cuádriceps fue evaluada con la prueba Force steadiness (FS) al 15 % de la contracción voluntaria máxima (CVM), ambas pruebas realizadas 6 a 12 meses post cirugía. Los resultados mostraron que no hubo diferencias estadísticamente significativas en la sensación de la posición articular (JPS 0°-30°) (p=0.564) y 31°-60° (p=0.681), mientras que en el rango 61°-90° (p=0.003) existieron diferencias estadísticamente significativas. En las mediciones de sensación de fuerza del cuádriceps (FS al 15 % CVM) entre los pacientes operados de LCA técnica HTH y el grupo control no hubo diferencias estadísticas (p= 0.987) La sensación de la fuerza del cuádriceps medida con la prueba FS al 15 % CVM no presentaría déficit entre los 6 a 12 meses en pacientes post operados de LCA al ser comparados con sujetos sin lesión ni cirugía de este ligamento. Se concluye que la sensación de la posición articular medida con la prueba JPS en en tres rangos articulares de pacientes con reconstrucción de LCA injerto HTH 6 a 12 meses post cirugía sólo mostró alteraciones en el rango de 61°- 90° al ser comparado con el grupo control, lo cual indica que la sensación de la posición articular presenta un déficit en este rango específico.

SUMMARY: The aim of the study was to compare the proprioceptive deficit through the Joint position sense (JPS) and Force steadiness in patients with anterior cruciate ligament (ACL) bone-patellar tendon-bone graft (PTH) reconstruction 6 to 12 months post-surgery. Fifteen patients (13 men and 2 women, 25.5 ± 1.3 years) with ACL reconstruction with HTH autograft and 20 persons without ACL injury (19 men and 1 woman, 24.1 ± 0.8 years) participated. To assess knee joint position sensation, Joint position sense (JPS) was measured in three ranges: 0°-30°, 31°- 60° and 61°-90° and quadriceps strength sensation was assessed with the Force steadiness (FS) test at 15 % of maximal voluntary contraction (MVC), both tests performed 6 to 12 months post surgery. The results showed that there were no statistically significant differences in joint position sensation (JPS 0°-30°) (p=0.564) and 31°-60° (p=0.681), while in the range 61°-90° (p=0.003) there were statistically significant differences. In the quadriceps strength sensation measurements (FS at 15 % CVM) between the patients operated on ACL HTH technique and the control group there were no statistical differences (p= 0.987). The quadriceps strength sensation measured with the FS test at 15 % CVM would not present a deficit between 6 to 12 months in post- operated ACL patients when compared to subjects without injury or surgery of this ligament. It is concluded that the joint position sensation measured with the JPS test in three joint ranges of patients with ACL reconstruction HTH graft 6 to 12 months post surgery only showed alterations in the range of 61°- 90° when compared to the control group, indicating that the joint position sensation presents a deficit in this specific range.

Bodyweight distribution between limbs, muscle strength, and proprioception in traumatic transtibial amputees: a cross-sectional study

OBJECTIVES: To evaluate how transtibial amputation (TT) affects bodyweight distribution, voluntary knee joint position sense (JPS), and quadriceps (QUA) and hamstrings (HAM) strength in prosthetized patients. METHODS: Only TT patients who had been prosthetized for more than one year were included, and an age-paired able-bodied group was used as control. The participants stood on force plates with their eyes open to measure bodyweight distribution between the limbs. Knee voluntary JPS was assessed by actively reproducing a set of given arbitrary joint angles using a video analysis approach, and QUA and HAM strength were assessed isometrically with a hand-held dynamometer. RESULTS: Sixteen TT subjects (age: 39.4±4.8 years) and sixteen age-paired control subjects (age: 38.4±4.3 years) participated in the study. The amputees supported their bodyweight majorly on the sound limb (54.8±8.3%, p<0.001). The proprioceptive performance was similar between the amputated (absolute error (AE): 2.2±1.6°, variable error (VE): 1.9±1.6°, constant error (CE): -0.7±2.0°) and non-amputated limbs (AE: 2.6±0.9°, VE: 2.1±0.9°, CE: 0.02±2.3°), and was not different from that of control subjects (AE: 2.0±0.9°, VE: 1.4±0.4°, CE: -1.1±1.7°). There was a considerable weakness of the QUA and HAM in the amputated limb compared with the sound limb and control subjects (p<0.001 both). CONCLUSIONS: The asymmetric bodyweight distribution in the transtibial amputees was not accompanied by a reduction in knee proprioception. There was significant weakness in the amputated limb, which could be a potential issue when designing rehabilitation programs.

