Knee Position Sense Research Articles

Relationship between sensation and balance and gait in multiple sclerosis patients with mild disability

BackgroundPatients with Multiple Sclerosis (PwMS) often experience sensory, balance, and gait problems. Impairment in any sensation may increase imbalance and gait disorder in PwMS. This study aimed to (1) compare foot plantar sensations, knee position sense, balance, and gait in PwMS compared to Healthy Individuals (HI) and (2) examine the relationship between plantar sensations, knee position sense, balance, and gait in PwMS. MethodsThirty PwMS with mild disability and 10 HI participated in this study. Light touch threshold, two-point discrimination, vibration duration, and knee position sense were examined on the Dominant Side (DS) and Non-Dominant Side (NDS). Balance and spatio-temporal gait analysis were evaluated in all participants. ResultsPwMS had higher postural sway with eyes closed on the foam surface, longer swing phase of DS, longer single support phase of NDS, and shorter double support phase of DS compared to HI (p < 0.05). The results of regression analysis showed that the light touch thresholds of the 1st and 5th toes of the DS were associated with postural sway in different sensory conditions (p < 0.05). In contrast, the light touch thresholds of the 1st and 5th toes, two-point discrimination of the heel, vibration duration of the 1st metatarsal head and knee position sense of the NDS, and light touch threshold in the medial arch of both sides were associated with the gait parameters (p < 0.05). ConclusionPwMS, even with mild disabilities needs neurorehabilitation to improve plantar sensation and knee position sense.

Effects of contrast water therapy on proprioception of the knee joint and degree of fatigue in sprinters after high intensity training.

To investigate the effect of contrast water therapy on proprioception of the knee joint and indicators associated with fatigue in sprinters after high intensity training. A total of 40 sprinters were selected and divided into an observation group and a control group. The observation group got 14 minutes of contrast water therapy, while the control group took 14 minutes of sitting rest after training. The knee position sense, muscle force sense, joint reaction angle to release, knee joint function, and indictors associated with fatigue were evaluated before and after exercise at different time points. At 24 h, 48 h, and 72 h after exercise, the active position sense and muscle force sense of the control group were significantly lower than those of the observation group (all P<0.05). At 48 h after exercise, the passive position sense of the control group was significantly lower than that of the observation group (all P<0.05). At 24 h and 48 h after exercise, the joint reaction angle to release of the control group was significantly greater than that of the observation group (all P<0.05). Additionally, the IKDC2000 and Lysholm scores after interference in the observation group were greater than those of the control group (all P<0.05). The indicators associated with fatigue after interference in the observation group were significantly lower than those of the control group (all P<0.05). Contrast water therapy can effectively alleviate muscle force sense, promote muscle proprioception, improve knee joint function, and enhance recovery from fatigue.

Reference value of knee position sense in weight-bearing and non-weight-bearing conditions

BackgroundOur study aimed to identify age-related changes in knee proprioception to provide reference values for weight-bearing (WB) and non-weight-bearing (NWB) conditions and to identify factors (age, WB condition, dominance, and sex) that can affect knee proprioception.MethodsA total of 84 healthy adult men and women were recruited. Active knee joint position sense (JPS) was measured using a digital inclinometer for knee proprioception. The participants performed the required movements actively, with verbal feedback from the examiner, slowly moving to the target angles (30° and 50°) and maintaining them for 5 s before returning to the starting position. Afterward, without assistance from the examiner, the participants actively moved back to the same angle, and the examiner confirmed the angles. This procedure was repeated twice for each target angle, and the average values were used as the data. The participants were barefoot, wearing shorts, and closed their eyes while the measurements were obtained. The measurements were first obtained on the dominant side under the NWB conditions. When a change in posture was needed during the measurement, the participants sat in a resting position for 2 min.ResultsExcept for age, all other factors (WB condition, dominance, sex) were not statistically significant. Age showed a significant difference in knee JPS, except for the non-dominant side at 30° and the dominant side at 50° in the NWB condition.ConclusionThis study indicates that the WB condition, dominant side, and sex need not be considered when measuring and assessing knee JPS. Age shows a negative correlation with knee joint position sense, and the reference values presented in this study can be used as objective target values during the rehabilitation process.

