Acute Impact of Proprioceptive Exercise on Proprioception and Balance in Athletes

This study aimed to compare the acute effect of a proprioceptive exercise session and a non-specific exercise session on knee position sense, and the static and dynamic balance of athletes. Sixty male athletes (19.4 ± 1.2 years) participated in a within-subjects repeated-measures study. Knee position sense in closed kinetic chain, and static (BESS test) and dynamic balance (Y-balance test) were measured before and after two exercise sessions, consisting of 10 min of non-specific exercise in a cycle-ergometer or proprioceptive exercise with an unstable platform. Overall, both exercise sessions significantly improved knee position sense, BESS score, and YBT composite score, and no differences were detected between proprioceptive and non-specific sessions (knee position sense, −6.9 ± 65.2% vs. −11.5 ± 75.0%, p = 0.680; BESS, −19.3 ± 47.7% vs. −29.03 ± 23.5%, p = 0.121; YBT, 2.6 ± 2.7% vs. 2.2 ± 2.2%, p = 0.305). Twenty athletes did not improve knee position sense after the exercise session (non-responders). When analyzing only the exercise responders, both sessions improved knee position sense, but the improvement was greater after the proprioceptive exercise session (56.4 ± 25.6% vs. 43.8 ± 18.9%, p = 0.023). In conclusion, a single proprioceptive, as well as non-specific, exercise session increased knee position sense and balance. The proprioceptive exercise seems to be more effective in improving joint position sense when considering only athletes who respond to the intervention.

Reliability of hip joint position sense tests using a clinically applicable measurement tool in elderly participants with unilateral hip osteoarthritis

Hip joint proprioception is vital in maintaining posture and stability in elderly individuals. Examining hip joint position sense (JPS) using reliable tools is important in contemporary clinical practice. The objective of this study is to evaluate the intra-rater and inter-rater reliability of hip JPS tests using a clinically applicable measurement tool in elderly individuals with unilateral hip osteoarthritis (OA). Sixty-two individuals (mean age = 67.5 years) diagnosed with unilateral hip OA participated in this study. The JPS tests were evaluated using a digital inclinometer in hip flexion and abduction directions. The absolute difference between target and reproduced angle (repositioning error) in degrees was taken to measure JPS accuracy. The intraclass correlation coefficient (ICC (2.k), was used to assess the reliability. The Intra rater-reliability for hip JPS tests showed very good agreement in the lying position (hip flexion-ICC = 0.88–0.92; standard error of measurement (SEM) = 0.06–0.07, hip abduction-ICC = 0.89–0.91; SEM = 0.06–0.07) and good agreement in the standing position (hip flexion-ICC = 0.69–0.72; SEM = 0.07, hip abduction-ICC = 0.66–0.69; SEM = 0.06–0.08). Likewise, inter-rater reliability for hip JPS tests demonstrated very good agreement in the lying position (hip flexion-ICC = 0.87–0.89; SEM = 0.06–0.07, hip abduction-ICC = 0.87–0.91; SEM = 0.07) and good agreement in the standing position (hip flexion-ICC = 0.64–0.66; SEM = 0.08, hip abduction-ICC = 0.60–0.72; SEM = 0.06–0.09). The results support the use of hip JPS tests in clinical practice and should be incorporated in assessing and managing elderly participants with hip OA.

Association between Kinesiophobia and Knee Pain Intensity, Joint Position Sense, and Functional Performance in Individuals with Bilateral Knee Osteoarthritis