Effect of Kinesio Taping at Knee on Position Sense and Lower-limb Function / 中国康复理论与实践

Objective:To observe the effects of Kinesio Taping and kneepad on position sense of knee in healthy young adult male. Methods:In September, 2019, 20 healthy adult male aged 21 to 27 were selected. They were measured the joint angle error in angle reproduction test, and tested with functional reach test (FRT), 10-meter walking time (10MWT), and Timed "Up and Go" Test (TUGT) under follow four conditions: non-intervention, simple Kinesio Taping, simple kneepad, and both Kinesio Taping and kneepad. Results:For the angle error, it was the most under non-intervention, and the least under simple Kinesio Taping (F = 61.260, P < 0.001). For FRT, there was no significant difference among all the conditions (F = 1.793, P = 0.988). For 10MWT, it was the least under simple Kinesio Taping (F = 23.817, P < 0.001). For TUGT, it was the most under non-intervention (F = 19.865, P < 0.001). Conclusion:Kinesio Taping can improve position sense of knee, as well as walking, without further benefit along with kneepad.

Test-retest Reliability of Lumbar Spine Position Sense for Aging People / 中国康复理论与实践

Objective:To determine the test-retest reliability of lumbar passive reposition accuracy for older people. Methods:A total of 58 healthy older people stood on an isokinetic dynamometer, and passively moved their trunk forward and backward to the target positions as accurately as possible. The targeted positions were set as flexion forward 15°, 30° and 60°, and flexion backward 15°. The absolute error (AE) was recorded. They were tested again a week latter. The intraclass correlation coefficient (ICC) and standard errors of measurement (SEM and SEM%) were calculated. Results:The ICC of AE was 0.699 to 0.833 for all the subjects, SEM was 1.18 to 3.26, and SEM% was 26.84% to 37.13%. For the men, the ICC was 0.462 to 0.818, SEM was 1.60 to 3.68, and SEM% was 36.37% to 48.78%. For the women, the ICC was 0.782 to 0.891, SEM was 1.48 to 2.71, and SEM% was 28.48% to 33.34%. Conclusions:Lumbar passive reposition accuracy is some reliable to assess the position sense for older people. However, there are too large errors for clinical measurement, which need further improvment.

Aerobic training in aquatic environment improves the position sense of stroke patients: A randomized clinical trial

AIMS: (Stroke patients often present sensory-motor alterations and less aerobic capacity. Joint position sense, which is crucial for balance and gait control, is also affected in stroke patients). To compare the effect of two exercise training protocols (walking in deep water and on a treadmill) on the knee position sense of stroke patients. METHODS: This study was designed as a randomized controlled clinical trial. Twelve adults, who suffered a stroke at least one year prior to the start of the study, were randomly assigned to one of two groups: 1) pool group submitted to aerobic deep water walking training; and 2) the treadmill group which was submitted to aerobic walk on a treadmill. Measurements: The position sense, absolute error and variable error, of the knee joint was evaluated prior to and after nine weeks of aerobic training. RESULTS: The pool group presented smaller absolute (13.9o versus 6.1o; p < 0.05) and variable (9.2o versus 3.9o; p < 0.05) errors after nine-weeks gait training than the treadmill group. CONCLUSIONS: Nine-week aerobic exercise intervention in aquatic environment improved precision in the position sense of the knee joint of stroke patients, suggesting a possible application in a rehabilitation program.(AU)