The effect of foot posture on static balance, ankle and knee proprioception in 18-to-25-year-old female student: a cross-sectional study

Background & purposeAfferent input from the sole affects postural stability. Cutaneous reflexes from the foot are important to posture and gait. Lower-limb afferents alone provide enough information to maintain upright stance and are critical in perceiving postural sway. Altered feedback from propreoceptive receptors alters gait and patterns of muscle activation. The position and posture of the foot and ankle may also play an important role in proprioceptive input.Therefore, the current research aims to compare static balance and ankle and knee proprioception in people with and without flexible flatfeet.Methodology91 female students between the ages of 18 and 25 voluntarily participated in this study, of which 24 were in the flexible flatfoot group and 67 were in the regular foot group after evaluating the longitudinal arch of the foot. The position sense of ankle and knee joints were measured using the active reconstruction test of the ankle and knee angle; Static balance was measured using the Sharpened Romberg test. Data were non-normally distributed. Accordingly, non-parametric tests were applied. The Kruskal-Wallis test was applied to compare differences between groups in variables.ResultKruskal-Wallis test showed a significant difference between two groups of flat feet and normal feet in the variables of static balance and position sense of ankle plantarflexion, ankle dorsiflexion, and knee flexion (p ≤ 0.05). A significant correlation was found between static balance and sense of ankle and knee position in the group with normal feet. The analysis of the regression line also showed that ankle and knee position sense could predict the static balance score in the regular foot group (ankle dorsiflexion position sense 17% (R2 = 0.17), ankle plantarflexion position sense 17% (R2 = 0.17) and knee flexion position sense 46% (R2 = 0.46) explain of changes in static balance).Discussion & conclusionFlexible flatfoot soles can cause loss of balance and sense of joint position; therefore, according to this preliminary study, clinicians must be aware and should take into account this possible deficit in the management of these patients.

Evaluation of Knee Position Sense in Children with Motor Disabilities and Children with Typical Development: A Cross-Sectional Study.

In children with motor disabilities, knee position during walking is often of concern in rehabilitation. This study aimed to investigate knee joint position sense. Thirty-seven children with Cerebral Palsy (CP), 21 with Myelomeningocele (MMC), 19 with Arthrogryposis (AMC), and 42 TD children participated in the study. Knee joint position sense, i.e., the difference between the criterion angle and the reproduced angle (JPS-error), was assessed in sitting while 3D motion capture was recorded at flexed knee 70 (Knee70), 45 (Knee45), and 20 (Knee20) degrees, and after three seconds at maintained criterion angle (CAM) and maintained reproduced angle (RAM). No differences were found between the groups in JPS-error, CAM, and RAM. At Knee70, CAM differed between the right and left legs in the TD group (p = 0.014) and RAM in the MMC group (p = 0.021). In the CP group, CAM was greater than RAM at Knee70 in the left leg (p = 0.002), at Knee45 in both legs (p = 0.004, p = 0.025), and at Knee20 in the right leg (p = 0.038). Difficulties in maintaining the knee position at CAM in the CP group sheds light on the need for complementary judgments of limb proprioception in space to explore the potential influence on knee position during walking.

Computer-aided design software measuring knee position sense: A valid and reliable method in subjects with Patellofemoral pain

Computer-aided design software measuring knee position sense: A valid and reliable method in subjects with Patellofemoral pain

Knee position sense and knee flexor neuromuscular function are similarly altered after two submaximal eccentric bouts.

