Joint Position Sense Error Research Articles

Joint position and force senses in young female tennis players and untrained adolescents.

The aim of the study was to determine the differences between tennis players and untrained peers in the development of upper limb proprioception in 10-15-year-olds. A group of 67 girls (12.75 ± 1.46 years old), including 33 tennis players and 34 age-matched untrained controls, was divided into three age groups: A1, 10-11-years-old; A2, 12-13-years-old; and A3, 14-15-years-old. Joint position sense (JPS) and force sense (FS) were assessed by reproducing memorized target angle or torque value of three joints: glenohumeral, elbow, and radiocarpal. The JPS error for the elbow joint in group A1 was 71% and 80% higher (p < 0.01) than that in groups A2 and A3, respectively, and the performance of all tennis players was 27.5% (p = 0.01) better than that of untrained controls. For FS, proprioception of only the more demanding task tested (reproduction of 50% maximal voluntary contraction) and specific function (elbow and radiocarpal extension, and glenohumeral internal rotation) showed development with age. The error values for elbow extension (A1, A2) and the glenohumeral joint (A3) of tennis players were lower than those of age-matched controls. We conclude that the development of FS in the upper limb varied and was related to the specific functions and joints. The 10-13-year-old tennis players showed elbow extensor FS performance at the level of the older participants, while the 14-15-year-old tennis players were characterized with superior FS internal rotation performance in the glenohumeral joint.

Assessing the reliability of a digital inclinometer app for measuring hip, knee, and ankle proprioception.

Proprioception can be defined as the ability of an individual to detect motion and position of the various joints in their bodies. Current tools for measuring proprioception lack consensus on their accuracy and validity; they also each have their own limitations, and, furthermore, present barriers to use for clinicians. We propose a new and reliable method for evaluating hip, knee, and ankle proprioception by utilizing a digital inclinometer app to measure joint position sense. The digital inclinometer app recorded the active joint position sense error after each of five trials for the hip and knee joint and ten trials for the ankle joint. To quantify the reliability of the digital inclinometer app, single-measurement and average-measurement intra-class correlation coefficients (ICC) along with the associated 95% confidence intervals (95% CI) were calculated for each joint's position sense error across trials. Both the hip (ICC (2,k) = 0.849 (95% CI = [0.783-0.897])) and knee joint (ICC (2,k) = 0.837 (95% CI = [0.750-0.897])) were found to have moderate to good reliability when the middle three of five trials were analyzed. Unlike the hip and knee, moderate to good reliability for ankle proprioception (ICC (2,k) = 0.785 (95% CI = [0.539-0.893])) was only achieved with the middle eight of ten trials. The results of this study indicate that this digital inclinometer app is able to accurately record joint position sense at the hip, knee, and ankle when the appropriate number of trials are collected; thus, allowing this tool and methodology to be considered for use in both clinical and research environments to measure proprioception, and furthermore, quantify proprioceptive deficits.

Longitudinal assessment of knee joint proprioception using weight-bearing and non-weight-bearing tests throughout rehabilitation after anterior cruciate ligament reconstruction

ObjectiveEvaluate active knee joint position sense (JPS) throughout rehabilitation after anterior cruciate ligament reconstruction (ACLR). DesignLongitudinal. SettingMotion laboratory. ParticipantsTwenty-two individuals post-ACLR and 22 activity-matched non-injured controls performed weight-bearing and non-weight-bearing knee JPS tests. The ACLR participants performed at three functional timepoints: T1, able to perform single-leg sit-to-stand; T2, able to hop maximally; T3, cleared for return to sports. Controls performed on one occasion. Main outcome measuresConstant, absolute, variable errors (CE, AE, VE) and interlimb symmetry estimates (100% signifying perfect symmetry), for 40° and 65° knee flexion target angles. ResultsFor the weight-bearing 40° condition, CE and AE of the ACLR knee significantly increased from T1 to T2 (P = 0.010) and T1 to T3 (P = 0.002). Consequently, interlimb asymmetry for AE significantly increased from T1 (AEsym% = 101.2% ± 55.4%) to T3 (AEsym% = 139.7% ± 54.8%). Compared to controls, AE for the ACLR knee was significantly smaller at T1 (P = 0.016). No other significant differences were observed. ConclusionsSmaller JPS errors at early rehabilitation while weight-bearing may have been due to heightened quadriceps activation and increased γ motor neuron sensitivity, compensating for deficient ACL mechanoreceptors. In contrast, non-weight-bearing testing did not reveal changes over time. Clinicians are advised to consider these distinctions when assessing proprioception at different rehabilitation stages.

