Test–retest reliability of wrist joint position sense in healthy adults in a clinical setting

Hand Therapy ◽  
2018 ◽  
Vol 23 (3) ◽  
pp. 100-109 ◽  
Author(s):  
Chloë Pilbeam ◽  
Victoria Hood-Moore

Introduction Proprioceptive assessments of the wrist inform clinical decision making. In wrist rehabilitation, joint position sense has emerged as one way of assessing conscious proprioception with varying methods and minimal psychometric analysis reported. The purpose of this study was to standardise the wrist joint position sense test method for clinical use and to determine its test–retest reliability in a healthy population. Methods Four wrist positions (20° and 45° flexion, 20° and 45° extension) were measured twice in a random order, by a single rater, using a universal goniometer on the same day. The absolute error in degrees between each position and reposition was calculated. For relative reliability analysis, the intraclass correlation coefficient (3,1) was calculated. For absolute reliability the standard error of the measurement was calculated and Bland–Altman plots visually inspected. Results Fifty-five healthy volunteers (mean age 31.1 SD±10.25 years) were assessed. The mean absolute error, summarised for all positions for test and retest, was 3.98°. The intraclass correlation coefficients were poor to fair (0.07–0.47), and standard error of the measurement was 2° (rounded) for all positions. The limits of agreement were fairly narrow, and the Bland–Altman plots showed random distribution of errors for each position, therefore the measurement error was clinically acceptable. Conclusions The active wrist joint position sense test using goniometry demonstrated poor to fair test–retest reliability and acceptable measurement error in healthy volunteers. The wrist joint position sense angle of 20° flexion was the most reliable.

2015 ◽  
Vol 24 (2) ◽  
Author(s):  
Nicola Relph ◽  
Lee Herrington

Context: Knee joint-position sense (JPS) plays a critical role in controlled and stable joint movement. Poor ability to sense position of the knee can therefore increase risk of injury. There is no agreed consensus on JPS measurement techniques and a lack of reliability statistics on methods. Objective: To identify the most reliable knee JPS measurement technique using image capture. Design: Interexaminer, intraexaminer, and test-retest reliability of knee JPS measurements. Setting: Biomechanics laboratory. Participants: 10 asymptomatic participants. Interventions: None. Main Outcome Measures: Relative and absolute error scores of knee JPS in 3 conditions (sitting, prone, active) through 3 ranges of movement (10-30°, 30-60°, 60-90°), into 2 directions (flexion and extension) using both legs (dominant and nondominant) collected during 15 trials and repeated 7 d after the first data collection. Results: Statistical analysis by intraclass correlations revealed excellent interexaminer reliability between researchers (.98) and intraexaminer reliability within 1 researcher (.96). Test-retest reliability was highest in the sitting condition from a starting angle of 0°, target angle through 60-90° of flexion, using the dominant leg and absolute-error-score variables (ICC = .92). However, it was noted smallest detectable differences were a high percentage of mean values for all measures. Conclusions: The most reliable JPS measurement for asymptomatic participants has been identified. Practitioners should use this protocol when collecting JPS data during prescreening sessions. However, generalizability of findings to a class/group of clients exhibiting knee pathologies should be done with caution.


2021 ◽  
pp. 1-6
Author(s):  
Fei Tian ◽  
Yaqi Zhao ◽  
Jixin Li ◽  
Wenjin Wang ◽  
Danni Wu ◽  
...  

