Proprioceptive Research Articles

Association between joint position sense, range of motion, pain-related anxiety, disability and deep neck muscles thickness in non-specific chronic neck pain patients with high and low levels of fear of pain: a cross-sectional study

Association between joint position sense, range of motion, pain-related anxiety, disability and deep neck muscles thickness in non-specific chronic neck pain patients with high and low levels of fear of pain: a cross-sectional study

Reliability of Sensorimotor Control Tests in Individuals with Adolescent Idiopathic Scoliosis

Background: The presence of sensorimotor control deficits in adolescent idiopathic scoliosis compared to typically developed adolescents is supported by the literature but lacks reliability studies for assessment in this population. This study aimed to assess the reliability of eight sensorimotor control tests, in terms of static and dynamic balance, joint position sense (JPS) tests of the extremities and the spine, and a functional upper extremity proprioceptive test in adolescent idiopathic scoliosis subjects. Methods: Sixty adolescent idiopathic scoliosis subjects were divided into four groups. Each group underwent two tests by the same examiner, repeated at 15 min intervals. Reliability was measured using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest detectable difference (SDD). Results: The results showed high reliability for the upper extremity functional proprioception test, for the dynamic and static balance test, and for the spinal lateral flexion joint position sense test in both directions. On the other hand, the shoulder external rotation, knee extension, elbow flexion, and spinal flexion joint position sense tests demonstrated poor reliability in adolescent idiopathic scoliosis subjects. Conclusions: Therapists are recommended to use the functional upper extremity proprioception test, the Fukuda test, the static balance test using a force footplate, and the spinal lateral flexion joint position sense test for assessing treatment progress in this population.

Good vibes for the brain - Placebo versus real vibration in patients with chronic neck pain: A randomized cross-over study

BackgroundNeck muscle vibration decreases pain and improves sensorimotor impairments in patients with chronic neck pain. However, the impact of placebo on these effects are still unclear. ObjectiveThe aim was to evaluate the effect of neck muscle vibration compared to placebo neck muscle vibration in patients with chronic neck pain. MethodsTwenty-three people with chronic neck pain participated in this double-blinded, randomized crossover study. After baseline assessment at day 1, patients received either neck muscle vibration or placebo neck muscle vibration at day 2. At day 3, patients underwent the other treatment. The primary outcomes assessed at each day were active cervical joint position sense acuity, resting pain, and pressure pain threshold. ResultsCervical joint position sense revealed a significant time effect (F1, 22 = 4.366, p = 0.016, η2 = 0.902). Post-hoc testing revealed significant increases in cervical joint position sense after neck muscle vibration (p = 0.023; d = 0.602) but not after placebo vibration. Resting pain (F1, 22 = 7.550, p = 0.003, η2 = 0.418) displayed significant time effects for neck muscle vibration and placebo vibration. Pressure pain threshold demonstrated a significant time to condition effect (F1, 22 = 6.146; p = 0.008, η2 = 0.369). Post-hoc tests revealed that only neck muscle vibration significantly increased pressure pain threshold (p = 0.043, d = 0.516). ConclusionThe study demonstrates the efficacy of neck muscle vibration to decrease neck pain and improve cervical joint position sense in patients with chronic neck pain. Nevertheless, the influence of placebo effects should not be underestimated as they may contribute to these effects, indicated by similar decreases in resting pain.

Effects of adding core stability training to conventional rehabilitation protocol on shoulder function after rotator cuff repair

Background. Rotator cuff tear (RCT) is a prevalent cause leading to shoulder disability and is widely recognized as one of the primary causes of pain as well as dysfunction in the shoulder. The core stabilization exercise program improved the strength of the shoulder muscles. The core stability training (CST) may be utilized during the early phases of shoulder rehabilitation. Purpose. To assess the impacts of adding CST to the conventional rehabilitation protocol on function, proprioception, as well as range of motion (ROM) of shoulder joint following rotator cuff repair (RCR). Methods. Fifty-two participants after RCR were assigned to two groups in a random manner; group I (n = 26) and group II (n = 26). Participants in groups I and II were engaged in a conventional rehabilitation protocol for 12 weeks after RCR. Group II additionally performed CST after the 8th week until the 12th week of RCR. Outcome measures were shoulder function using the Arabic shoulder pain and disability index (SPADI), shoulder joint position sense (JPS) (proprioception accuracy through detecting absolute angle of error) using digital inclinometer, ROM in shoulder flexion, abduction, internal rotation, as well as external rotation using the digital inclinometer. Unpaired t-test, chi square, and MANOVA test were implemented for data analysis. Results. Compared to the pre-treatment condition, the post treatment results revealed that there were statistical substantial improvements (p < 0.05) in SPADI score, absolute angle of error, and ROM flexion, abduction, external rotation and internal rotation) in both groups, even though there were substantial differences among both groups at all post-treatment measures (p < 0.05) in favor of group II. Conclusion. Incorporating CST into the conventional rehabilitation protocol after RCR leads to notable enhancements in shoulder joint function, proprioception, and ROM for flexion, abduction, internal rotation, as well as external rotation.