EFFECTS OF BALANCE TRAINING WITH STROBOSCOPIC GLASSES ON JOINT POSITION SENSE, POSTURAL STABILITY, AND FUNCTIONAL PERFORMANCE TESTING IN CHRONIC ANKLE INSTABILITY NATIONAL ATHLETES: A SINGLE-BLINDED RANDOMIZED CONTROLLED TRIAL

Chronic Ankle Instability (CAI) significantly affects athletic performance and increases the risk of recurrent ankle sprains. Stroboscopic Glasses (SG) may enhance proprioceptive feedback and postural control. We aimed to evaluate the augmented effects of Proprioceptive Feedback Training (PFT) combined with SG in athletes with CAI. We conducted a single-blinded randomized controlled trial with participants assigned to the PFT+SG or PFT alone groups. The interventions were administered over an eight-week period. Improvements in the Foot and Ankle Ability Measure Sport subscale (FAAM-S), Identification of Functional Ankle Instability (IdFAI) Questionnaire, Joint Position Sense (JPS) error value, postural stability via the Balance Velocity Test (BVT), Functional Performance Tests (FPTs), and giving-way episodes were assessed pre- and post-intervention. Substantial improvements in FAAM-S and IdFAI scores were observed in the PFT+SG group compared to those in the PFT group. JPS and BVT were significantly higher in the PFT+SG group than in the PFT group. FPTs and giving-way episodes were significantly higher in the PFT+SG group than in the PFT group. The inclusion of SG in PFT significantly enhanced rehabilitation outcomes in athletes with CAI. SG combined with PFT may address proprioceptive deficits and improve functional performance in patients with CAI.

Effects of slow dynamic, fast dynamic, and static stretching on recovery of performance, range of motion, balance, and joint position sense in healthy adults

IntroductionConsidering the effects of fatigue on athletic performance and the subsequent increase in the probability of injury, the purpose of this study was to compare the effects of slow dynamic, fast dynamic, and static stretching on the recovery of performance, range of motion (ROM), balance, and joint position sense.MethodsFifteen collegiate healthy females were involved in four separate sessions of slow dynamic stretching (SDS), fast dynamic stretching (FDS), static stretching (SS), and control condition (CC; without stretching), in a random order with at least 48 h of rest between sessions. After warming up, the individuals performed ROM, balance, joint position sense (JPS) maximum voluntary isometric contraction (MVIC) force as well as countermovement (CMJ) and squat jump (SJ) as pre-tests. After performing the knee fatigue protocol of 4 sets of knee extension and flexion at 60% of 1 repetition maximum (RM) to exhaustion (CC; without stretching) or stretching programs (SDS or FDS or SS), the subjects repeated all the tests at post-test 1 (after 5 min) and post-test 2 (after 60 min).ResultsA significantly lower JPS error was detected with SDS while JPS error increased in the SS and control conditions (p < 0.0001). MVIC force significantly increased with SDS and FDS but decreased in control and SS conditions (p < 0.0001). Moreover, a significant decrease in CMJ and SJ height in SS and control conditions was revealed (p < 0.0001). Also, a significant decrease in balance with the control condition was revealed. But only SDS minimized fatigue-induced balance decrements (p < 0.0001). Additionally, the control condition experienced a significant decrease in knee extensor ROM, which contrasted with the significant increase in the quadriceps flexibility with the stretching conditions.ConclusionsThe present results support the idea that SDS may increase quadriceps MVIC force, knee extensor ROM and knee JPS. So according to the present results, it is suggested that the SDS could be implemented and incorporated into a regular recovery program.

