Passive Repositioning Research Articles

Effectiveness of Rehabilitation for Disk Displacement of the Temporomandibular Joint—A Cross-Sectional Study

(1) Background: Dislocations of articular disk can occur as a result of parafunctions in the Temporo Mandibular Joint (TMJ), which limits the opening of the mandible and other movements. The aim of this study was to evaluate the effectiveness of rehabilitation in patients with disk displacement of the TMJ. A total of 327 subjects with Temporo Mandibular Disorders underwent stomathognatic physiotherapy. (2) Methods: Based on the results obtained by a manual functional analysis, 35 patients who were identified with articular disk locking (disk displacement without reduction) were included in the study. The study group (N = 35) was subjected to passive repositioning of the articular disk, reposition splints, and physiotherapy. The patient’s TMJs were then examined before the therapy, immediately after the therapy, and during the follow-up visit 3–6 weeks after the therapy. The Diagnostic Criteria for the Most Common Intra-articular Temporomandibular Disorders was used to evaluate the effects of rehabilitation on the patients’ range of motions and the Numeric Pain Rating Scale (NPRS). For the statistical analysis, Pearson’s r correlation coefficient test and Wilcoxon signed-rank test were used. (3) Results: The results showed a significant improvement in the range of motion of the mandible movements. The level of improvement was dependent on the time from the incident until undergoing rehabilitation. (4) Conclusions: The stomatognathic physiotherapy applied increased the range of motion of the mandible and reduced pain levels to the expected range.

Lumbar joint position sense measurement of patients with low back pain.

Lumbar position sense can be assessed by measurement instruments including the goniometer, isokinetic dynamometry, and electronic motion monitoring equipment, which have demonstrated relatively high reliability. This literature provides a comprehensive overview of influencing factors of lumbar position sense measurement, including repositioning method, fatigue degree, and posture during the reposition. It highlights the significant role of muscle proprioception, which contributes to greater accuracy in active reposition compared to passive reposition. The differences in lumbar position sense with different measurement positions may be explained by the presence of mechanoreceptors in the load-bearing structures of the lumbar spine, especially in the facet joint capsules. These mechanoreceptors play a crucial role in providing sensory feedback and proprioceptive information pertaining to the position and movement of the lumbar spine. Individuals with low back pain (LBP) demonstrate alterations in lumbar position sense compared to those without LBP. The auto motor sensory feedback transmission mechanism of patients with non-specific LBP was more unstable than that of healthy people. These findings suggest that lumbar position sense may play a potential role in the development and perpetuation of LBP. At present, the commonly used clinical assessment methods for determining position sense include both active and passive repositioning. However, neither method exhibits high sensitivity and specificity, leading to the poor comparability of relevant studies and posing challenges for clinical application.

Quantitative evaluation of shoulder proprioception 6\xa0months following stroke

BackgroundChronic shoulder pain following cerebrovascular stroke (CVS) is a major problem that persists after maximum recovery of motor functions. Such pain has been attributed to altered shoulder joint kinematics causing soft tissue damage.AimEvaluation of shoulder proprioception in the ipsilateral paretic arm and contralateral unaffected side 6 months following cerebrovascular event.Subject and methodThirty adult patients (G1) with ischemic strokes ranging from 6 months to 1 year and 30 healthy control (G2) were assessed for shoulder proprioception. Angular displacement error was measured during active and passive repositioning of shoulder external and internal rotation in both patients’ shoulders and in control’s dominant upper limb.ResultsStatistically significant increase in angular displacement error was found in all tests in the affected shoulder compared to the unaffected contralateral shoulder and dominant arm of control subjects. The contralateral unaffected shoulder of patients showed within normal values and no differences with control values. Passive external and internal rotations showed statistically higher errors in patients with cortical lesions compared to those with subcortical lesions.ConclusionSix months following the CVS, shoulder proprioception deficit in the affected hemiparetic side persists. Contralateral side shows no abnormalities. Cortical lesions might be associated with late shoulder proprioception recovery compared to subcortical lesions. The side of the lesion does not seem to affect the severity of proprioception deficit.

