Joint Position Error Test Research Articles

Cervical proprioceptive impairment in patients with rheumatoid arthritis.

Rheumatoid arthritis (RA) involving the cervical spine can lead to various neurologic defects and impairmentof proprioception is just one of them. The aim of this study was the assessment of cervical proprioception and its relation with radiographic, clinical, and functional characteristics of patients with RA. One hundred and six rheumatoid arthritis patients who diagnosed according to the 2010American College of Rheumatology/European League Against Rheumatism criteria and age, gender, educational status matched one hundred and six healthy volunteers were enrolled in this study. Cervical joint position error test (CJPET) was applied to healthy volunteers and RA patients for cervical proprioception assessment. Fatigue, depression, balance, quality of life and balance scales were administered to all patients. Cervical radiography was used to assess cervical subluxations. Regression analysis was used for grading the factors which had relations with cervical proprioception. Mean age of patients and healthy volunteers was 51 ± 11.1 and 48.9 ± 9.2, respectively. Scores of CJPET were statistically significantly higher in RA group than healthy volunteers (p = 0.001). CJPET scores were negatively correlated with Berg balance scale findings in right rotation, left rotation, flexion and extension (rho = -0.421,-0.473,-0.448,-0.515). There was weak or not significant correlation between the scores of CJPET and fatigue, depression, and quality of life scales. Scores of CJPET in patients with atlantoaxial subluxations (AAS) were statistically significantly higher than those without AAS (p < 0.05). Regression analysis results showed that the AAS was related to impaired cervical proprioception on right and left rotations. There was no correlation between CJPET scores and functional parameters. Cervical proprioception impaired in RA patients. This impairment was related to the existence of AAS and balance problems.

Does Sensorimotor Dysfunction Exist in Asymptomatic Individuals with Forward Head Posture? A Case-Control Study

Background: Forward head posture (FHP), an anterior deviation of the cervical spine, is a common postural malalignment and contributor to neck pain. Impaired muscle activity and continuous excessive loading are commonly seen in individuals with FHP. Centrally, the postural impairment alters incoming sensory information, it's processing in the brain, and consequent output to muscles, causing sensorimotor dysfunction. This study aimed to find whether sensorimotor dysfunction exists in asymptomatic individuals with Forward Head Posture. Our secondary objective was to study whether sensorimotor tests could discriminate between persons with FHP and persons with neutral posture.Case Summary: A case-control study of 31 individuals with FHP and 58 controls with neutral head posture was conducted. We assessed all participants on outcome measures. In addition, a between-group comparison withappropriate statistical analytic tests and AUC plotting of outcome measures was done.Outcome measures: The following outcome measure was used for this study. 1. Cervical joint position error (JPE). 2. Craniocervical flexion test (CCFT). 3. Laterality judgement accuracy. 4. Movement control tests (MCT). 5. Fear Avoidance Behavioral Questionnaire (FABQ)Results: The results of the study indicate that there were significant differences in performance cervical joint position error test (p value&lt;0.05), movement control tests (Total score of 13 MCT &lt;0.05), CCFT activation scores, and performance index scores (p value=0.00) between the two groups. Values of areas under the curve (AUC) indicate that tests for JPE (0.993), CCFT AS (0.841), CCFT PI (0.941), and MCT (0.996) could discriminate well between the two groups. Amongst the 13 movement control tests 3 most discriminative tests are rotation (AUC=0.988), lateral flexion (AUC=0.988) and protraction-retraction (AUC=1.0).Conclusion: We conclude that asymptomatic individuals with forward head posture alter sensorimotor functions. This study gives an insight into the sensorimotor deficits present in asymptomatic individuals with FHP. Emphasis on early correction of FHP should be done to limit these sensorimotor deficits.

Does Sensorimotor Dysfunction Exist in Asymptomatic Individuals with Forward Head Posture? A Case-Control Study