Assessment of joint position sense in active and passive modes with various elbow flexion angles and movement speeds using an isokinetic dynamometer

BackgroundJoint position sense is the ability to detect body segment position in space and is commonly used to represent proprioceptive performance. The isokinetic dynamometer is frequently used to evaluate elbow joint position sense during active and passive reproduction tasks with various testing protocols. However, few studies have reported the performance of joint position sense under different testing conditions. ObjectiveTo compare elbow joint position sense between active and passive reproduction tasks under different matching speeds and reference targets. DesignA cross-sectional study. MethodsTwenty participants without a history of upper-extremity surgery or neuromuscular diseases that affect the joint position sense of the elbow. Active and passive ipsilateral matching tasks were performed at four movement speeds (0.5°/s, 1°/s, 2°/s, and 4°/s) and three reference targets (elbow flexion at 0°–15°, 45°–60°, and 75°–90°), using an isokinetic dynamometer. The absolute and variable errors of each condition were calculated for comparison. ResultsIn active matching task with elbow flexion of 0°–15°, the absolute error at 0.5°/s was significantly larger than that at 2°/s and 4°/s, while the variable error at 1°/s was significantly larger than that at 2°/s. However, no differences were found at elbow flexion angles of 45°–60° and 75°–90°. Larger absolute errors were found at 4°/s with three testing angles in passive matching task. ConclusionsThis study compared the joint position sense errors under various testing conditions in the active and passive reproduction tasks. The movement speeds and target position effects should be considered during evaluation.

Heart rate-related physiological changes induced by classical music-elicited emotions do not underlie alterations in healthy adults’ ankle joint target-matching strategy

Emotions have the potential to modulate human voluntary movement by modifying muscle afferent discharge which in turn may affect kinesthetic acuity. We examined if heart rate (HR)-related physiological changes induced by music-elicited emotions would underlie alterations in healthy young adults’ ankle joint target-matching strategy quantified by joint position sense (JPS). Participants (n = 40, 19 females, age = 25.9 ± 2.9 years) performed ipsilateral-, and contralateral ankle target-matching tasks with their dominant and non-dominant foot using a custom-made foot platform while listening to classical music pieces deemed to evoke happy, sad, or neutral emotions (each n = 10). Participants in the 4th group received no music during the task. Absolute (ABS), constant (CONST), and variable (VAR) target-matching errors and HR-related data were analyzed. Participants performed the contralateral target-matching task with smaller JPS errors when listening to sad vs. happy music (ABS: p < 0.001, d = 1.6; VAR: p = 0.010, d = 1.2) or neutral (ABS: p < 0.001, d = 1.6; VAR: p < 0.001, d = 1.4) music. The ABS (d = 0.8) and VAR (d = 0.3) JPS errors were lower when participants performed the task with their dominant vs. non-dominant foot. JPS errors were also smaller during the ipsilateral target-matching task when participants (1) listened to sad vs. neutral (ABS: p = 0.007, d = 1.2) music, and (2) performed the target-matching with their dominant vs. non-dominant foot (p < 0.001, d = 0.4). Although emotions also induced changes in some HR-related data during the matching conditions, i.e., participants who listened to happy music had lower HR-related values when matching with their non-dominant vs. dominant foot, these changes did not correlate with JPS errors (all p > 0.05). Overall, our results suggest that music-induced emotions have the potential to affect target-matching strategy and HR-related metrics but the changes in HR-metrics do not underlie the alteration of ankle joint target-matching strategy in response to classical music-elicited emotions.