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.

Assessment of Cervical Joint Position Sense and Head Posture in Individuals With Myogenic Temporomandibular Dysfunctions and Identifying Related Factors: A Case-Control Study.

Temporomandibular dysfunctions (TMDs) have the potential to cause changes in cervical muscle strength, muscle endurance and position sense by changing muscle activation patterns, especially as a result of forward head posture. The effects of TMDs on cervical joint position sense (CJPS) and head posture remain controversial. The aim of this study was to evaluate the head posture and CJPS of individuals with TMDs and compare them with healthy individuals. This research, which was designed as a case-control study, was concluded with the inclusion of total of 84 participants (42 individuals diagnosed with myogenic TMDs, 42 controls). The assessment of participants included pain severity, neck and jaw functionality and disability, CJPS, head posture and temporomandibular joint (TMJ) range of motion (ROM). Individuals with TMDs exhibited higher angular deviation in CJPS during flexion and extension (p < 0.001). Additionally, individuals with TMDs demonstrated higher TMJ pain, limitation and dysfunction severity, as well as a more limited TMJ ROM (p < 0.001). Head posture was similar between groups (p > 0.05). There is a significant relationship between VAS-TMJ with VAS-cervical, FAI, NDI, JFLS-8 and TMJ ROM (p < 0.05). Moreover, a significant correlation was observed between NDI with FAI and TMJ ROM (p < 0.05). These results indicate that in addition to higher pain severity, disability and lower jaw ROM, CJPS of individuals with TMDs is also negatively affected. Also, parameters related to disability and functionality of cervical and TMJ were significantly correlated. Further studies are needed to determine the factors contributing to these results.

The middle class and the media in post-war Japanese mass society theory: domination, satisfaction, connection, and construction

The inconsistency between an objective socioeconomic position and subjective sense of belonging is challenging for middle class studies. Scholars have argued that the information and images the media conveys can become a ‘reference group’ influencing people’s subjective sense of belonging to the middle class, leading to subjective-objective inconsistency. However, the media—the crucial influencing factor—was always on the periphery of class research. This article demonstrates that in today’s media-saturated world, the media plays a critical role in progressively altering social structures, cognitive underpinnings, and behavioral logic; therefore, it is a key variable in class studies. The analysis of discussions on the middle class and media in post-war Japanese mass society theory reveals that some representative viewpoints remain relevant for understanding the middle class from a media perspective. This article revisits the theories of mass society in post-war Japan, and affirms the media’s role in mediating subjective and objective middle-class identities, and constructing class belongingness. It identifies four fundamental perspectives—domination, satisfaction, connection, and construction—to investigate the relationship between media and the middle class. It also highlights the potential to analyze the middle class from a media standpoint, and issues that subsequent research should address.

The effect of juggling on the proprioceptive and attentional abilities among older women.

Age-related changes in attentional abilities can lead to a decline in body segment awareness in space. However, studies have reported that physical activity can improve proprioception among older adults, although proven activities with this potential are limited. Juggling is a promising activity for enhancing proprioception, as it requires high levels of attention and sensory precision. The first hypothesis posited that a juggling intervention would positively impact ipsilateral and contralateral elbow joint position matching without visual input. The second hypothesis suggested a correlation between cognitive abilities and joint position sense efficiency. A total of 20 older women (mean age: 69.95 ± 4.58) participated in a repeated-measures study using a Latin square design. Measurements were taken at three time points (baseline, post-juggling, and control). Ipsilateral and contralateral elbow joint position matchings without visual or verbal feedback of accuracy were used to assess proprioception. Attention and reaction time variables were measured using the Vienna Test System protocols. Although significant changes were observed between baseline and subsequent time points in joint position sense accuracy, no specific effect of juggling was detected. Low and medium correlations were found between decision time and the variability of choice reaction time with contralateral accuracy. For ipsilateral accuracy, a relationship was observed only with handedness. No correlations were found between attention test scores and joint position sense accuracy. The study did not demonstrate a significant effect of juggling on position-matching ability. However, cognitive abilities such as decision speed and the stability of choice reaction time may play a role in enhancing position-matching in older women. ClinicalTrials.gov, identifier NCT06108713.