Correlation of Lumbar Vertebrae Position Perception to Psoas Muscles Endurance and Pain in Chronic Non-specific Low Back Pain Patients / 中国康复理论与实践

@#Objective To investigate the position sense in chronic non-specific low back pain (CNLBP) patients, and the correlation to pain and endurance of psoas muscles. Methods From January, 2014 to May, 2015, 30 patients with CNLBP and other 30 healthy subjects were measured spine flexion and extension position sense absolute error (AE) and psoas endurance with Biodex System 3 synchronously, and the patients were self-assessed the pain in lumbar with Numerical Rating Scale (NRS). The Pearson correlation coefficient of AE to pso-as endurance and NRS was calculated. Results AE of flexion and extension was both more in the patients than in the healthy (t>1.862, P<0.05), and the psoas muscle endurance was less (t=2.307, P<0.05). AE of flexion (r=-0.71) and extension (r=-0.47) negatively correlated with the psoas muscle endurance in the patients, and positively correlated with NRS score (r=0.78 for flexion, and r=0.49 for extension). AE mildly negative correlated with the psoas muscle endurance (r=-0.38 for flexion, and r=-0.29 for extension). Conclusion Spine sensation has been impaired in CNLBP patients, and may associate with pain and psoas muscles endurance loss.

Immediate Effects of Lower Limb with Open Chain Weight-adding on Joint Position Sense and Gait Symmetry in Stroke Patients / 中国康复理论与实践

Objective To investigate the immediate effects of lower limb with open chain weight-adding on joint position sense and gait symmetry in stroke patients. Methods From January, 2016 to January, 2017, 39 stroke patients were included. Their joint position sense and gait symmetry were compared before and after weight-adding. The joint position senses of active reproduction of active positioning (ARAP) and passive reproduction of passive positioning (PRPP) were assessed during lower limb straight leg raise. The gait symmetry was also as-sessed and three indexes were recorded including the symmetry of foot rotation angle, step length and percentage of single leg support phase. Results After weight-adding, the position sense of PRPP did not improve (t=0.832, P=0.832), nor of the symmetry of foot rotation an-gle (t=-0.704, P=0.483) and percentage of single leg support phase (t=0.381, P=0.702);the position sense of ARAP improved (t=3.158, P=0.011), as well as the symmetry of step length (t=2.022, P=0.041). Conclusion The lower limb with open chain weight-adding could im-prove the active joint position sense and symmetry of step length.

The Brief Kinesthesia test is feasible and sensitive: a study in stroke

BACKGROUND: Clinicians lack a quantitative measure of kinesthetic sense, an important contributor to sensorimotor control of the hand and arm. OBJECTIVES: The objective here was to determine the feasibility of administering the Brief Kinesthesia Test (BKT) and begin to validate it by 1) reporting BKT scores from persons with chronic stroke and a healthy comparison group and 2) examining the relationship between the BKT scores and other valid sensory and motor measures. METHOD: Adults with stroke and mild to moderate hemiparesis (N=12) and an age-, gender-, and handedness-matched healthy comparison group (N=12) completed the BKT by reproducing three targeted reaching movements per hand with vision occluded. OTHER MEASURES: the Hand Active Sensation Test (HASTe), Touch-Test(tm) monofilament aesthesiometer, 6-item Wolf Motor Function Test (Wolf), the Motor Activity Log (MAL), and the Box and Blocks Test (BBT). A paired t-test compared BKT scores between groups. Pearson product-moment correlation coefficients assessed the relationship between BKT scores and other measures. RESULTS: Post-stroke participants performed more poorly on the BKT than comparison participants with their contralesional and ipsilesional upper extremity. The mean difference for the contralesional upper extremity was 3.7 cm (SE=1.1, t=3.34; p<0.008). The BKT score for the contralesional limb was strongly correlated with the MAL-how much (r=0.84, p=0.001), the MAL-how well (r=0.76, p=0.007), Wolf (r=0.69, p=0.02), and the BBT (r=0.77, p=0.006). CONCLUSIONS: The BKT was feasible to administer and sensitive to differences in reaching accuracy between persons with stroke and a comparison group. With further refinement, The BKT may become a valuable clinical measure of post-stroke kinesthetic impairment.

