Joint Position Sense Testing in Young Children.

Abstract

The standard physical examination evaluation for a proprioception abnormality depends upon the patient's ability to follow directions and respond to the examiner, a skill not yet developed in toddlers. This study demonstrates a new proprioception examination method that may allow for better localization of lesions and determines whether healthy toddlers would cooperate with this test. By placing stickers on children's hands, covering their eyes, and then moving their hands, the examiner can see whether the children reach for where their hands and stickers were previously located or to their new location, which serves as an indicator of proprioception ability. When tested on 12- to 36-month-old children without known neurologic issues, we found that older children were more cooperative during the test but that the ability to successfully find the sticker did not depend on age. We have optimized the test for efficient usage in a clinic setting and propose that this is a useful test that can be applied in children, with no change in confidence based on age. No children with known deficits in proprioception were tested, so sensitivity could not be assessed.