Exploring the Interplay Between Kinesiophobia, Lumbar Joint Position Sense, Postural Stability, and Pain in Individuals With Chronic Low Back Pain: A Cross-Sectional Analysis

ObjectiveThe objectives of the study were to (1) determine the association between kinesiophobia and lumbar joint position sense (JPS) in individuals with chronic low back pain (CLBP); (2) examine the relationship between kinesiophobia and postural stability in individuals with CLBP; and (3) investigate whether pain intensity mediates the relationship between kinesiophobia, lumbar JPS, and postural stability in individuals with CLBP. MethodsIn this cross-sectional study, a total of 83 individuals diagnosed with CLBP were included. The level of fear of movement was assessed using the Tampa Scale for Kinesiophobia (TSK). Lumbar JPS was measured using the active target repositioning technique, which involved evaluating JPS in 3 directions: lumbar flexion, side-bending to the left, and side-bending to the right. The repositioning accuracy of the lumbar joint was quantified in degrees using a dual digital inclinometer. Postural stability was assessed using a stabilometric force platform, which measured anterior to posterior (A-P) sway, medial to lateral (M-L) sway, and the ellipse area in mm². ResultsThe findings of this study revealed a statistically significant and moderate positive correlation between kinesiophobia and lumbar JPS in various directions, including flexion (r = 0.51, P < .001), side-bending to the left (r = 0.37, P = .001), and side-bending to the right (r = 0.34, P = .002). Similarly, a significant positive association was observed between kinesiophobia and postural stability, as indicated by the correlation coefficients: A-P sway (r = .47, P < .001), M-L sway (r = 0.58, P < .001), and ellipse area (r = 0.51, P < .001). Furthermore, the analysis revealed that pain significantly mediated the relationship between kinesiophobia and both lumbar JPS (P < .05) and postural stability (P < .05). These findings were demonstrated through mediation analysis. ConclusionsThis study identified a significant association between kinesiophobia, lumbar JPS, and postural stability. Additionally, we observed the presence of pain as a potential mediator in this relationship. However, it is important to note that our cross-sectional study design precludes establishing causality or determining the direct mediation effect of pain on adverse outcomes.

Effect of the menstrual cycle on knee joint position sense and dynamic balance

The objective of this study was to examine how the menstrual cycle affects knee joint position sense (JPS) and dynamic balance. Forty-five physically active women (age 20.87 ± 0.54 years) participated in this study. Pain was measured with a Visual Analogue Scale (VAS). Knee JPS was measured using the passive-active repositioning method using a digital inclinometer. The modified Star Excursion Balance Test was used to assess dynamic balance (SEBT). The VAS scores were higher in the menses phase compared to the mid-luteal phase (p < 0.001) and mid-follicular phase (p = 0.002). No significant differences were found between phases of the menstrual cycle for JPS in 30° (p > 0.05) and 60° of knee flexion (p > 0.05). There were significant differences in the anterior (p = 0.028), posteromedial (p < 0.001), and posterolateral (p < 0.001) directions of the modified SEBT. The values of the anterior direction in a mid-follicular phase were higher than the menses phase (p = 0.017). Mid-luteal phase values in the posteromedial direction were greater than mid-follicular phase (p = 0.008) and menses phase (p < 0.001). The values of the posterolateral direction in the mid-luteal phase (p < 0.001) and mid-follicular phase (p = 0.009) were higher than in the menses phase. In conclusion, the knee JPS did not change during the menstrual cycle in physically active women. However, the dynamic balance performance was at the lowest level in the menses phase. The risk of injury should be considered during menstruation, especially in activities that require dynamic balance skills in physically active women.