Context: Many methods used to evaluate knee proprioception have shortcomings that limit their use in clinical settings. Based on an inexpensive 3D camera, a new portable device was recently used to evaluate the joint position sense (JPS) of the knee joint. However, the test–retest reliability of the new method remains unclear. This study aimed to evaluate the test–retest reliability of the new device and a long-arm goniometer for assessing knee JPS, and to compare the variability of the 2 methods. Design: Prospective observational study of the test–retest reliability of knee JPS measurements. Methods: Twenty-one healthy adults were tested in 2 sessions with a 1-week interval. Three target knee flexion angles (30°, 45°, and 60°) were reproduced in each session. Target and reproduced angles were measured with both methods. Intraclass correlation coefficients, standard error of the measurement, and Bland–Altman plots were used to quantify test–retest reliability. Paired t tests were used to compare knee JPS (absolute error of the target-reproduced angle) between the methods. Results: The new device (good to excellent intraclass correlation coefficients .74–.80; standard error of the measurement 0.52°–0.61°) demonstrated better test–retest reliability than the goniometer (poor to fair intraclass correlation coefficients .23–.43; standard error of the measurement 0.89°–2.07°) and better test–retest agreement (respective mean differences for the 30°, 45°, and 60° knee angles: 0.11°, 0.13°, and 0.41° for the new system; 0.84°, 1.52°, and 1.18° for the goniometer). The measurements (absolute errors of the target-reproduced angles) with the goniometer were significantly greater than those with the new device (P < .05); the SDs of repeated measurements with the goniometer (1.50°–2.41°) were greater than with the new device (1.08°–1.38°). Conclusions: Given that the new device has good reliability and sufficient precision, it is the better alternative for evaluating knee JPS. Goniometers should be used with caution to assess knee JPS.


2019 ◽  
Vol 28 (7) ◽  
Author(s):  
Barıs Seven ◽  
Gamze Cobanoglu ◽  
Deran Oskay ◽  
Nevin Atalay-Guzel

Context:The evaluation of the wrist strength and proprioception gives clinicians and researchers information about effectiveness of their rehabilitation protocol or helps diagnosis of various neuromuscular and somatosensorial disorders. Isokinetic dynamometers are considered the gold standard for these evaluations. However, the studies about test–retest reliability of isokinetic dynamometer are inadequate.Objective:The purpose of this study was to determine the test–retest reliability of isokinetic wrist strength and proprioception measurements using the Cybex isokinetic dynamometer.Design:Test–retest reliability study.Setting:University laboratory.Participants:Thirty participants were enrolled (age 23.2 [2.8] y, height 171.1 [7] cm, weight 66.6 [11.6] kg) in this study.Intervention:Cybex isokinetic dynamometer was used for strength and proprioception measurements.Main Outcome Measures:Concentric flexion–extension strength test was performed at 90°/s angular velocity, and eccentric flexion–extension strength test was performed at 60°/s angular velocity. The proprioception of the wrist was assessed via active joint position sense. The 30° extension of the wrist, which is accepted as the functional position of the wrist, was selected as the targeted angle. The intraclass correlation coefficient (ICC2,1) method was used for test–retest analysis (P < .05).Results:The active joint position sense measurements of dominant (ICC2,1: .821) and nondominant (ICC2,1: .763) sides were found to have good test–retest reliability. Furthermore, with the exception of dominant eccentric extension strength (moderate reliability) (ICC2,1: .733), eccentric and concentric flexion (dominant: ICC2,1 = .890–.844; nondominant: ICC2,1 = .800–.898, respectively), and extension (dominant: ICC2,1 = .791 [concentric], nondominant: ICC2,1 = .791–.818, respectively) strength measurements of both sides were found to have good reliability.Conclusions:This study shows that the Cybex isokinetic dynamometer is a reliable method for measuring wrist strength and proprioception. Isokinetic dynamometers can be used clinically for diagnosis or rehabilitation in studies which contain wrist proprioception or strength measurements.


2015 ◽  
Vol 24 (1) ◽  
Author(s):  
Nicola Relph ◽  
Lee Herrington

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.


2014 ◽  
Vol 20 (4) ◽  
pp. 448-453 ◽  
Author(s):  
Márcia Barbanera ◽  
Flávia de Andrade e Souza Mazuchi ◽  
José Paulo Berretta Batista ◽  
Janaina de Moura Ultremare ◽  
Juliana da Silva Iwashita ◽  
...  

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.


2021 ◽  
Author(s):  
Peter Sutton ◽  
Marie Ohlsson ◽  
Ulrik Röijezon

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.


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