In current clinical practice, fear of movement has been considered a significant factor affecting patient disability and needs to be evaluated and addressed to accomplish successful rehabilitation strategies. Therefore, the study aims (1) to establish the association between kinesiophobia and knee pain intensity, joint position sense (JPS), and functional performance, and (2) to determine whether kinesiophobia predicts pain intensity, JPS, and functional performance among individuals with bilateral knee osteoarthritis (KOA). This cross-sectional study included 50 participants (mean age: 67.10 ± 4.36 years) with KOA. Outcome measures: The level of kinesiophobia was assessed using the Tampa Scale of Kinesiophobia, pain intensity using a visual analog scale (VAS), knee JPS using a digital inclinometer, and functional performance using five times sit-to-stand test. Knee JPS was assessed in target angles of 15°, 30°, and 60°. Pearson’s correlation coefficients and simple linear regressions were used to analyze the data. Significant moderate positive correlations were observed between kinesiophobia and pain intensity (r = 0.55, p < 0.001), JPS (r ranged between 0.38 to 0.5, p < 0.05), and functional performance (r = 0.49, p < 0.001). Simple linear regression analysis showed kinesiophobia significantly predicted pain intensity (B = 1.05, p < 0.001), knee JPS (B ranged between 0.96 (0° of knee flexion, right side) to 1.30 (15° of knee flexion, right side)), and functional performance (B = 0.57, p < 0.001). We can conclude that kinesiophobia is significantly correlated and predicted pain intensity, JPS, and functional performance in individuals with KOA. Kinesiophobia is a significant aspect of the recovery process and may be taken into account when planning and implementing rehabilitation programs for KOA individuals.

Effect of Topical Cooling with Ice and Cold Spray on Knee Joint Position Sense of Athletes with Patellofemoral Pain Syndrome

Background: Patellofemoral pain syndrome (PFPS) is one of the most common knee injuries in athletes and non-athletes. Due to the pain and muscle inhibition, it is possible that the disorder has negative effects on joint position sense. Cryotherapy is one of the most common methods applied in sports injuries. Objectives: The aim of this study was to evaluate the effect of topical cooling with ice and cold spray on knee joint position sense of athletes with PFPS. Methods: In this quasi-experimental study, 30 athletes with PFSP were divided into two groups of cold spray and crushed ice application. The effect of cooling on joint position sense was measured by the target reconstruction method (30° of knee flexion) while standing. In order to analyze the data, SPSS 23 and statistical tests of Shapiro-Wilk, paired t-test, and independent t-tests were used. The absolute error of 30° knee flexion angle reconstruction immediately after cryotherapy was significantly higher than before it in various cooling methods. Nevertheless, crushed ice application had a greater impact on the accuracy of joint position sense than spraying. Results: The results of this study indicate the negative effects of cryotherapy on the accuracy of the knee joint position sense (P < 0.05). However, cryotherapy with crushed ice application has a greater effect on reducing the accuracy of joint position sense (P < 0.001) than cold spray (P < 0.001). Conclusions: Decreased accuracy of position sense is likely to cause mechanical instability and increase the rate of injury. Therefore, it is recommended to use crushed ice application rather than topical cooling to reduce the knee joint position sense.

The Effects of Estrogen and Progesterone Hormones on Active Hip Joint Position Sense in Healthy Women in Different Phases of a Menstrual Cycle

Introduction: The proprioceptive system is a sensory system based on an individual’s knowledge of his or her body. This knowledge is transmitted to the brain through inputs received from joints, muscles, tendons, and ligaments. As a result, these inputs inadvertently inform the brain of the state of the body’s muscles. Numerous factors can affect this system. This study aimed to investigate the effect of estrogen and progesterone hormones on understanding and recognizing the proprioceptive sense of hip joint in healthy women during the menstrual cycle. Materials and Methods: In this quasi-experimental study, 15 healthy women participated voluntarily. They had regular menstrual cycles without any history of disease and drug use. The concentration of estrogen and progesterone during a cycle in the follicular (4-6 days), ovulation, and luteal phases were evaluated to detect their effects on the sense of perception and cognition of the proprioceptive joint in the two movements of abduction and flexion by the target angle reconstruction method (30°). Results: The errors of active joint position sense were reduced in abduction and flexion during ovular and luteal phases compared to the follicular phase. However, in the flexion direction of hip movement, there was a significant difference in absolute error during hormonal changes in the menstrual cycle (P=0.000). Conclusion: The results showed that due to more involvement of motor control of hip muscles joint by motor neuron activity (increase release of estrogen hormone), all errors reduced in ovular and luteal phases compared to the follicular phase. The flexion movement is more disturbed, and due to more flexibility in this direction, absolute errors are significantly reduced. This reduction of errors in ovular and luteal phases compared to the regular stage of hormone release (follicular phase) may cause some rigidity in the hip joint and an increase of trauma in external mechanical forces. This study’s findings showed that the lowest proprioception sensation is in the follicular phase. Decreasing the concentration of sex hormones in this phase is likely to reduce the sense of recognition of the joint, thus increasing the likelihood of injury in this phase. Findings from this study showed that the lowest proprioceptic sensation is in the follicular phase. The results of this study showed that the least sense is Prvpryvsptyk in Fazfvlykvlar.

