Effect of Load, Angle, and Contraction Type on Clinically Assessed Knee Joint Position Sense

2021 ◽  
pp. 1-6
Author(s):  
Adam L. Haggerty ◽  
Janet E. Simon ◽  
Dustin R. Grooms ◽  
Jeffrey A. Russell
Keyword(s):  
Body Position ◽  
Eccentric Contraction ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Active Joint ◽  
Concentric Contraction ◽  
Target Angle ◽  
Significant Difference ◽  
Contraction Type

Context: Proprioception is an individual’s awareness of body position in 3-dimensional space. How proprioceptive acuity changes under varying conditions such as joint position, load, and concentric or eccentric contraction type is not well understood. In addition, a limitation of the variety of techniques to assess proprioception is the lack of clinically feasible methods to capture proprioceptive acuity. The purpose of this study was to implement a readily available instrument, a smartphone, in the clinical evaluation of knee active joint position sense and to determine how joint angle, joint loading, and quadriceps contraction type affect an individual’s active joint position sense. Design: Cross-over study. Methods: Twenty healthy, physically active university participants (10 women and 10 men: 21.4 [2.0] y; 1.73 [0.1] m; 70.9 [14.3] kg) were recruited. Individuals were included if they had no neurological disorder, no prior knee surgery, and no recent knee injury. The participants were given a verbal instruction to locate a target angle and then were tasked with reproducing the target angle without visual or verbal cues. An accelerometer application on a smartphone was used to assess the angle to the nearest tenth of a degree. Three variables, each with 2 levels, were analyzed in this study: load (weighted and unweighted), contraction type (eccentric and concentric), and joint position (20° and 70°). A repeated-measures analysis of variance was conducted to assess the within-subjects factors of load, contraction, and position. Results: A significant difference of 0.50° (0.19°) of greater error with eccentric versus concentric contraction (P = .02) type was identified. In addition, a significant interaction was found for contraction × position, with a mean increase in error of 0.98° (0.33°) at the 20° position when contracting eccentrically (P = .03). Conclusions: Contraction type, specifically eccentric contraction at 20°, showed significantly greater error than concentric contraction. This suggests that, during eccentric contractions of the quadriceps, there may be decreased proprioceptive sensitivity compared with concentric contractions.

scholarly journals Dynamic-Position-Sense Impairment’s Independence of Perceived Knee Function in Women With ACL Reconstruction

2012 ◽  
Vol 21 (1) ◽  
pp. 44-53 ◽  
Author(s):  
Andrew E. Littmann ◽  
Masaki Iguchi ◽  
Sangeetha Madhavan ◽  
Jamie L. Kolarik ◽  
Richard K. Shields
Keyword(s):  
Processing Time ◽  
Cruciate Ligament ◽  
Position Sense ◽  
Joint Position Sense ◽  
Knee Function ◽  
Joint Position ◽  
Active Joint ◽  
Cross Sectional ◽  
Outcome Measurements ◽  
Target Angle

Context:There is conflicting evidence in the literature regarding whether women with anterior cruciate ligament reconstruction (ACLR) demonstrate impaired proprioception. This study examined dynamic-position-sense accuracy and central-nervous-system (CNS) processing time between those with and without long-term ACLR.Objective:To compare proprioception of knee movement in women with ACLR and healthy controls.Design:Cross-sectional.Setting:Human neuromuscular performance laboratory.Participants:11 women (age 22.64 ± 2.4 y) with ACLR (1.6–5.8 y postsurgery) and 20 women without (age 24.05 ± 1.4 y).Interventions:The authors evaluated subjects using 3 methods to assess position sense. During knee flexion at pseudorandomly selected speeds (40°, 60°, 80°, 90°, and 100°/s), subjects indicated with their index finger when their knee reached a predetermined target angle (50°). Accuracy was calculated as an error score. CNS processing time was computed using the time to detect movement and the minimum time of angle indication. Passive and active joint-position sense were also determined at a slow velocity (3°/s) from various knee-joint starting angles.Main Outcome Measurements:Absolute and constant error of target angle, indication accuracy, CNS processing time, and perceived function.Results:Both subject groups showed similar levels of error during dynamic-position-sense testing, despite continued differences in perceived knee function. Estimated CNS processing time was 260 ms for both groups. Joint-position sense during slow active or passive movement did not differ between cohorts.Conclusions:Control and ACLR subjects demonstrated similar dynamic, passive, and active joint-position-sense error and CNS processing speed even though ACLR subjects reported greater impairment of function. The impairment of proprioception is independent of post-ACLR perception of function.