Passive and active repositioning of a traumatically intruded immature permanent incisor: 5-year follow up

Passive and active repositioning of a traumatically intruded immature permanent incisor: 5-year follow up

Comparison of Shoulder Proprioception in Women with and without Generalized Joint Laxity

Objective Generalized joint hypermobility predisposes some individuals to a wide variety of musculoskeletal complaints, especially in the shoulder joint. Proprioception, which includes joint position sense and sense of movement, has an important role in the functional stability of shoulder joint. Given the critical role of proprioception in the functional stability of shoulder, the primary aim of this study was to compare shoulder joint position sense and sense of movement (kinesthesia) between individuals with and without general joint hyper mobility. The secondary aim of this study was to compare proprioception between dominant and non-dominant sides in each group. Materials & Methods In this causal-comparative study, 20 females with generalized joint laxity (Mean[SD] age=22.05[2.30] y) and 20 females without generalized joint laxity (Mean[SD] age=22.65[2.53] y) participated in the study. Testing was performed in the supine position. Prior to beginning each proprioception tests, the participants were given to practice trials to become familiar with the testing procedure. Proprioception tests were performed during passive repositioning and kinesthesia using an isokinetic dynamometer. The shoulder external rotation range was measured with a standard goniometer, and 90% of its range was considered as a target angle in passive reposition test. The kinesthetic sense of the shoulder was evaluated by measuring the threshold for passive external rotation. The speed of threshold to detection of passive motion test was at 0.5 deg/s and passive reproduction of joint position was at 2 deg/s. Both dominant and non-dominant sides of all the subjects were evaluated. Test sequences for measuring the threshold to detection of passive motion and passive reproduction of joint position, as well as dominant and non-dominant shoulder were random. The blindfold and headphones were used to remove visual and auditory feedback. The mean of three repetitions of passive reproduction of target angle and threshold to detection of passive motion were calculated. Independent t-test was used to compare joint position sense and kinesthesia between females with and without generalized joint lax ity, and paired t test was used to statistically analyze differences between dominant and non-dominant sides in each group. Results No significant difference was observed in joint position test acuity and of detection of motion in each of dominant and non-dominant sides between females with and without generalized joint laxity (dominant side: P=0.47, non-dominant: P=0.70). Females with generalized joint laxity exhibited significantly larger errors in passive joint reproduction tests in both dominant and non-dominant sides (P=0.001) compared with those without generalized joint laxity. Conclusion The results revealed that the angle repositioning sense in the extreme range of shoulder joints in females with generalized joint laxity is reduced compared to those without generalized joint laxity. Lower joint position test acuity in females with generalized joint laxity may relate to the disturbance or loss of sensory messages from joint receptors to the central nervous system. Reduced proprioception feedback may lead to biomechanically unsound limb positions being adopted. Such a mechanism may allow acceleration of degenerative joint conditions and may account for the increased prevalence of musculoskeletal complaints seen in subjects with generalized joint laxity. A B S T R A C T

The Effects of Sex, Limb Dominance, and Soccer Participation on Knee Proprioception and Dynamic Postural Control.

Both female athletes' participation in soccer and associated injuries have greatly increased in recent years. One issue is the 2-9 times greater incidence of noncontact anterior cruciate ligament (ACL) injuries in female athletes relative to male athletes in comparable sports. Several factors such as limb dominance and sporting history have been proposed to play a role in ACL incidence rates between male and female athletes. However, evidence about the effects of these factors and how they interact with sex is mixed, and thus no consensus exists. To quantify the effects of sports participation, limb dominance, and sex on dynamic postural control and knee-joint proprioception. Cross-sectional study. University research laboratory. 19 male soccer players, 17 female soccer players, 19 sedentary men, and 18 sedentary women. Joint-position sense was tested using reproduction of passive positioning on a Biodex isokinetic dynamometer (30°, 45°, and 60° from 90° of knee flexion). Three Star Excursion Balance Test directions were used to assess dynamic postural control. Normalized reach distance (% of leg length) in the anterior, posteromedial, and posterolateral directions on each leg quantified dynamic postural control. Average absolute error and constant error for both limbs quantified joint-position sense. Posteromedial reach distance was significantly better in soccer players than sedentary individuals (P = .006). Anterior reach distance was significantly better (P = .04) in sedentary individuals than soccer players. No limb-dominance or sex differences were identified for dynamic postural control, and no differences in absolute- or constant-error scores were identified. Sporting history has a direction-specific impact on dynamic postural control. Sporting history, sex, and limb dominance do not influence knee-joint proprioception when tested in an open kinetic chain using passive repositioning.

