Evaluation of shoulder kinesthesia in patients with unilateral frozen shoulder

Background: Intact sensory-motor system provides kinesthesia for maintaining joint stability. Joint proprioception or joint kinesthetic sensation is often used alternately to describe a deep sensation of joint motion and joint position sense. Mechanoreceptors located in superficial layer of joint capsule, muscle spindle, golgi tendon organ complex and ligaments around joint provides joint kinesthetic sensation. Frozen shoulder or adhesive capsulitis is one of the common musculoskeletal disorders encountered in Indian population with a prevalence of almost 50% older patients with diabetes and 2-10% in non-diabetic patients. This study assessed joint kinesthetic sensation during shoulder movements in people with frozen shoulder and healthy controls which may be affected due to presence of disease process or pain. Authors hypothesized that pain and alterations in non-contractile tissues (mainly capsule) around shoulder joint due to frozen shoulder may interfere with the joint kinesthetic sensation.Methods: Case group consisted of 41 participants with frozen shoulder and 41 healthy participants without shoulder pathology. Joint kinesthesia was assessed in frozen shoulders and dominant shoulders using angle reproduction test by actively reproducing the target angle placed passively by the therapist during flexion, abduction, medial and lateral rotation movements. The angle reproduced was measured using universal goniometer by the same therapist and 3 readings were recorded.Results: Results indicate significant differences between the mean difference of angle reproduction test during shoulder movements in cases of frozen shoulder and healthy group (p value <0.05).Conclusions: Significant shoulder kinesthetic deficits were observed in patients with unilateral frozen shoulder. Therefore, clinicians should consider rehabilitation of kinesthesia in treatment of patients with frozen shoulder.

Proprioception of Knee Joint in Athletes and Non-Athletes Obese

<p><strong>BACKGROUND</strong><strong>: </strong>Proprioception plays an integral role in the neuromotor control of the knee joint. The objective of this study was to evaluate the relationship of knee joint proprioception deficit and regular exercise activities with obesity.</p><p><strong>MATERIAL/METHOD</strong><strong>: </strong>In this case control study, we had 60 participants, aged 18 to 35 in four groups (15 athletes obese; 15 athletes with normal weight; 15 non-athletes obese; 15 non-athletes with normal weight). The average Body Mass Index for the obese groups was 33.50±(3.10) kg/m² and for the normal weight groups was 23.77±(2.94) kg/m². We used a Biodex Multi-Joint System 4 Isokinetic Dynamometer to examine proprioception acuity as the amount of a subject's error when trying to reproduce a test knee extension angle (a measure of the joint position sense). We tested proprioception actively (active reproduction test; AAR) and passively (passive reproduction test; PAR) in the right leg.</p><p><strong>RESULTS: </strong>The non-athlete obese group had significantly poorer proprioception acuity in the knee extension movement compared to the normal weight groups and also compared to the athlete obese group. For knee active angle reproduction test AAR, a significant difference was found (p=0.011). The results for passive angle reproduction test PAR, revealed no significant differences between the four groups (p=0.596).</p><p><strong>CONCLUSIONS:</strong> The obese groups showed a deficit in the proprioception function in knee extension movement. Furthermore, the findings suggest that doing regular weight bearing training is associated with better proprioceptive function, even in obese groups. It could manifest that the deleterious effect of obesity on the knee joint proprioception might be stronger than the beneficial influence of exercise training.</p>