Background: Forward head posture (FHP), an anterior deviation of the cervical spine, is a common postural malalignment and contributor to neck pain. Impaired muscle activity and continuous excessive loading are commonly seen in individuals with FHP. Centrally, the postural impairment alters incoming sensory information, it's processing in the brain, and consequent output to muscles, causing sensorimotor dysfunction. This study aimed to find whether sensorimotor dysfunction exists in asymptomatic individuals with Forward Head Posture. Our secondary objective was to study whether sensorimotor tests could discriminate between persons with FHP and persons with neutral posture.Case Summary: A case-control study of 31 individuals with FHP and 58 controls with neutral head posture was conducted. We assessed all participants on outcome measures. In addition, a between-group comparison withappropriate statistical analytic tests and AUC plotting of outcome measures was done.Outcome measures: The following outcome measure was used for this study. 1. Cervical joint position error (JPE). 2. Craniocervical flexion test (CCFT). 3. Laterality judgement accuracy. 4. Movement control tests (MCT). 5. Fear Avoidance Behavioral Questionnaire (FABQ)Results: The results of the study indicate that there were significant differences in performance cervical joint position error test (p value&lt;0.05), movement control tests (Total score of 13 MCT &lt;0.05), CCFT activation scores, and performance index scores (p value=0.00) between the two groups. Values of areas under the curve (AUC) indicate that tests for JPE (0.993), CCFT AS (0.841), CCFT PI (0.941), and MCT (0.996) could discriminate well between the two groups. Amongst the 13 movement control tests 3 most discriminative tests are rotation (AUC=0.988), lateral flexion (AUC=0.988) and protraction-retraction (AUC=1.0).Conclusion: We conclude that asymptomatic individuals with forward head posture alter sensorimotor functions. This study gives an insight into the sensorimotor deficits present in asymptomatic individuals with FHP. Emphasis on early correction of FHP should be done to limit these sensorimotor deficits.

Effects of Neck Taping in the Treatment of Hemispatial Neglect in Chronic Stroke Patients: A Pilot, Single Blind, Randomized Controlled Trial.

Background and objectives: Hemispatial neglect is a common consequence of stroke, with an estimated incidence of 23%. Interventions for treating hemispatial neglect may be categorized as either top-down or bottom-up processing. The aim of top-down approaches is to train the person to voluntarily compensate for their neglect. Such approaches require awareness of the disorder and a high level of active participation by the patient. Differently, bottom-up approaches are based on manipulation of a patient’s sensory environment and so require less awareness of behavioral bias. In line with the latter, it is conceivable that elastic therapeutic taping applied to the left neck surface may provide bottom-up inputs that reduce hemispatial neglect symptoms. The aim of this study was to assess the effect of therapeutic neck taping on visuo-spatial abilities, neck motion, and kinesthetic sensibility in chronic stroke patients with hemispatial neglect. Materials and Methods: After randomization, 12 chronic stroke patients with hemispatial neglect received 30 consecutive days of real (treatment group) or sham (control group) neck taping. The outcomes were as follows: Stars Cancellation Test; neck active range of motion; Letter Cancellation Test; Comb and Razor Test; Cervical Joint Position Error Test evaluated before and after one month of taping. Results: Between-group comparison showed significant differences only for the Cervical Joint Position Error Test after treatment (p = 0.009). Conclusions: Our preliminary findings support the hypothesis that neck taping might improve cervicocephalic kinesthetic sensibility in chronic stroke patients with hemispatial neglect. Further studies are needed to strengthen our results and better investigate the effects of elastic therapeutic taping on visuo-spatial abilities in stroke patients with hemispatial neglect.

Impact of smartphone usage on cervical proprioception and balance in healthy adults

Purpose: Individuals are utilizing smartphones for different tasks on a daily basis. Prolonged smartphone usage might lead to deficient postures such as forward head posture and rounded shoulders. The purpose of this study was to look at the impact of the heavy use of smartphones versus light use on Joint Position Error (JPE), Craniovertebral Angle (CVA), and balance measures. Method: Thirty healthy participants were recruited in this study, and they were divided into two groups: light use (phone use 4 h/d). Subjects were assessed for cervical repositioning errors using the JPE test. Forward head posture was measured by CVA. Dynamic balance was assessed using the Biodex stability system. Results: There was a significant increase in JPE of both right and left rotation in the heavy-use group compared with that of light-use group. Also, there was a significant increase in balance indices in the heavy-use group. However, there was no significant difference in CVA between groups. Conclusion: Our study showed that prolonged duration of smartphone use could negatively affect cervical proprioception and dynamic balance ability. Further considerations are required to outline the negative impacts of heavy usage of smartphones and to implement preventive measures.

The immediate effects of therapeutic keyboard music playing for finger training in adults undergoing hand rehabilitation.

[Purpose] The purpose of this study was to examine the immediate effects of therapeutic keyboard music playing on the finger function of subjects’ hands through measurements of the joint position error test, surface electromyography, probe reaction time, and writing time. [Subjects and Methods] Ten subjects were divided randomly into experimental and control groups. The experimental group used therapeutic keyboard music playing and the control group used grip training. All subjects were assessed and evaluated by the joint position error test, surface electromyography, probe reaction time, and writing time. [Results] After accomplishing therapeutic keyboard music playing and grip training, surface electromyography of the two groups showed no significant change, but joint position error test, probe reaction time, and writing time obviously improved. [Conclusion] These results suggest that therapeutic keyboard music playing is an effective and novel treatment for improving joint position error test scores, probe reaction time, and writing time, and it should be promoted widely in clinics.