This study examined eccentric-induced fatigue effects on knee flexor (KF) neuromuscular function and on knee position sense. This design was repeated across two experimental sessions performed 1week apart to investigate potential repeated bout effects. Sixteen participants performed two submaximal bouts of KF unilateral eccentric contractions until reaching a 20% decrease in maximal voluntary isometric contraction force. Knee position sense was evaluated with position-matching tasks in seated and prone positions at 40° and 70° of knee flexion so that KF were either antagonistic or agonistic during the positioning movement. The twitch interpolation technique was used to assess KF neuromuscular fatigue. Perceived muscle soreness was also assessed. Measurements were performed before, immediately (POST) and 24h after (POST24) each eccentric bout. No repeated bout effect on neuromuscular function and proprioceptive parameters was observed. At POST, central and peripheral factors contributed to the force decrement as shown by significant decreases in voluntary activation level (-3.8 ± 4.8%, p < 0.01) and potentiated doublet torque at 100Hz (-10 ± 15.8%, p < 0.01). At this time point, position-matching errors significantly increased by 1.7 ± 1.9° in seated position at 40° (p < 0.01). At POST24, in presence of muscle soreness (p < 0.05), although KF neuromuscular function had recovered, position-matching errors increased by 0.6 ± 2.6° in prone position at 40° (p < 0.01). These results provide evidence that eccentric-induced position sense alterations may arise from central and/or peripheral mechanisms depending on the testing position.

Acute Impact of Proprioceptive Exercise on Proprioception and Balance in Athletes

This study aimed to compare the acute effect of a proprioceptive exercise session and a non-specific exercise session on knee position sense, and the static and dynamic balance of athletes. Sixty male athletes (19.4 ± 1.2 years) participated in a within-subjects repeated-measures study. Knee position sense in closed kinetic chain, and static (BESS test) and dynamic balance (Y-balance test) were measured before and after two exercise sessions, consisting of 10 min of non-specific exercise in a cycle-ergometer or proprioceptive exercise with an unstable platform. Overall, both exercise sessions significantly improved knee position sense, BESS score, and YBT composite score, and no differences were detected between proprioceptive and non-specific sessions (knee position sense, −6.9 ± 65.2% vs. −11.5 ± 75.0%, p = 0.680; BESS, −19.3 ± 47.7% vs. −29.03 ± 23.5%, p = 0.121; YBT, 2.6 ± 2.7% vs. 2.2 ± 2.2%, p = 0.305). Twenty athletes did not improve knee position sense after the exercise session (non-responders). When analyzing only the exercise responders, both sessions improved knee position sense, but the improvement was greater after the proprioceptive exercise session (56.4 ± 25.6% vs. 43.8 ± 18.9%, p = 0.023). In conclusion, a single proprioceptive, as well as non-specific, exercise session increased knee position sense and balance. The proprioceptive exercise seems to be more effective in improving joint position sense when considering only athletes who respond to the intervention.

Functional and biochemical improvement following total knee arthroplasty in early postoperative period.

There are very few studies about total knee arthroplasty biomechanical and biochemical effects in the early postoperative period. The aim of this study was to investigate the effect of total knee arthroplasty on pain intensity, knee joint valgus angle, malalignment, functional status, knee joint position sense, and cytokine levels. A total of 29 patients (female/male: 24/5) who underwent total knee arthroplasty were included in the late-stage knee osteoarthritis group, and 22 patients (female/male: 13/9) with grade 4 osteoarthritis were included in the early-stage knee osteoarthritis group. The visual analog scale and the Western Ontario and McMaster Universities Osteoarthritis Index were used to evaluate the pain intensity and functional status. Alignment and knee position sense measurements were also calculated. Systemic venous blood samples were taken to evaluate the interleukin-6, tumor necrosis factor-alpha, and interleukin-1 beta cytokine levels. In the study group, there were positive improvements in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 70° knee flexion angle parameters, and interleukin-6 of patients at the postoperative 6th week compared to the preoperative period (p<0.05). The patients in the study group had similar or better results in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 35°, 55°, and 70° knee flexion angles parameters, and in interleukin-6, compared to the control group at postoperative 6th week. Total knee arthroplasty provides improvements in pain, function, valgus angle, joint position sense, and interleukin-6 in the early postoperative period.