Research Status and Prospects of Lumbar Proprioception Test (review) / 中国康复理论与实践

Lumbar dysfunction closely relates to the weakness or deficiency of lumbar proprioception, and accurate and comprehensive lumbar proprioception test is the important basis of training program formulation, efficacy assessment and prognostic evaluation. Compre-hensive lumbar proprioception test includes position sense test, kinesthesia test and vibration sense test. It has been widely used in clinic at abroad, and is rich in test equipments and methods. Domestic research is still at the preliminary stage in this field, and is lack of accurate, ob-jective and unified test methods. According to an overview of relevant literature, this article discussed the lumbar proprioception test meth-ods, the influential factors and reliability of the test, finally, put forward the prospects about the research direction in this field.

Research Status and Prospects of Lumbar Proprioception Test (review) / 中国康复理论与实践

@#Lumbar dysfunction closely relates to the weakness or deficiency of lumbar proprioception, and accurate and comprehensive lumbar proprioception test is the important basis of training program formulation, efficacy assessment and prognostic evaluation. Comprehensive lumbar proprioception test includes position sense test, kinesthesia test and vibration sense test. It has been widely used in clinic at abroad, and is rich in test equipments and methods. Domestic research is still at the preliminary stage in this field, and is lack of accurate, objective and unified test methods. According to an overview of relevant literature, this article discussed the lumbar proprioception test methods, the influential factors and reliability of the test, finally, put forward the prospects about the research direction in this field.

Semi-rigid brace and taping decrease variability of the ankle joint position sense / Órtese semi-rígida e bandagem funcional diminuem a variabilidade do senso de posição da articulação do tornozelo / Órtesis semi-rígida y vendaje funcional reducen la variabilidad de la sensación de posición articular del tobillo

The present study investigated the effect of taping and the semi-rigid ankle brace on ankle joint position sense. Sixteen healthy women (20.8 ± 2.3 years old) actively placed the ankle in a target position. The experimental conditions were: 1) wearing no orthosis device, 2) using semi-rigid brace, and 3) wearing ankle taping. Absolute error (AE) and variable error (VE) were calculated to obtain the joint position sense. We found an interaction effect between condition and target angle at 15o of plantar flexion for the variable VE, which showed smaller errors during the use of taping and semi-rigid brace. In conclusion, the use of ankle joint orthoses, whether taping or semi-rigid brace, decrease the variability of the position sense at 15o of plantar flexion, potentially decreasing ankle sprains occurrence...

"Órtese semi-rígida e bandagem funcional diminuem a variabilidade do senso de posição da articulação do tornozelo." O presente estudo investigou o efeito da bandagem funcional e da órtese semi-rígida no senso de posição da articulação do tornozelo. Dezesseis mulheres saudáveis (20.8 ± 2.3 anos) posicionaram seus tornozelos ativamente nas posições alvo. As condições experimentais foram: 1) sem o uso de órtese, 2) com órtese semi-rígida de tornozelo e 3) com bandagem funcional. O erro absoluto (AE) e o erro variável (EV) foram calculados para a obtenção do senso de posição. Houve efeito da interação dos fatores condição e ângulo alvo somente para o EV obtido a 15o de flexão plantar, cujos valores foram menores tanto com o uso de bandagem funcional, quanto com o uso de órtese semi-rígida. Pode-se concluir que o uso de dispositivos de tornozelo, seja bandagem funcional ou órtese semi-rígida, diminui a variabilidade do senso de posição da articulação do tornozelo a 15o de flexão plantar, o que sugere uma possível diminuição do risco de ocorrência de entorse de tornozelo...