Normative values and the influence of sex, hand dominance, and direction of movement on active wrist joint position sense in young healthy adults

BackgroundActive wrist joint position sense (JPS) is a feasible method for determining wrist proprioception. However, the normative values and factors affecting wrist JPS are not known. ObjectivesTo identify normative values of active wrist JPS in young healthy adults and explore the influence of sex, hand dominance and direction of wrist movement. DesignCross-sectional study. MethodJPS of 100 individuals aged 18–40 years, (male: female = 51:49) were measured at two wrist positions (20° flexion/extension) using the active wrist JPS test. Absolute error (in degrees) was calculated and summarized using descriptive measures. Kruskal-Wallis analysis of variance was performed to determine the differences in JPS error based on sex, dominance and direction of wrist movement. ResultsMean absolute JPS flexion error on the dominant side was 3.47°(SD = 3.91°), and non-dominant side was 3.26°(SD = 3.23°). Mean absolute JPS extension error on the dominant side was 3.35°(SD = 3.43°), and non-dominant side was 4.59°(SD = 4.82°). Compared to males, females had more absolute error for flexion and extension on the dominant side. No significant difference was found in the absolute error between the dominant and non-dominant sides or between flexion and extension. ConclusionThese normative values of active JPS in young healthy adults can help clinicians while assessing proprioceptive impairments of the wrist. Differences in JPS errors due to sex were found, but not due to dominance or direction of movement. These findings can guide future research on mechanisms involved in wrist JPS.

Joint position sense error in the hip and knee without reference to the joint angle

BACKGROUND: Joint position reproduction measures the angle acuity of reference angle reproduction using an indicator angle. However, reference angles are often not available. OBJECTIVE: This study aimed to examine joint position sense at three different targeted joint angles, which were estimated from the maximum range of motion (maxROM) without a reference angle at each targeted joint angle. METHODS: The maxROM was measured in straight leg raise (SLR) and active knee extension (AKE) positions. In both positions, a targeted joint angle at 75% of the maxROM was assessed first, followed by that at 50% and 25% of the maxROM. A one-sample t-test was used to analyze differences between the targeted and reproduced angles in both positions. RESULTS: All reproduced angles significantly differed from the targeted angle in both SLR and AKE positions except for the reproduced angle measured at 75% maxROM. Overall, position errors in the AKE position were higher than those in the SLR position. CONCLUSIONS: Estimating the angle based on the maxROM without a matched reference angle may lead to significant discrepancies in comparison with the targeted joint angle. In clinical settings, if accurate reproduction of motions is required to improve proprioception, providing a reference angle might be helpful.

Ab. No. 170 Impact of Dynamic Postural Exercises on Electromyographic Activity, Co-Contraction and Joint Position Sense in Upper Cross Syndrome: A Pilot Study

Introduction: A greater prevalence with no strong rehabilitation program for Upper Crossed Syndrome (UCS) accompanied the purpose to find out the efficacy of dynamic postural exercise developed on the basis of identification of muscle activation pattern in UCS.This will help in effective management of patients suffering from UCS. Methods: 14 subjects with diagnosed UCS were randomly allocated to experimental and control groups (N=14; n=7). Participants were asked to perform 4 exercises (YTWL) using elastic resistance band during which amplitude of muscle activation and cocontraction ratio with Surface electrodes using 4 channel electromyographic system were measured.12 muscles of both side (Upper, middle and lower trapezius, serratus anterior, pectoralis major, anterior scalene) were assessed. The intervention of experimental group consisted of seven exercises. Both groups were given hot pack, TENS and cervical AROM exercises. The intervention was prescribed for three days a week for 8 weeks. Cervical kinesthesia was measured using joint position sense error (JPSE) test. All the outcome variables were recorded at the baseline and after 8 weeks. Result: Statistically significant difference (p≤0.05) of mean amplitude in pre-post values of experimental group as well as between group were found. Between group analysis of UT:LT, SC:AS contraction ratio and joint position sense also found to be significant(p≤0.05). Conclusion: There was a significant improvement in mean amplitude and cocontraction of cervicothoracic muscles in Dynamic Postural Exercise group. Kinesthesia also improved in experimental group. Implications: A focused rehabilitation program for UCS will help in improving the quality of life and functional efficacy.