Effect of multidirectional and unidirectional wobble board lateral step-upexercise in pain, symptom and ADLamong unilateral medial compartmental osteoarthrosis of knee

Introduction and Aim:Osteoarthrosis is defined as degenerative condition of the synovial joints. Weak thigh muscle will cause impaired walking and balance and leads to risk of fall during activities of daily living. Use of MD and UD wobble board is hypothesized to improve balance and proprioception. So, pain, muscle power and proprioception are clinically important for balance control. Hence there is a need to study weight bearing exercise to hip abductor in various balance strategies to achieve muscle strength, joint position sense, balance, and activity of daily living. Methodology: Knee osteoarthrosis subjects(n=219) were selected according to selection criteria andwere randomly allocated into 3 groups as multidirectional wobble board lateral step-up exercise group, unidirectional wobble board lateral step-up exercise group and control group. The pre-test KOOS pain, symptoms and ADL measurements were taken before the intervention and another measurement during the 2nd week of intervention and at the end of the intervention period during 4thweek post-test measurements were measured and statistically analysed. Results: At the end of 4th week control, UD and MD was found to be statistically significant with H=200.192 with p<0.001. KOOS symptoms between 3 groups was found to be statistically significant with H=200.288 and p <0.001. KOOS ADL values was found to be statistically significant between 3 groups with H=193.640 and p<0.001. Conclusion: This study concludes that both unidirectional and multidirectional wobble board lateral step-up exercise showed improvement with KOOS pain, symptom and ADL scores compared to control group.

The effect of static stretching of agonist and antagonist muscles on knee joint position sense

Background/Aims Proprioception acuity is important in sports activities and stretching is widely used in warm-up programmes. The main objective of this study was to evaluate if a warm-up programme with and without stretching flexors and extensors muscles could affect knee joint position sense. Methods The effects of different stretching regimens on joint position sense were examined. A total of 12 semi-professional football players completed four warm-up sessions over 4 weeks: standard warm-up programme; standard warm-up programme with quadriceps stretching; standard warm-up programme with hamstring stretching; and standard warm-up programme with stretching of both quadriceps and hamstrings. Open kinetic chain knee joint position sense was estimated from the ability to reproduce the three target angles (20°, 45° and 60° knee flexion) in the dominant limb before and after the intervention. Results In the absolute angular error, there was a statistically significant three-way interaction between the warm-up programme, target angle and time (F (6, 54)=6.88, P=0.001). Findings of post-hoc analysis demonstrated that there was a statistically significant difference between the pre- and post-stretching of hamstrings for the target angles of 20° (4.70 vs 1.57, P=0.01), 45° (1.70 vs 4.50, P=0.02), and 60° (1.93 vs 4.20, P=0.02). In the relative angular error, interaction of time by the warm-up programme was significant (F (3, 27)=3.41, P=0.03). Conclusions The warm-up programme with static stretching of hamstrings had a negative effect on open kinetic chain knee joint position sense during the flexion to extension repositioning task, which may not only have a negative effect on performance of athletes as a part of warm-up exercises, but may also lead to further injuries.

Watching Your Neck: The Influence of Real-Time Visual Feedback on Cervical Joint Position Sense in Chronic Neck Pain

Patients with neck pain demonstrate a variety of sensorimotor impairments, such as decreased cervical joint position sense (CJPS) acuity, which might also be associated with an impaired internal body representation. The present study evaluated the effect of real-time visual feedback of the individual’s own neck on CJPS compared to observing a book. Twenty-three patients with neck pain participated in the experiment and received the interventions in randomized order on separate days in a within-subject pretest–posttest design. Before and immediately after each intervention, CJPS was measured by a therapist blinded to the intervention. The results demonstrate a significantly different development of CJPS (p = .04), with increased CJPS acuity after observing one’s own neck and decreased acuity after observing a book. Real-time visual feedback of the neck improved CJPS acuity in patients with neck pain without active movements of the neck, indicating the importance of central nervous system processing for CJPS acuity.