"Órtesis semi-rígida y vendaje funcional reducen la variabilidad de la sensación de posición articular del tobillo." El objetivo del presente estúdio era poder conocer los efectos de los vendajes y de las tobilleras semi-rígidas en la sensación de posición articular de la articulación del tobillo. Dieciséis mujeres sanas (20,8 ± 2,3 años) tomaron sus tobillos activamente en posiciones de destino. Las condiciones experimentales fueron: 1) sin usar ningún dispositivo ortopédico, 2) con órtesis semi-rígida, y 3) con vendaje funcional. Los errores absolutos (EA) y los errores variables (EV) fueron calculados para obtener la sensación de posición articular. Hubo un efecto de la interacción entre la condición y el ángulo de destino a 150 flexión plantar sólo para el EV, el cual mostró menores errores en cuenta con vendaje funcional, como así también con la órtesis semi-rígida. En conclusión, el uso de órtesis de tobillo, ya sean la vendaje o bien órtesis semi-rígida, reducen la variabilidad de la sensación de posición articular a 150 flexión plantar, lo que sugiere una posible disminución en el riesgo de esguince de tobillo...

The reliability of knee joint position testing using a dynamometer / 中华物理医学与康复杂志

Objective To determine the intra-and inter-tester reliability of a dynamometer in assessment of knee joint position senses (JPS).Methods Sixteen healthy volunteers (intra-rater N =6,inter-rater N =10) were examined with regard to intra-and inter-tester reliability of knee JPS by using Biodex System 3 dynamometer,measured by passive replication test,with subjects passively returning to the initial positions at 30°,45° and 60° knee flexion.The absolute error (AE) angle was recorded.Both intra-and inter-tester reliability studies involved two testers.Results The intra-tester reliability of the AE were moderate reliable at 30°,45°and 60° knee flexion,and the values of intra-class correlation coefficients (ICC) were 0.728,0.780 and 0.807,respectively.The values of Pearson's correlation coefficients for inter-tester reliability were 0.676,0.610 and 0.705,respectively (P ＜ 0.05).There was no significant difference between the AE values of dominance and non-dominant knees,test and retest,and in the AE values of 30°,45°and 60° knee flexion (P ＞ 0.05).The 95％ confidence upper limits of all subjects' AE values were less than 3°.Conclusion The major findings of this study suggest that the test-retest reliability of the knee JPS were moderate using Biodex System 3 dynamometer,and selecting a target angle of passive replication test can achieve the same purpose in 30° to 60°knee flexion.The clinical significance should be taken into consideration when the AE changes were greater than 3 degrees.

Lumbar Repositioning Accuracy as a Measure of Proprioception in Patients with Back Dysfunction and Healthy Controls

STUDY DESIGN: A control group cross-sectional design. PURPOSE: To compare the difference in repositioning accuracy, as a measure of lumbar proprioception, between patients with back dysfunction and healthy subjects. OVERVIEW OF LITERATURE: Evidence suggests that spinal stability might be compromised in patients with back dysfunction. Lumbar proprioception in back dysfunction has not, however, been adequately investigated. METHODS: Forty-five participants, representing three groups, took part in the study. Subjects in group one (n = 15) were healthy subjects. Subjects in group two (n = 15) had a history of non-specific mechanical back dysfunction, while subjects in group three (n = 15) had discogenic back dysfunction. Subjects were required to reproduce a target position of 30degrees lumbar flexion and the absolute error (AE) was calculated. RESULTS: The AEs between target and reproduced positions were calculated. The average repositioning AEs were 2.8, 7.5, and 7.1degrees for the control, mechanical, and discogenic back dysfunction groups respectively. Analysis of variance revealed significant difference between the three groups (p < 0.0002). The AEs were greater in the two back dysfunction groups compared to the control group. Post-hoc tests revealed significant difference in AEs between the control and mechanical group (p < 0.0003), and discogenic group (p < 0.0001), while there was no significant difference between the mechanical and discogenic back dysfunction groups (p = 0.73). CONCLUSIONS: Differences in proprioception do exist between subjects with back dysfunction and normal subjects. The proprioceptive deficits do exist regardless of the cause of the back dysfunction, and may represent an important aspect of the patho-physiology of such a condition.

