Abstract
ObjectiveThe aim of the study was to examine the differences in joint position sense at the elbow joint between 15 children with unilateral cerebral palsy (CP) and 15 typically developing (TD) controls without neurological or other health deficits.MethodologyJoint position sense, a major proprioceptive component, was evaluated actively using a Kin Com 125 AP isokinetic dynamometer (Chattanooga Group, Chattanooga, TN).ResultsA significant interaction was found (p<0.05) between disability and side, with respect to the active reproduction movement scores. Post-hoc independent t-tests, with Bonferroni adjustments, revealed significant differences for the dominant (t=-3.63, p=0.001) and non-dominant sides respectively (t=-6.19, p=0.000). Repeated measures t-test revealed wider errors with the non-dominant (affected side) in the active reproduction test, compared to the dominant (nonaffected) side for the CP group of children (t=-4.73, p=0.000). A positive correlation was evident between the level of spasticity and joint position sense (Rho=0.71, p=0.003).ConclusionsBased on our findings, joint position sense is impaired at the elbow joint in children with spastic hemiplegia. The proprioceptive deficit is present at both the affected and unaffected sides and is related to the level of spasticity.
Highlights
A positive correlation was evident between the level of spasticity and joint position sense (Rho=0.71, p=0.003)
Joint position sense is impaired at the elbow joint in children with spastic hemiplegia
Proprioception refers to the individual's awareness of body parts' position and movement in space, and it is synthesized by two components: kinesthesia and joint position sense
Summary
Proprioception refers to the individual's awareness of body parts' position and movement in space, and it is synthesized by two components: kinesthesia and joint position sense. According to Han et al [4], the three most commonly used techniques are as follows: a) detection of passive movement, b) joint position reproduction, and c) active reproduction of movement. Hillier et al [5] proposed three techniques or clusters: a) active or passive joint position reproduction, b) detection of the threshold of passive movement, and c) detection of the direction of movement. Detection of passive movement evaluates the ability of the participant to detect the direction or the movement at various joints of the body at slow speed and with the eyes closed. Joint position reproduction evaluates joint position compared to the ipsilateral or contralateral side, actively or passively, with slow to normal speed, while blindfolded. Functional active reproduction of movement can be conducted actively with eyes open, but without directly looking at the joint tested (general vision available), and requires the judgment of different movementdisplayed distances [6]
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