The effects of gluteus medius and tibialis anterior kinesio taping on postural control, knee kinematics, and knee proprioception in female athletes with dynamic knee valgus

ObjectivesThis study aimed to investigate the effects of Kinesio taping on postural control, kinematics, and knee proprioception in female athletes with dynamic knee valgus (DKV).Design: a single-blind randomized clinical trial. Participants40 female athletes between the age of 18 and 28 years with DKV in single-leg drop landing (>13°) participated in this study. They were randomly classified into the Kinesio taping (KT) and placebo control (PC) groups. Main outcome measuresAll the evaluations and measurements were performed on each subject in the pre-test and post-test stages (with an interval of 72 h). The dynamic balance (Y balance test), proprioception (Knee position sense error), and knee kinematics (flexion and DKV angles) of the subjects were measured, prior and post gluteus medius and tibialis anterior KT. ResultsThe results of study demonstrate that the DKV angle and knee position sense error significantly decreased and YBT increased in the KT group from pre-test to post-test (p < 0.05). Nevertheless, there was no significant difference in knee flexion angle (p > 0.05). ConclusionThe results of the present study indicated that KT improves dynamic balance and proprioception and reduces the DKV angle. Therefore, KT is recommended for female athletes with DKV.

The relationship of pain, anxiety, and fatigue with knee position sense, balance, and dual task performance during menstrual cycle in females with multiple sclerosis

Purpose This study was carried out to investigate the relationship of pain, anxiety, and fatigue with position sense, balance, and dual task performance during the menstrual cycle in females with multiple sclerosis. Methods This study included 14 females with multiple sclerosis with regular menstrual cycles. The individuals' position sense, balance, and dual task performance were evaluated with a digital inclinometer, Biodex Balance System, and the Time Up and Go Test, respectively. Pain, anxiety, and fatigue were assessed with the Visual Analogue Scale, State-Trait Anxiety Inventory, and Fatigue Severity Scale, respectively. The study protocol was registered at http://clinicaltrials.gov (NCT04408742). Results In the early follicular phase, the pain was correlated with right knee position sense, and pain + activity was correlated with right knee position sense and dual task performance (p < .05). The correlation analysis revealed that no correlation was found between pain, pain + activity, anxiety, and fatigue, and position sense, balance, and dual task performance in the ovulation phase. In the luteal phase, the right knee position sense was correlated with pain, pain + activity, and fatigue (p < .05). Similarly, the left knee position sense was correlated with pain, pain + activity, and fatigue (p < .05). Conclusions As a result, there may be a relationship between pain and position sense in the early follicular phase and luteal phase, and a relationship between pain and motor dual task performance in the early follicular phase. Considering these changes occurring in different phases of the menstrual cycle, we think that each phase of the menstrual cycle should be taken into consideration in the follow-up of physiotherapy evaluations in females with multiple sclerosis. Abbreviations: MS: multiple sclerosis; CNS: central nervous system; FwMS: females with multiple sclerosis; eFP: early follicular phase; OP: ovulation phase; LP: luteal phase

Neuromuscular training improves knee proprioception in athletes with a history of anterior cruciate ligament reconstruction: A randomized controlled trial

BackgroundAthletes exhibit deficits in knee proprioception following anterior cruciate ligament reconstruction. Neuromuscular training programs improve knee proprioception in uninjured athletes; however, the effects on knee proprioception in athletes who have undergone anterior cruciate ligament reconstruction is not well understood. The purpose of this study was to examine the effects of a neuromuscular training program on knee proprioception in athletes who have returned to sport following anterior cruciate ligament reconstruction. MethodsTwenty-four male athletes, who had undergone anterior cruciate ligament reconstruction within the previous 6–12 months and returned to sport, participated in this randomized controlled trial. Athletes were randomly allocated to an experimental group (n = 12) that took part in an 8-week neuromuscular training program or a control group (n = 12) that simply continued their typical training routine. Knee position sense was assessed at baseline and after the 8-week period (post-testing). One-way analysis of covariance, with baseline performance included as a covariate, was used to compare knee position sense errors for the reconstructed limbs of the experimental and control groups at the post-testing time point. FindingsKnee position sense errors decreased by 51.7% for the experimental group and only 4.4% for the control group over the 8-week period. As a result, the experimental group demonstrated lower knee position sense errors, compared to the control group, at the post-testing time point (P < .001). InterpretationAthletes with a history of anterior cruciate ligament reconstruction may benefit from participation in a neuromuscular training program, even after completing post-operative rehabilitation.

