The role of weightbearing in the clinical assessment of knee joint position sense

Abstract

Knee joint position sense was assessed by active tests with active limb matching responses in supine lying and in unilateral weightbearing (WB) stance using (re)positioning of the whole limb whilst focusing on the knee, and in supine lying using (re)positioning confined to the knee. Following five tests at approximately 45 degrees knee flexion in all three test conditions, position sense was found to be significantly more accurate and reliable following the WB procedure. Possible explanations are, first, that during WB the subjects were more able to assist identification of the test positions using cues obtained during movement of the knee to and from these positions. Second, a larger volume of proprioceptive afferent information may have been derived from sources outside the examined knee, and even outside the examined limb. Whilst WB joint position sense assessments are more functional, the obtained results may not characterise the capacity of the proprioceptors in and around the examined (knee) joint. Since the WB and NWB results were not correlated, one procedure cannot be used to predict results from the others. Also, predominantly unilateral WB stance is often impractical for subjects with limited balance or WB pain.