Monitoring Cortical and Neuromuscular Activity: Six-month Insights into Knee Joint Position Sense Following ACL Reconstruction.

Changes in cortical activation patterns after rupture of the anterior cruciate ligament (ACL) have been described. However, evidence of these consequences in the early stages following the incident and through longitudinal monitoring is scarce. Further insights could prove valuable in informing evidence-based rehabilitation practices. To analyze the angular accuracy, neuromuscular, and cortical activity during a knee joint position sense (JPS) test over the initial six months following ACL reconstruction. Study design: Cohort Study. Twenty participants with ACL reconstruction performed a JPS test with both limbs. The measurement time points were approximately 1.5, 3-4 and 6 months after surgery, while 20 healthy controls were examined on a single occasion. The active JPS test was performed seated with a target angle of 50° for two blocks of continuous angular reproduction (three minutes per block). The reproduced angles were recorded simultaneously by an electrogoniometer. Neuromuscular activity of the quadriceps muscles during extension to the target angle was measured with surface electromyography. Spectral power for theta, alpha-2, beta-1 and beta-2 frequency bands were determined from electroencephalographic recordings. Linear mixed models were performed with group (ACL or controls), the measurement time point, and respective limb as fixed effect and each grouping per subject combination as random effect with random intercept. Significantly higher beta-2 power over the frontal region of interest was observed at the first measurement time point in the non-involved limb of the ACL group in comparison to the control group (p = 0.03). Despite individual variation, no other statistically significant differences were identified for JPS error, neuromuscular, or other cortical activity. Variation in cortical activity between the ACL and control group were present, which is consistent with published results in later stages of rehabilitation. Both indicate the importance of a neuromuscular and neurocognitive focus in the rehabilitation. 3.

Joint position sense error in the hip and knee without reference to the joint angle.

Joint position reproduction measures the angle acuity of reference angle reproduction using an indicator angle. However, reference angles are often not available. This study aimed to examine joint position sense at three different targeted joint angles, which were estimated from the maximum range of motion (maxROM) without a reference angle at each targeted joint angle. The maxROM was measured in straight leg raise (SLR) and active knee extension (AKE) positions. In both positions, a targeted joint angle at 75% of the maxROM was assessed first, followed by that at 50% and 25% of the maxROM. A one-sample t-test was used to analyze differences between the targeted and reproduced angles in both positions. All reproduced angles significantly differed from the targeted angle in both SLR and AKE positions except for the reproduced angle measured at 75% maxROM. Overall, position errors in the AKE position were higher than those in the SLR position. Estimating the angle based on the maxROM without a matched reference angle may lead to significant discrepancies in comparison with the targeted joint angle. In clinical settings, if accurate reproduction of motions is required to improve proprioception, providing a reference angle might be helpful.

Mediating the Connection: The Role of Pain in the Relationship between Shoulder Muscle Strength, Joint Position Sense, and Sub-Acromial Impingement Syndrome

Sub-acromial Impingement Syndrome (SIS) is a prevalent shoulder pathology characterized by pain, muscle weakness, and altered joint position sense (JPS). This prospective study aimed to comprehensively assess the relationship between shoulder muscle strength, JPS, and pain in individuals with SIS. A total of 100 participants, including 50 with SIS and 50 healthy controls, underwent shoulder muscle strength testing and JPS evaluation in various directions (flexion, abduction, medial rotation, and lateral rotation). Pain intensity was quantified using a visual analog scale. Correlation analyses were conducted to explore the associations between muscle strength, JPS, and pain, with Cohen’s d values indicating the effect size. Individuals with SIS exhibited significantly lower shoulder muscle strength and greater JPS errors compared to the healthy controls (p &lt; 0.001, Cohen’s d = 0.51 to 0.84). The results showed strong positive correlations between muscle strength and JPS in all assessed directions (p &lt; 0.001, with r values ranging from 0.35 to 0.62). Mediation analysis revealed that pain partially mediated the relationship between muscle strength and JPS in all directions (p &lt; 0.005). This study highlights the multifaceted nature of SIS, emphasizing the coexistence of muscle weakness, proprioceptive impairments, and pain. The findings underscore the importance of addressing these factors in the comprehensive rehabilitation of individuals with SIS to optimize functional outcomes and enhance their quality of life.