Altered Position Sense after Submaximal Eccentric Exercise-inducing Central Fatigue.

The purpose of this study was to concomitantly investigate the acute and delayed effects of a submaximal eccentric-induced muscle fatigue on the position sense and the neuromuscular function of the right knee extensor muscles. Thirteen young and physically active participants performed a unilateral isokinetic eccentric exercise of their right lower limb until a decrease in maximal voluntary isometric contraction (MVIC) of 20% was reached. Neuromuscular (i.e., MVIC, voluntary activation (VA) level, and evoked contractile properties [DB100 and DB10]) and psychophysical evaluations (i.e., bilateral position-matching task, perceived muscle soreness, and perceived fatigue) were performed at four time points: before (PRE), immediately after (POST), 24 (POST24), and 48 (POST48) the exercise. The acute 20% MVIC reduction (P < 0.001) was associated with both central (i.e., -13% VA decrease, P < 0.01) and peripheral (i.e., -18% and -42% reduction of DB100 and DB10, respectively, P < 0.001) fatigue. In the following days (POST24 and POST48), VA levels had recovered despite the presence of a persisting peripheral fatigue and delayed-onset muscle soreness. Knee position sense, as revealed by position errors, was significantly altered only at POST (P < 0.05) with participants overestimating the length of their knee extensor. Position errors and VA deficits were significantly correlated at POST (r = -0.60, P = 0.03). Position errors returned to nonsignificant control values in the following days. The acute central fatigue induced by the eccentric exercise contributes to the position sense disturbances. Central fatigue might lead to alterations in the sensory structures responsible for the integration and the processing of position-related sensory inputs.

An investigation of knee position sense, balance, and dual task performance in different phases of menstrual cycle in females with multiple sclerosis: a pilot study

BackgroundSex hormones have been thought to play an important role in disease progression and inflammatory activity in females with multiple sclerosis. The aim of this study was to investigate knee position sense, balance, and dual task performance in different phases of menstrual cycle in females with multiple sclerosis. MethodsThe study included 14 females diagnosed with MS and 13 healthy females with regular menstrual cycles who did not use oral contraceptives. The disability level was determined using the Expanded Disability Status Scale. The mental state was assessed using the Mini-Mental State Examination. Knee position sense was evaluated with an Acumar dual digital inclinometer (Acu360, Acumar, Lafayette, IN, USA). The balance was measured with the Biodex Balance System (Biodex Medical Systems, Shirley, NY, USA). Time taken to complete the Timed Up and Go test (TUG) under 3 conditions (TUG without task, TUG with counting backward from 100 by 3s or listing the names starting with the letter “A” [TUGcognitive], and TUG while carrying three glasses of water on a tray [TUGmotor]) was measured. Measurements were conducted in the early follicular, ovulation, and luteal phases. ResultsAs a result, it was found that knee position sense, dynamic balance, and dual task performance decreased in the early follicular phase in both the group of females with multiple sclerosis and the control group (p<0.05). The change of dynamic balance and gait performance in the three phases of the menstrual cycle were different between the groups (p<0.05). ConclusionAs a result, it was found that knee position sense, dynamic balance, and dual task performance in females with multiple sclerosis changed throughout the menstrual cycle. The change in dynamic balance and gait performance differed from the control group during the menstrual cycle. Therefore, we think that each phase of the menstrual cycle should be taken into consideration in the follow-up of physiotherapy evaluations in females with multiple sclerosis.