Immediate effects of neuromuscular joint facilitation intervention after anterior cruciate ligament reconstruction.

[Purpose] The aim of this study was to examine the immediate effects of neuromuscular joint facilitation (NJF) on the functional activity level after rehabilitation of anterior cruciate ligament (ACL) reconstruction. [Subjects and Methods] Ten young subjects (8 males and 2 females) who underwent ACL reconstruction were included in the study. The subjects were divided into two groups, namely, knee joint extension muscle strength training (MST) group and knee joint extension outside rotation pattern of NJF group. Extension strength was measured in both groups before and after the experiment. Surface electromyography (sEMG) of the vastus medialis and vastus lateralis muscles and joint position error (JPE) test of the knee joint were also conducted. [Results] JPE test results and extension strength measurements in the NJF group were improved compared with those in the MST group. Moreover, the average discharge of the vastus medialis and vastus lateralis muscles on sEMG in the NJF group was significantly increased after MST and NJF treatments. [Conclusion] The obtained results suggest that NJF training in patients with ACL reconstruction can improve knee proprioception ability and muscle strength.

The effect of neck torsion on joint position error in subjects with chronic neck pain

The conventional cervical joint position error (JPE) test has been used as a measure of cervical afferent dysfunction in people with neck pain. However, head movement during the test may also stimulate the vestibular system. This study's objective is to investigate the effect of the modified JPE test with a neck torsion manoeuvre in order to determine if the new test is a more definitive measure of cervical afferent dysfunction. Twenty five volunteers with chronic neck pain and 26 healthy controls aged 18 to 60 were assessed on three tests of JPE: ‘JPE conventional’, ‘JPE torsion’ and ‘Enbloc’ (Control) using Fastrak and laser apparatus. The neck pain group was found to have significantly greater JPE in one conventional JPE test and almost all the torsion tests (p < 0.05). No differences in Enbloc(Control) tests were seen. Moderate to strong significant correlations were also seen between measures of JPE using the Fastrak and laser methodology (p ≤ 0.01). The results of this preliminary study indicate that ‘JPE torsion’ may be a more suitable test than ‘JPE conventional’ for cervical afferent dysfunction in people with chronic neck pain although future comparisons with people suffering from vestibulopathy is warranted to support these findings. Additionally, the laser method is comparable to Fastrak and may be useful as a clinical measure of repositioning errors for both conventional and torsion tests.

Neck exercises, physical and cognitive behavioural-graded activity as a treatment for adult whiplash patients with chronic neck pain: design of a randomised controlled trial.

BackgroundMany patients suffer from chronic neck pain following a whiplash injury. A combination of cognitive, behavioural therapy with physiotherapy interventions has been indicated to be effective in the management of patients with chronic whiplash-associated disorders. The objective is to present the design of a randomised controlled trial (RCT) aimed at evaluating the effectiveness of a combined individual physical and cognitive behavioural-graded activity program on self-reported general physical function, in addition to neck function, pain, disability and quality of life in patients with chronic neck pain following whiplash injury compared with a matched control group measured at baseline and 4 and 12 months after baseline.Methods/DesignThe design is a two-centre, RCT-study with a parallel group design. Included are whiplash patients with chronic neck pain for more than 6 months, recruited from physiotherapy clinics and an out-patient hospital department in Denmark. Patients will be randomised to either a pain management (control) group or a combined pain management and training (intervention)group. The control group will receive four educational sessions on pain management, whereas the intervention group will receive the same educational sessions on pain management plus 8 individual training sessions for 4 months, including guidance in specific neck exercises and an aerobic training programme. Patients and physiotherapists are aware of the allocation and the treatment, while outcome assessors and data analysts are blinded. The primary outcome measures will be Medical Outcomes Study Short Form 36 (SF36), Physical Component Summary (PCS). Secondary outcomes will be Global Perceived Effect (-5 to +5), Neck Disability Index (0-50), Patient Specific Functioning Scale (0-10), numeric rating scale for pain bothersomeness (0-10), SF-36 Mental Component Summary (MCS), TAMPA scale of Kinesiophobia (17-68), Impact of Event Scale (0-45), EuroQol (0-1), craniocervical flexion test (22 mmHg - 30 mmHg), joint position error test and cervical range of movement. The SF36 scales are scored using norm-based methods with PCS and MCS having a mean score of 50 with a standard deviation of 10.DiscussionThe perspectives of this study are discussed, in addition to the strengths and weaknesses.Trial registrationThe study is registered in http://www.ClinicalTrials.gov identifier NCT01431261.