The Efficacy of Modern Technology to Improve Healthy and Injured Shoulder Joint Position Sense

1999 ◽  
Vol 8 (1) ◽  
pp. 10-23 ◽  
Author(s):  
Semyon M. Slobounov ◽  
Shannon T. Poole ◽  
Robert F. Simon ◽  
Elena S. Slobounov ◽  
Jill A. Bush ◽  
...  
Keyword(s):  
Shoulder Joint ◽  
Healthy Subjects ◽  
Position Sense ◽  
Joint Position Sense ◽  
Modern Technology ◽  
Shoulder Abduction ◽  
Joint Position ◽  
Reproduction Task ◽  
Significant Difference ◽  
Visualization Techniques

Assessment and enhancement of joint position sense is an inexact science at best. Anew method of evaluating and improving this sense using motion-tracking technology that incorporates computer visualization graphics was examined. Injured and healthy subjects were evaluated for their abilities to determine shoulder joint position, after abduction, in two tasks. The first was active reproduction of a passively placed angle. The second was visual reproduction of such an angle. A training protocol was added to determine the effectiveness of proprioceptive training in conjunction with 3-D visualization techniques. The primary findings were (a) a significant difference (p= .05) in the level of joint position sense in injured vs. healthy subjects; (b) significantly less accurate reproduction of larger shoulder abduction vs. the smaller movement in the active reproduction task; (c) significantly greater ability to accurately reproduce angles actively vs. visually; and (d) that proprioception training using 3-D visualization techniques significantly increased activeandvisual reproductions of passively placed angles.

scholarly journals Criterion-Related Validity of Knee Joint-Position-Sense Measurement Using Image Capture and Isokinetic Dynamometry

2015 ◽  
Vol 24 (1) ◽  
Author(s):  
Nicola Relph ◽  
Lee Herrington
Keyword(s):  
Knee Joint ◽  
Knee Flexion ◽  
Cost Effective ◽  
Absolute Error ◽  
Knee Extension ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Image Capture ◽  
Significant Difference

Context: Clinicians require portable, valid, and cost-effective methods to monitor knee joint-position-sense (JPS) ability. Objective: To examine the criterion-related validity of image-capture JPS measures against an isokinetic-dynamometer (IKD) procedure. Design: Random crossover design providing a comparison of knee JPS measures from image capture and IKD procedures. Participants: 10 healthy participants, 5 female, age 28.0 ± 13.29 y, mass 60.3 ± 9.02 kg, height 1.65 ± 0.07 m, and 5 male, 29.6 ± 10.74 y, mass 73.6 ± 5.86 kg, height 1.75 ± 0.07 m. Main Outcome Measures: The dependent variables were absolute error scores (AES) provided by 2 knee directions (flexion and extension). The independent variables were the method (image capture and IKD). Results: There was no significant difference between clinical and IKD AED into knee-extension data (P = .263, r = 0.55). There was a significant difference between clinical and IKD AES into knee-flexion data (P = .016, r =.70). Conclusions: Analysis of photographic images to assess JPS measurements using knee flexion is valid against IKD techniques. However, photo-analysis measurements provided a lower error score using knee-extension data and thus may provide an optimal environment to produce maximal knee JPS acuity. Therefore, clinicians do not need expensive equipment to collect representative JPS ability.

scholarly journals A Clinical Shoulder Proprioception Test Shows Good Reliability, and Decreased Shoulder Joint Position Sense Due to Local Fatigue in Handballers: A Repeated Measures Design

2021 ◽  
Author(s):  
Peter Sutton ◽  
Marie Ohlsson ◽  
Ulrik Röijezon
Keyword(s):  
Shoulder Joint ◽  
Repeated Measures ◽  
Intraclass Correlation ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Good Reliability ◽  
Repeated Measures Design ◽  
Significant Difference ◽  
Specialized Equipment

Abstract Background: Assessment of shoulder proprioception outside the laboratory in the absence of specialized equipment remains a challenge with field-based tests often lacking good reliability, validity and feasibility. This study aimed to enhance the knowledge base surrounding the assessment of shoulder proprioception and investigated the effect of fatigue on shoulder joint position sense (JPS) amongst amateur male handball players.Method: 27 healthy recreationally active participants and 13 amateur male handball players undertook two sessions of active JPS tests using laser pen technology and a calibrated 2-dimensional target to assess test-retest reliability. The active JPS test was then utilized on the subgroup of handball players who were subjected to five bouts of a repeated throwing task in order to investigate the effect of local fatigue on shoulder JPS. Results: The intraclass correlation coefficient for the active JPS test was 0.78 (95% CI = [0.57; 0.89]). Standard error of measurement between trials was 0.70° (range 0.57°-0.90°). For the throwing task, repeated measures analysis of variance revealed a significant interaction for arm x bout (F5=2.74, p=0.028) and a significant effect for arm (F1=5.85, p=0.034). Post hoc analysis showed a significant difference between throwing arm and non-throwing arm after throwing bout one (p=0.036), three (p=0.026) and four (p=0.041). Conclusion: Assessment of the active JPS test showed acceptable reliability and measurement error. Repeated throwing to fatigue decreased shoulder JPS in amateur male handball players which indicate validity of the test to identify reduced proprioception.