Long-Term Reprogramming of Cardiovascular Function in Infants of Active Smokers

Newborn infants of smokers show symptoms of cardiovascular stress hyperreactivity. Persistent hyperreactivity could increase the risk of short- and/or long-term complications, such as hypertension. Here we determined whether incipient dysfunction in a smoker's infant persists or worsens with age, by comparing cardiovascular reflex function of control and tobacco-exposed infants longitudinally from birth to 1 year. We compared infants born at term to nonsmoking couples (controls; n=19) and mothers who smoked moderately (average consumption=15 cigarettes per day; n=17). All were tested at 1 to 3 weeks, 3 months, and 1 year during sleep. We recorded blood pressure and heart rate noninvasively during passive repositioning (60 degrees head-up tilt). Tilting control infants raised blood pressure slightly above baseline at 1 week (+2%) and much more at 1 year (+10%). This trend was reversed in the tobacco-exposed cohort (+10% at 1 week but only +4% at 1 year). At 3 months and 1 year, the heart rate response of tobacco-exposed infants to tilt was also abnormal (highly exaggerated). Our study reveals that maternal smoking leads to long-lasting "reprogramming" of infant blood pressure control mechanisms. The underlying dysfunction in a smoker's infant could plausibly be a precursor or early marker of long-term susceptibility to complications, such as raised blood pressure.

Correlation between proprioception, muscle strength, knee laxity, and dynamic standing balance in patients with chronic anterior cruciate ligament deficiency

Proprioception and muscle strength are both reported to influence single-limb stance balance in patients with chronic anterior cruciate ligament (ACL) injuries. However, the effects of these parameters on dynamic stance balance in such patients are currently unknown. This study was undertaken to ascertain whether proprioception, muscle strength, and knee laxity are correlated with dynamic standing balance in patients with ACL deficiency. Ten young men with unilateral ACL deficiency participated in this study. The mean time interval from the injury to the study was 12.8 months. Knee laxity measurements, passive re-positioning (PRP) and threshold for detection of passive motion (TTDPM) proprioception tests, quadriceps and hamstring muscle strength tests, and dynamic single-limb balance tests were performed for both injured and uninjured limbs. Significant differences between the injured and uninjured sides were observed for all test parameters. As independent variables, knee laxity, PRP proprioception, and muscle strength did not correlate with dynamic standing balance for the injured limb. However, a significant positive correlation (P<0.05) between TTDPM proprioception and dynamic single-limb stance balance was observed for the injured limb. To improve dynamic single-limb stance balance in patients with ACL injuries, training in TTDPM proprioceptive ability is recommended as the most important initial approach for such patients.

Lumbar position sense and the risk of low back injuries in college athletes: a prospective cohort study

BackgroundImpaired proprioception in the lumbar spine has often been reported in people with low back pain. However, no prospective studies exist to assert the cause and effect of this association. We hypothesized that athletes with a history of low back injury (LBI) would demonstrate poorer lumbar position sense (PS) than athletes without a history of LBI, and that this deficit would be a risk factor for future LBI.MethodsThis was a prospective cohort study with 2–3 year follow-up. Lumbar spine PS in the transverse plane was evaluated in 292 athletes using three tests: 1) passive and 2) active trunk repositioning, and 3) motion perception threshold. Mean absolute (accuracy) and variable (precision) errors were computed.ResultsThere were no significant differences in the repositioning errors or motion perception threshold between athletes with and without a history of LBI or between those who did and did not get injured during the follow-up. Active trunk repositioning resulted in smaller errors than passive repositioning (1.6°± 0.8°) versus 2.1°± 1.0°) and 1.7°± 0.8°) versus 2.3°± 1.1°) for the absolute and relative errors, respectively).ConclusionPoor trunk PS in transverse plane is not associated with LBI in athletes, nor does it appear that poor trunk PS predisposes athletes to LBI.