Prevalence and associated factors of non-traumatic shoulder pain during spike and serve movements in male high school volleyball players: a cross-sectional study

BackgroundNontraumatic shoulder pain is a prevalent issue among male high school volleyball players, but its comprehensive assessment has been lacking in prior research, which often isolated specific aspects of shoulder function. This study aimed to identify contributing factors to shoulder pain in this population. HypothesisThe hypothesis posited that limited shoulder internal rotation (IR) range of motion (ROM), imbalance in rotator cuff muscle strength, intrinsic sensory disturbance, and joint stability are associated with shoulder pain in male high school volleyball players. Additionally, there was an anticipation that a substantial proportion of players would experience shoulder pain but refrain from reporting it to coaches. MethodsForty-nine male volleyball players aged 15-17 years were evaluated between February and June 2023. Questionnaires assessed the prevalence of shoulder pain during spiking and/or serving, as well as the frequency of reporting this pain to coaches. Various factors, including acromio-humeral distance, shoulder ROM, isometric strength, proprioception, joint stability (Upper Quarter Y-Balance Test), joint position sense, and upper extremity power (Seated Medicine Ball Throw Test; SMBT), were quantified. Logistic regression analyses was conducted to explore potential connections between these variables and shoulder pain. ResultsShoulder pain was reported by 39% of participants, but it was rarely communicated to coaches (95%). Jump serves (odds ratio 1.84, p=0.02) and reduced shoulder IR ROM (odds ratio 0.94, p=0.03) were associated with shoulder pain. ConclusionThis study provides crucial insights into the prevalence, severity, and associated factors of shoulder pain among male high school volleyball players. The findings underscore the importance of improving athlete-coach communication to facilitate early intervention and preventive measures. Significant associations were observed between the use of jump serves, reduced shoulder internal rotation range of motion, and shoulder pain, highlighting the relevance of specific volleyball techniques in injury prevention. These findings offer valuable guidance to coaches and trainers in developing interventions aimed at mitigating the risk of shoulder pain and enhancing player performance.

Successful ACL repair by dynamic intraligamentary stabilisation is non-inferior in functional performance and worse in proprioception compared to healthy controls in a case-matched study.

The primary aim of this study was to assess non-inferiority in functional performance of the knee after dynamic intraligamentary stabilisation (DIS) surgery at a minimal follow-up of 1 year compared to healthy controls, based on limb symmetry index (LSI) of the single leg hop test (SLH). Additionally, functional performance based on the single leg triple hop test (SLTH) and side hop test (SH), proprioception and subjective outcome were evaluated. A total of 45 DIS patients were 1-to-1 matched to a healthy control. Functional performance was evaluated by LSI and absolute values on the SLH, SLTH and SH. Proprioception was assessed by joint position sense (JPS) test and International Knee Documentation Committee (IKDC) scores were obtained. Non-inferiority in functional performance after DIS compared to healthy controls was confirmed based on the mean LSI of the SLH and SLTH (97.6% vs. 99.6% and 97.5% vs. 100.6%, respectively) and non-confirmed on the SH (98.8% vs. 100.0%, respectively). No significant differences were found in absolute value of the SLH and SLTH and a significantly higher absolute value of the SH was found in the DIS group (p = 0.01). JPS absolute angular error was significantly higher in the DIS group compared to the control group (p = 0.01). The median IKDC score of the DIS group was significantly lower (92, IQR 85-95) than the control group (100, IQR 99-100), p < 0.001. In conclusion, functional performance after DIS was confirmed non-inferior compared to healthy controls based on the SLH and SLTH, although non-confirmed on the SH. Level III.

How effective is proprioception exercise on pain, grip force, dexterity and proprioception of elbow joint in patients with tennis elbow? A randomized controlled trial

BackgroundPatients with tennis elbow (TE) disorder suffer from proprioception deficits alongside other symptoms, which usually is neglected to be targeted in different physiotherapy protocols. This study aimed to investigate the effects of proprioception exercises on treatment outcomes. MethodsIn this RCT, 14 males and 30 females TE volunteered patients were randomly divided into two intervention (IG) and control (CG) groups, in which CG received routine physiotherapy, while IG underwent further proprioception exercises for 18 sessions within six weeks. Pain, function, grip force, dexterity, and proprioception of elbow joint were evaluated using Patient-Rated Elbow Evaluation (PREE) questionnaire, handheld dynamometer, Purdue Pegboard, and isokinetic dynamometer, respectively. ResultsA significant within group improvement was observed in terms of pain (IG: 49.93%, CG: 42.75%), function (IG: 61.9%, CG: 48.95%), grip force (IG: 22.1% CG: 16.9%), dexterity (IG: 18.96% CG: 11.82%), active joint position error (IG: 32.99, CG: 7.33 %), and the threshold to detection of passive motion (TTDPM) for both groups (IG: 24.35, CG: 24.86%) in both groups after treatment as compared to before treatment (p < .0001), with no statistically significant differences between the groups for these variables except for active joint position error, which showed a significant reduction in the IG (p < .02). ConclusionIt could be concluded that proprioception exercises has a limited added value on routine physiotherapy it terms of pain, function, grip force, and dexterity. However, adding proprioception exercises found to be beneficial for improving variables determining joint position sense.