Proprioception: An evidence-based review

BackgroundProprioception is an essential sensory function of the body. Proprioception is defined as one’s awareness of their body’s position and movement through space. It contributes to both the conscious and unconscious awareness of limb and trunk position and movement. The purpose of this review is to provide an evidence-based review of proprioception and conditions that interfere with proprioceptive acuity. PurposeThe purpose of this review is to provide an evidence-based review of proprioception and conditions that interfere with proprioceptive acuity. Study DesignThis narrative literature review examines studies that determine proprioceptive systems and their implication for rehabilitation. MethodsRelevant study data were extracted as part of this review. ResultsTypes of proprioceptive interventions can include active or passive movement training, somatosensory stimulation training, force reproduction, and somatosensory discrimination training. Joint position sense error is the most widely used objective measure of proprioception. ConclusionsTherapists should consider using a standardized measure to ascertain proprioceptive deficits in their patients following upper extremity injury or disease to determine the deficits and measure change. There are a variety of interventions that can be used in hand rehabilitation to restore proprioceptive acuity, and active movement interventions have been found to be the most effective.

Known-group validity of passive knee joint position sense: a comparison between individuals with unilateral anterior cruciate ligament reconstruction and healthy controls

BackgroundKnee joint position sense (JPS) might be negatively affected after injuries to the anterior cruciate ligament (ACL). Recent systematic reviews suggest further investigation of psychometric properties, including validity, of knee JPS tests following ACL reconstruction (ACLR). This study investigated the known-group validity by comparing knee JPS errors between individuals who underwent unilateral ACLR and healthy controls.MethodsThis cross-sectional study involved 36 men, including 19 after ACLR (ACLR group) and 17 healthy controls (control group). In both groups, the absolute error (AE), constant error (CE) and variable error (VE) of passive knee JPS were calculated in the flexion and extension directions, for two target angles (30° and 60° flexion) per direction. Discriminative validity was evaluated by comparing JPS errors between the operated and non-operated knees in the ACLR group. Known-group validity was evaluated by comparing JPS errors between the operated knees in the ACLR group and the asymptomatic non-dominant knees of healthy controls.ResultsMean AE, CE and VE for all tests were 4.1°, − 2.3° and 3.6° for the operated knees in the ACLR group, 5.5°, − 2.6° and 3.3° for the non-operated knees in the ACLR group and 4.6°, − 2.6° and 3.3° for the non-dominant knees in the control group, respectively, regardless of the test direction and target angle. The operated knees in the ACLR group did not show significantly greater JPS errors compared to the contralateral knees in the ACLR group and to the non-dominant knees in the control group (p ≥ 0.05). On the other hand, the non-operated knees showed significantly greater AE for the 0°–60° flexion test (p = 0.025) and CE for the 0°–30° flexion test (p = 0.024) than the operated knees in the ACLR group. JPS errors did not significantly differ in the operated knees in the ACLR group based on the direction of movement and the target angle. However, the errors were significantly higher when the knee was moved through a greater range compared to that of a lesser range between the starting and target angles.ConclusionThe ACLR knees did not show greater passive JPS errors than the contralateral or control knees. The direction of movement and target angle did not influence the JPS acuity after ACLR. However, higher JPS errors were evident when the knee was moved through a greater range compared to a lesser range of motion. Further studies investigating the psychometric properties of standardized JPS tests following ACLR are warranted.