Passive repositioning of maxillary fractures: An occasional impossibility without osteotomy

To present cases where passive repositioning of maxillary fractures was not achievable during surgery, and a method to provide passive occlusal positioning in those cases. Over a 10-year period, the maxillae of 24 patients with fractures of the maxilla could not be passively repositioned during surgery. In these cases, a Le Fort I osteotomy was performed in addition to reduction and fixation of the other midfacial fractures. All patients had passive restoration of their pretrauma occlusion during surgery. All patients except 1 had maintenance of their pretrauma occlusion at the last follow-up visit (6 weeks or more) following surgery. When passive positioning of the maxilla is not possible, a concomitant Le Fort I osteotomy can provide passive positioning of the occlusion.

Is there a difference in hip joint position sense between young and older groups?

Joint position sense (JPS) in the knee has been shown by many authors to decline with age. It has been speculated that this decrease contributes to abnormal joint mechanics during load-bearing activities and putatively results in joint degeneration. Surprisingly little research has been conducted on the human hip to determine benchmarks for normal JPS. Fifty-nine community dwelling subjects, 30 young (mean age 21.7 years) and 29 older (mean age 75 years), were recruited to determine normal reference ranges for the effect of age on hip JPS. Active and passive repositioning tasks were performed in inner and outer ranges of the hip abduction plane of movement. An electromagnetic tracking system was used to obtain accurate error measurements of the angular displacement. Results indicated no difference in hip JPS between the young and older subjects (F(1,57) = 0.011, p = .917). However, it was found that for both age groups, accurate reproduction of position at the hip joint occurred in the inner range (F(1,57) = 13.760, p < .001). For both groups, active repositioning was more accurate than passive (F(1,57) = 9.265, p = .004). In this study, no difference in hip JPS was found between young and older subjects. Accuracy was greater in the inner range, with active repositioning demonstrating higher precision compared to passive repositioning of the limb.

The effect of body orientation on shoulder proprioception

Objectives. To evaluate the effect of sitting versus lying supine on proprioception of asymptomatic shoulders, and to determine the relationship between shoulder position and movement sense acuity. Design. Repeated measures design. Setting. Laboratory in an educational institution. Participants. Fifteen healthy right-hand males. Method. Tests of passive repositioning and the threshold for detection of imposed movement were employed to examine position and movement sense acuity, respectively. Main outcome measure. For the passive repositioning test, the angular difference between the target and matching positions, i.e. ‘matching error’, and variance of matching error over repeated trials were calculated. For the threshold test, the amount of joint excursion required to detect correctly the direction of movement, i.e. ‘threshold for detection of imposed movement’, was calculated. Results. Matching error variance and threshold for detection of shoulder external rotation were significantly lower when subjects were tested in the sitting compared with supine lying positions ( p<0.05). No relationship between shoulder position and movement sense acuity was established ( r=−0.16–0.06). Conclusions. Body orientation influences shoulder proprioception. Thus, researchers and clinicians need to consider subjects' body orientation when performing shoulder proprioceptive assessment or rehabilitation. Position sense is different from movement sense. Consequently, position sense may not be used to generalise to movement sense or vice versa.

QUANTITATIVE EVALUATION OF PROPRIOCEPTION ON SURFERS AND INJURED ATHLETES

Proprioception is related to neural input to the brain regarding the position, speed and direction of the movement, vibration and pressure in a particular joint. It protects against excessive forces and injury. The PURPOSE of this study was to evaluate active and passive proprioception in 5 surfers, 4 injured athletes and 5 controls. The HYPOTHESIS was that the injured subjects have lower proprioceptive indices than the surfers. An isokinetic device (Biodex 3) was used with the knee at 20° of flexion. Testing was done following Guido's protocol. The perception of the joint position was recorded with active and passive actions. The subjects were blinded and performed 3 trials for each repositioning. The score was the difference between the repositioned angle and the starting angle of 20° degrees. The mean ± sd were calculated. RESULTS:Tablea) p = 0.003, surfers: active vs passive; b) p = 0.001 surfers vs injured; c) p = 0.001 surfers vs controls; CONCLUSION: The surfers showed better scores (p = 0.001) than the injured and the controls groups. The active re-positioning occurred with less error than the passive repositioning, and this might mean that the muscle contraction of the active mode was a stronger stimuli for the proprioceptors than the stretching of the same receptors during the passive mode, resulting in better proprioceptive feedback.