The immediate effect of lumbopelvic manipulation on knee pain, knee position sense, and balance in patients with patellofemoral pain: A randomized controlled trial

BackgroundPatellofemoral pain (PFP) is a common musculoskeletal disorder. Quadriceps and core muscle neuromuscular control impairments are frequently associated with PFP. Lumbopelvic manipulation (LPM) has been shown to improve quadriceps and core muscle activation and decrease their inhibition, but changes in balance and knee joint position sense (JPS) after this intervention remain unknown. ObjectiveTo determine whether LPM decreases knee pain and JPS error and increases balance performance in patients with PFP. DesignRandomized controlled trial. SettingBiomechanics laboratory at a rehabilitation science research center. MethodsForty-four patients with PFP participated in this study that randomly divided into two equal groups. One group received LPM and the other received sham LPM (positioning with no thrust) in a single session. At baseline and immediately after the intervention, the outcomes of pain using a visual analog scale, balance using the modified star excursion balance test (mSEBT), and JPS at 20° and 60° of knee flexion using a Biodex dynamometer. ResultsThere was a statistically significant improvement in pain, balance control (anterior direction) and JPS in the LPM group immediately after the intervention. In addition, we observed significant differences between groups in pain, balance control (anterior direction) and JPS at 60° of knee flexion immediately after the intervention. ConclusionA single session of LPM immediately improved balance control, knee JPS, and pain in patients diagnosed with PFP. Clinical rehabilitation impactFindings suggest that LPM may be used as a therapeutic tool for immediate improvement of symptoms of PFP. However, more research is needed to determine long term results.

Relationship between Muscle Damage Magnitude and Sense of Knee Position

It has been proposed in the literature that muscle damage may temporarily and negatively affect proprioceptive capacity, which can be tested through the ability to replicate angles, while muscle damage can be verified by quantifying creatine kinase (CK) in the bloodstream. PURPOSE: to verify the relationship between muscle damage and sense of position in the isokinetic dynamometer, in knee extensors, after an eccentric exercise protocol. METHODS: ten male college students (age: 20.6 ± 1.8 years, body mass: 75.0 ± 11.7 kg, height: 177.4 ± 6.9 cm), with no prior experience with resistance exercises, were submitted to an eccentric exercise protocol, in the isokinetic dynamometer, for induction of muscle damage composed of two phases: 1st phase: 10 sets of 10 repetitions with 30 seconds of rest (100 eccentric contractions) - Speed ​​= 30 ° / s. There was a 5 minute break between the phases. 2nd phase: 11 sets of 10 repetitions and 30 seconds of rest (110 eccentric contractions) - Speed ​​= 180 ° / s. To evaluate the muscle damage was used the values of CK peak found in the post-tests shortly after exercise, 24h, 48h, 72h and 96h. To verify the sense of position, the subjects, blindfolded, should find the angle of 60° in the right knee on the isokinetic dynamometer. Was used a subtraction of the target value (60°) by the angle performed by the subjects on the day of CK peak. The normality of the sample data was verified using the Shapiro-wilk test and Pearson's correlation was applied between peak CK and significance level of 5%. RESULTS: There was a significant correlation (p = 0.014) between CK and knee position sense, with r = 0.742 classified as strong (Devore, 2006). CONCLUSIONS: the induction of muscle damage caused by eccentric exercise significantly influences the subjects' proprioception, since the higher the CK values, the greater the angular discrepancies between the expected value and the one performed by the subjects.