Investigating the Mediating Role of Pain in the Relationship between Ankle Joint Position Sense and Balance Assessed Using Computerized Posturography in Individuals with Unilateral Chronic Ankle Instability: A Cross-Sectional Study

Chronic ankle instability (CAI) is characterized by impaired ankle joint position sense (JPS) and compromised balance. Despite previous studies investigating the correlation between ankle JPS and balance in individuals with CAI, the potential mediating effect of pain in this relationship remains unclear. Understanding the role of pain as a mediator between ankle JPS and balance could provide valuable insights into the complex interplay among these variables in individuals with CAI. Therefore, further research is needed to elucidate the mediating effect of pain and its implications in assessing and managing ankle JPS and balance deficits in individuals with CAI. This cross-sectional study aimed to investigate the mediating role of pain in the association between ankle JPS and balance in individuals with unilateral CAI. Methods: Fifty-five individuals diagnosed with CAI participated in this study. Ankle JPS was assessed using a digital inclinometer, whereas the balance was measured using a computerized dynamic posturography device. Results: Participants with CAI showed impaired ankle JPS in the affected leg compared to that in the asymptomatic leg (p &lt; 0.001). Ankle JPS errors were greater in both dorsiflexion and plantarflexion directions in the CAI. Balance was compromised in the CAI leg (p &lt; 0.001). Moderate correlations (p &lt; 0.001, r = 0.31 to 0.48) were found between the balance variables. Pain significantly mediated the ankle JPS-balance relationship in the CAI (p &lt; 0.05, Sobel test). The findings suggest that individuals with CAI exhibit impaired ankle JPS and compromised balance. Pain plays a mediating role in the association between ankle JPS and balance in individuals with CAI. These results highlight the importance of considering pain as a potential mediator when assessing and treating balance issues in individuals with CAI. Healthcare professionals should incorporate assessments of ankle JPS and pain into the management of interventions that address these factors and improve balance and functional ability.

Relationship of Knee and Hip Joint Proprioception with Competition Success in Aerobic Gymnastics

The aim of the study was to (1) evaluate the joint position sense development in young aerobic gymnasts of different age groups and (2) investigate the relationship of position sense with execution success in competition. 112 competition athletes from four different age groups participated in the study. Joint position sense tests with a smartphone and phone app fixed to the lower extremities were performed during the Aerobic Gymnastics Turkey Championship competitions. Correlation and linear regression analysis were performed on the participant data, which showed normal distribution within the competition age groups. There were negative and significant correlations between 45o knee extension absolute errors and competition execution points. The 45o knee flexion absolute score correlated to competition execution points. 90o hip flexion absolute error scores were significantly associated with competition execution points. A positive correlation was found between the age of the gymnasts and the competition execution points. Considering the entire sample, results demonstrated that a final model consisting solely of hip extension absolute scores was able to explain a significant amount of variance in competition execution points. When the data is partitioned according to gender, the model fails to explain variation in competition execution scores in the male sample. However, a final model consisting of joint position sense error scores of hip flexion and knee extension could explain a significant proportion of variance in competition execution points of the female sample. In conclusion, gymnasts who made more positional errors had lower execution scores. Target position replication accuracy in gymnasts improved with age. The effect of joint position sense accuracy in predicting the outcome of the competition was significant. Training that develops joint position sense can improve gymnasts' competitive results.

Right hemisphere brain lateralization for knee proprioception among right-limb dominant individuals.