scholarly journals Reliability of joint position sense measured in the knee using the level function of the iPhone “Measure” application

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256561
Author(s):  
Yuki Nakashima ◽  
Daisuke Iwaki ◽  
Toshihiro Kawae ◽  
Kenichi Fudeyasu ◽  
Hiroaki Kimura
Keyword(s):  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Position Sense ◽  
Joint Position Sense ◽  
Initial Position ◽  
Lower Limbs ◽  
Joint Position ◽  
Target Angle ◽  
Level Function ◽  
The Difference

An impaired joint position sense (JPS) causes activity limitations, postural imbalance, and falls. This study compares the reliability of knee JPS measurements between the iPhone’s “Measure” application and VICON motion capture system. Eleven healthy participants were recruited for the study. To conduct the study measures, the blindfolded participant, with an iPhone fixed to the lower non-dominant leg, was seated with their lower limbs in a relaxed position. The examiner held the participant’s leg at the target angle (30°/60° from initial position) for 5 s before releasing it. The participant was then instructed to move the leg to the same target angle and hold it for 5 s (replicated angle). Absolute angular error (AAE), i.e., the difference between the target and replicated angles, was measured. Intraclass and Pearson correlation coefficients established statistically significant relationships. The study comprised 6 males and 5 females of mean age 27.6±5.6 years, mean height 1.67±0.10 m, and mean body weight 60.7±10.3 kg. Strong correlations existed between iPhone and VICON 30° (ICC = 0.969, r = 0.960, P < 0.001) and 60° AAEs (ICC 0.969, r = 0.960, P < 0.001). Bland-Altman plots showed a mean difference of 0.43° and 0.20° between the AAE measurements at 30° and 60°, respectively. The iPhone’s “Measure” application is a simple and reliable method for measuring JPS in clinical practice and sports/fitness settings.

Effects of Extensive Training on Female Teenage Gymnasts’ Active and Passive Ankle-Joint Position Sense

2002 ◽  
Vol 11 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Taner Aydin ◽  
Yavuz Yildiz ◽  
Cemil Yildiz ◽  
Tunç Alp Kalyon
Keyword(s):  
Ankle Joint ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Mean Values ◽  
Extensive Training ◽  
Significant Difference ◽  
Group 2 ◽  
Female Gymnasts

Objective:To compare the ankle-joint position-sense patterns of gymnasts and nongymnasts.Design:Proprioceptive ability was evaluated with active and passive angle-reproduction tests.Participants:40 subjects assigned to 2 groups: group 1 (n = 20), healthy subjects, and group 2 (n = 20), teenage female gymnasts.Measurements:Joint-position sense was actively measured with a Cybex NORM™ isokinetic dynamometer and passively with a proprioception-testing device.Results:A Mann-Whitney U test was used to compare the mean values of the gymnasts’ and controls’ ankles. Results revealed statistically significant differences (P < .05) between the 2 groups. No statistically significant difference between the dominant and nondominant ankles in the 2 groups was observed.Conclusions:The results suggest that extensive training might affect ankle-joint position sense, but genetics and natural selection could be the reason. It is thought that athletes are able to develop enhanced neurosensory pathways as a result of long-term training.

scholarly journals Surgical Reconstruction with the Remnant Ligament Improves Joint Position Sense as well as Functional Ankle Instability: A 1-Year Follow-Up Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Kamizato Iwao ◽  
Deie Masataka ◽  
Fukuhara Kohei
Keyword(s):  
Ankle Instability ◽  
Intervention Group ◽  
Position Sense ◽  
Joint Position Sense ◽  
Surgical Reconstruction ◽  
Functional Improvement ◽  
Control Group ◽  
Joint Position ◽  
Functional Ankle Instability ◽  
Significant Difference

Introduction. Chronic functional instability—characterized by repeated ankle inversion sprains and a subjective sensation of instability—is one of the most common residual disabilities after an inversion sprain. However, whether surgical reconstruction improves sensorimotor control has not been reported to date. The purpose of this study was to assess functional improvement of chronic ankle instability after surgical reconstruction using the remnant ligament.Materials and Methods. We performed 10 cases in the intervention group and 20 healthy individuals as the control group. Before and after surgical reconstruction, we evaluated joint position sense and functional ankle instability by means of a questionnaire.Results and Discussion. There was a statistically significant difference between the control and intervention groups before surgical reconstruction. Three months after surgery in the intervention group, the joint position sense was significantly different from those found preoperatively. Before surgery, the mean score of functional ankle instability in the intervention group was almost twice as low. Three months after surgery, however, the score significantly increased. The results showed that surgical reconstruction using the remnant ligament was effective not only for improving mechanical retensioning but also for ameliorating joint position sense and functional ankle instability.

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