Relationship Between Thoracolumbar Joint Position Sense And Range Of Motion Among Collegiate Baseball Players

Relationship Between Thoracolumbar Joint Position Sense And Range Of Motion Among Collegiate Baseball Players

Three-Axis Flat and Lightweight Force/Torque Sensor for Enhancing Kinesthetic Sensing Capability of Robotic Hand

Three-Axis Flat and Lightweight Force/Torque Sensor for Enhancing Kinesthetic Sensing Capability of Robotic Hand

Knee joint position sense and kinematic control in relation to motor competency in 13 to 14-year-old adolescents

BackgroundMotor competence (MC) is a key component reflecting one’s ability to execute motor tasks and is an important predictor of physical fitness. For adolescents, understanding the factors affecting MC is pertinent to their development of more sophisticated sporting skills. Previous studies considered the influence of poor proprioceptive ability on MC, however, the relationship between lower limb joint position sense, kinematic control, and MC is not well understood. Therefore, the aim of this study was to determine the relation between joint position sense and kinematic control with MC in adolescents during a lower limb movement reproduction task.MethodsThis study was a cross-sectional design. Young people (n = 427, 196 girls and 231 boys) aged 13 to 14 years were recruited. A movement reproduction task was used to assess joint position sense and kinematic control, while the Movement Assessment Battery for Children (mABC-2) was used to assess MC. In this study, participants were categorized into the Typically Developed (TD, n = 231) and Probable Developmental Coordination Disorder (DCD, n = 80) groups for further analysis of joint position sense, kinematic control, and MC between groups.ResultsKinematic data, specifically normalized jerk, showed a significant correlation with MC. There was no correlation between knee joint position sense and MC, and no group differences between DCD and TD were found.ConclusionsJoint position sense should not be used as a measure to distinguish TD and DCD. Rather than joint position sense, control of kinematic movement has a greater influence on the coordination of the lower limbs in adolescents. Movement control training should be implemented in the clinical setting to target kinematic control, rather than focus on joint position sense practice, to improve motor competency.Trial Registration IdentifierNCT03150784. Registered 12 May 2017, https://clinicaltrials.gov/study/NCT03150784.

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.

The Relationships Between Wrist Joint Position Sense, Anthropometric Characteristics and Grip Strength of the Hand in Healthy Individuals

The Relationships Between Wrist Joint Position Sense, Anthropometric Characteristics and Grip Strength of the Hand in Healthy Individuals

Visual experience is required to develop a flexible sense of position.

Visual experience is required to develop a flexible sense of position.

Effects of gait retraining in knee joint position sense

BackgroundJoint position sense (JPS) is crucial for maintaining posture, protecting joints, and carrying out daily activities such as walking. Studies show that exercises to strengthen muscles and improve proprioception can positively impact JPS during passive and less complex activities. Evidence suggests that motor training can effectively enhance sensory function, including JPS, due to the extensive connections between the motor cortex and somatosensory areas. Gait retraining using real-time feedback has improved outcomes among patients with musculoskeletal disorders. The effect of gait retraining on JPS has not been investigated. This study assessed the effects of gait retraining to reduce knee extension in joint position sense in individuals with knee hyperextension walking patterns. MethodsTen women with asymptomatic knee hyperextension (KH) >5° during overground walking participated in this study. Sagittal-plane kinematics were assessed using a three-dimensional (3D) motion analysis system. The JPS was assessed using the Knee Position Active Reproduction Test. The knee with the highest hyperextension was the focus of the gait retraining intervention, which consisted of six 1-h sessions using verbal instructions and visual kinematic feedback. Comparisons of peak knee extension during walking and knee JPS overall error (RMSE) were made using a paired t-test. ResultsGait retraining intervention significantly reduced knee extension angle during walking (83.8 % change; p < 0.001; Cohen's d = −1.6) and improved knee JPS (62 % change; p = 0.023; Cohen's d = 0.8) post-training. In addition, the improvements in joint kinematics (36.7 % change; p = 0.005; Cohen's d = −1.2) and JPS (52.6 % change; p = 0.015; Cohen's d = 0.9) were observed in the untrained knee. SignificanceGait retraining can improve joint position sense. This study addresses a gap in our understanding of how gait retraining can influence JPS. Our results corroborate that gait retraining is an evolving and promising strategy for improving gait outcomes, particularly in individuals with KH walking patterns.