Aerobic training in aquatic environment improves the position sense of stroke patients: A randomized clinical trial

AIMS (Stroke patients often present sensory-motor alterations and less aerobic capacity. Joint position sense, which is crucial for balance and gait control, is also affected in stroke patients). To compare the effect of two exercise training protocols (walking in deep water and on a treadmill) on the knee position sense of stroke patients. METHODS This study was designed as a randomized controlled clinical trial. Twelve adults, who suffered a stroke at least one year prior to the start of the study, were randomly assigned to one of two groups: 1) pool group submitted to aerobic deep water walking training; and 2) the treadmill group which was submitted to aerobic walk on a treadmill. Measurements: The position sense, absolute error and variable error, of the knee joint was evaluated prior to and after nine weeks of aerobic training. RESULTS The pool group presented smaller absolute (13.9o versus 6.1o; p < 0.05) and variable (9.2o versus 3.9o; p < 0.05) errors after nine-weeks gait training than the treadmill group. CONCLUSIONS Nine-week aerobic exercise intervention in aquatic environment improved precision in the position sense of the knee joint of stroke patients, suggesting a possible application in a rehabilitation program.

Knee position sense: does the time interval at the target angle affect position accuracy?

[Purpose] This study examined whether the interval at the target angle during knee joint position sense (JPS) affected reposition accuracy, and evaluated the consequence of this factor on test-retest reliability. [Subjects and Methods] Twenty healthy subjects participated in this study. Reposition ability was measured after the knee was placed at a target angle (ranging from 40° to 60°) for intervals of 3, 6, 9, and 12 seconds, in randomized order. Two trials were performed for each condition. The measurement was repeated after a week. The absolute error (AE) of each trial and average AE under each condition within the two measures were used for data analysis. [Results] No significant difference was found in comparing the AE or the average AE during all trials and between the two measures. Fair-to-good reliability was found for the AE results of all trials under the conditions of 3, 6, and 12 seconds. Poor reliability was found with time interval of 9 seconds. [Conclusion] The length of time needed to memorize the target angle during knee JPS test might affect test reliability. Practitioners can use this information when collecting JPS data.

The Effects of Whole-Body Vibration Training for Rehabilitation after ACL Reconstruction: A Systematic Review

We investigated the effects of short-term WBVT program for rehabilitation after ACL reconstruction on postural control, knee position sense, and knee laxity. This review was restricted to randomized controlled trials, which investigated the rehabilitation effects of WBVT on physical function compared with conventional rehabilitation program. Data from a total of 99 participants with ACL reconstruction in 3 studies were included. Articles with high risk of bias were included based on the criteria of Cochrane Review Guideline. Furthermore, based on the International Society of Musculoskeletal and Neuronal Interactions recommendation, the lack of information on the WBV settings was found in them. Meta-analysis showed that, after WBVT intervention, no significant standardized mean difference (SMD) was observed in postural stability (n = 3; -0.58[-1.32-0.16], p = 0.13) with large heterogeneity (I2 = 67%) and knee laxity (n = 2; -0.10[-0.50-0.70], p = 0.74) with no heterogeneity (I 2 = 0%), whereas a significant SMD was observed in position sense (n = 2; SMD = -1.44[-2.22- -0.67],p = 0.0003) with large heterogeneity (I 2 = 85%). We concluded that WBVT might be a promising alternative exercise therapy for rehabilitation after ACL reconstruction. However, to clarify the effects of WBVT on prevention from re-injury after returning to sports activities, future studies with longer term WBVT with better quality are strongly

Comparison of the effect of weight-bearing and non-weight-bearing positions on knee position sense in patients with chronic stroke.

[Purpose] The purpose of this study was to investigate the knee joint proprioception in weight-bearing (WB) and non-weight-bearing (NWB) positions and to study the difference between the methods in chronic stroke patients. [Subjects and Methods] The subjects were 15 stroke patients who were randomly scheduled to perform both positions by a physical therapist not involved in the study. The subjects performed the positions (WB and NWB) based on a randomized controlled cross-sectional design. WB subjects were positioned in one-leg standing to assess the knee joint position sense. NWB subjects were instructed to sit comfortably in a chair and maintain the knees at 90° of flexion with the leg out of the plinth. [Results] The results revealed that the WB position showed a significant difference in knee position sense. The proprioception sense in the WB position was a higher than that in the NWB position. [Conclusion] The knee proprioception of chronic stroke patients differs between the weight-bearing and non-weight-bearing positions.