The Evaluation of Proprioceptive Function and Effectiveness of Joint Position Sense Test after Meniscal Allograft Transplantation / 대한스포츠의학회지

To evaluate the effects on the restoration of proprioception, we compared joint position sense (JPS) after meniscal allograft transplantation. Nine patients who underwent meniscal allograft transplantation between March 2008 and January 2010 were evaluated at preoperation and 6 months post-operation. International Knee Documentation Committee (IKDC) subjective score and Lysholm score were evaluated. The peak torque of the isokinetic flexor and extensor strength test was performed using Biodex system III. Passive JPS was assessed to evaluate proprioceptive function. In the results, IKDC subjective score and Lysholm score were improved (p=0.05). The flexor and extensor power decreased, however there was no statistically significant difference. In the assessment of JPS, there was improvement from 6.56degrees and 4.11degrees to 4.89degrees and 1.89degrees, however, this was not statistically significant. Although, proprioception was improved in JPS at 6 months after meniscus transplantation, it did not show statistic significance. Therefore, future studies using combined methods will be needed to evaluate proprioceptive function after meniscal allograft transplantation.

The Effectiveness of Joint Position Sense Test in Evaluating the Proprioceptive Function after Anterior Cruciate Ligament Reconstruction / 대한스포츠의학회지

We designed a study to evaluate the change of the proprioceptive function with joint position sense (JPS) during 1 year follow-up period after anterior cruciate ligament (ACL) reconstruction using hamstring autograft. Thirty-eight men who underwent ACL reconstruction were tested for International Knee Documentation Committee subjective knee score, Tegner activity score, Lysholm score, KT-2000 arthrometer, isokinetic strength test, functional performance test (carioca, co-contraction, shuttle run test, one-hop test) and JPS at preoperation, 6 months, and 12 months postoperation. The contralateral healthy knee was used as control. There were no significant differences of JPS between the involved knee and healthy knee at any time period. Repeated measures analysis of variance of the active JPS revealed that there was no significant difference during the follow up periods. The change patterns of passive JPS of extension and flexion were out of accordance with the improving clinical status following ACL reconstruction. Most of the clinical parameters did not show the significant correlation with active and passive JPS at any time period. In conclusion, JPS does not reflect the change of proprioceptive function following ACL reconstruction.

Reliability of Passive Knee Joint Position Sense Test

OBJECTIVE: To investigate the optimal number of repetition trials and to evaluate the test-retest reliability of passive knee joint position sense test. METHOD: Thirty healthy subjects were tested with isokinetic machine. The knee joints were placed in starting angle of 0degrees for flexion test and 90degrees for extension test. To memorize the target angle, the knees were passively positioned to the target angle (30degrees in flexion test and 60degrees in extension test) and left hold for 10 seconds, and returned to starting position. After these processes, knee joints were passively moved toward target angles. The subjects were instructed to press button when the memorized angles were estimated to be reproduced. The tests were performed 6 times for each test angle. After 48 hours, the tests were repeated. Intra-class correlation coefficients (ICC) were calculated with the values of test and retest. RESULTS: There were no significant differences in absolute angular errors (AAE) between dominant and non-dominant side. The ICC value of above five repetitions of test showed excellent reliability (0.807) whereas three and four repetitions showed moderate reliabilities (0.536~0.709). CONCLUSION: From the results of this study, we suggest that five repetitions of test could be appropriate for the passive joint position sense test.