Studies indicate that brain response during proprioceptive tasks predominates in the right hemisphere. A right hemisphere lateralization for proprioception may help to explain findings that right-limb dominant individuals perform position matching tasks better with the non-dominant left side. Evidence for proprioception-related brain response and side preference is, however, limited and based mainly on studies of the upper limbs. Establishing brain response associated with proprioceptive acuity for the lower limbs in asymptomatic individuals could be useful for understanding the influence of neurological pathologies on proprioception and locomotion. We assessed brain response during an active unilateral knee joint position sense (JPS) test for both legs of 19 right-limb dominant asymptomatic individuals (females/males = 12/7; mean ± SD age = 27.1 ± 4.6 years). Functional magnetic resonance imaging (fMRI) mapped brain response and simultaneous motion capture provided real-time instructions based on kinematics, accurate JPS errors and facilitated extraction of only relevant brain images. Significantly greater absolute (but not constant nor variable) errors were seen for the dominant right knee (5.22° ± 2.02°) compared with the non-dominant left knee (4.39° ± 1.79°) (P = 0.02). When limbs were pooled for analysis, significantly greater responses were observed mainly in the right hemisphere for, e.g., the precentral gyrus and insula compared with a similar movement without position matching. Significant response was also observed in the left hemisphere for the inferior frontal gyrus pars triangularis. When limbs were assessed independently, common response was observed in the right precentral gyrus and superior frontal gyrus. For the right leg, additional response was found in the right middle frontal gyrus. For the left leg, additional response was observed in the right rolandic operculum. Significant positive correlations were found between mean JPS absolute errors for the right knee and simultaneous brain response in the right supramarginal gyrus (r = 0.464, P = 0.040). Our findings support a general right brain hemisphere lateralization for proprioception (knee JPS) of the lower limbs regardless of which limb is active. Better proprioceptive acuity for the non-dominant left compared with the dominant right knee indicates that right hemisphere lateralization may have meaningful implications for motor control.

Immediate Effects of Mulligan Mobilization on Elbow Proprioception in Healthy Individuals: A Randomized Placebo-Controlled Single-Blind Study

ObjectiveThe aim of this study was to investigate the immediate effects of Mulligan's mobilization with movement (MWM) on elbow proprioception. MethodsThe study included 26 participants in the intervention group and 30 participants in the control group. The intervention group received MWM, while the control group received a sham application. Proprioception was assessed with joint position sense error at baseline, immediately after mobilization, and 30 minutes after mobilization with 70° and 110° of elbow flexion. The hypothesis of interest was the group × time interaction. ResultsAt 110° of elbow flexion, group × time interaction was significant (F[2, 108] = 11.48, P = .001). In the paired comparisons, there was a statistically significant difference in favor of the control group in the first measurement (P = .003). No difference was detected in other time points (P = 1.00). At 70° of elbow flexion, there was no significant difference between the time point × group interaction (F[2, 108] = 1.37, P = .10). Therefore, no pairwise comparison was made. ConclusionIn this study of healthy participants, no immediate difference was found between MWM and sham application on elbow proprioception.

Comparison of proprioception recovery following anterior cruciate ligament reconstruction using an artificial graft versus an autograft

BackgroundTo compare proprioception recovery after anterior cruciate ligament reconstruction (ACLR) with a hamstring tendon autograft versus the artificial Ligament Advanced Reinforcement System (LARS).Material and methodsForty patients (9 females, 31 males) with anterior cruciate ligament (ACL) rupture were enrolled in this prospective study. Patients were randomized to two groups, 1) ACLR using a hamstring tendon autograft (n = 20) or 2) ACLR using artificial LARS (n = 20). Proprioception was assessed with knee joint position sense (JPS) passive-passive test at 45° and 75° flexions, with the contralateral healthy knee as a control baseline to calculate the JPS error. Knee JPS absolute error was used as the main outcome variable and defined as the absolute difference between the reproduction and target angles.ResultsJPS error in both groups at 3 months after ACLR was significantly higher than that at 12 months. However, no significant difference in JPS error was detected between the LARS and autograft groups at either 3 or 12 months after ACLR. Analyzing JPS data by grouping patients according to whether ACLR was performed more or less than 1 year following injury regardless of graft type showed a statistically significant difference between the groups at 3 months, but not at 12 months, after ACLR. Patients receiving the graft within 1 year of injury had a lower JPS error than those receiving the graft more than 1 year after injury at 3 months. No complications were associated with either ACLR method.ConclusionACLR with a hamstring tendon autograft or LARS artificial graft is similarly safe and effective for recovering knee proprioception.