1
|
Mirghaderi P, Poursalehian M, Eshraghi N, Ayati Firoozabadi M, Mortazavi SMJ. Patients' joint perception after anterior cruciate ligament reconstruction as a reliable patient-reported outcome measure. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 39132712 DOI: 10.1002/ksa.12416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 07/11/2024] [Accepted: 07/18/2024] [Indexed: 08/13/2024]
Abstract
PURPOSE This study aims to evaluate and compare patients' joint perception (PJP) with other commonly employed patient-reported outcome measures (PROMs) in a cohort of patients following anterior cruciate ligament reconstruction (ACLR). METHODS A retrospective study was conducted on 108 patients who underwent ACLR between 2017 and 2021, with complete data available for visual analogue scale (VAS) pain, PJP, Forgotten Joint Score (FJS), Tegner Activity Scale, Lysholm Knee Scoring Scale, Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI), Single Assessment Numeric Evaluation (SANE), Cincinnati Knee Rating System (CKRS) and The Hospital for Special Surgery Anterior Cruciate Ligament Satisfaction Survey (HSS ACL-SS) at a mean follow-up of 3 years. Spearman's rank-order correlation was used to determine the correlations between clinical scores. A receiver operating characteristic (ROC) curve analysis was used to assess the discriminatory power of the chosen PROMs in detecting natural joint perception. Natural joint perception was defined as patients responding 'like a native or natural joint' or PJP = 1. This study hypothesized that PJP would demonstrate significant correlations with established PROMs, indicating its reliability and validity as a tool for assessing outcomes following ACLR. RESULTS PJP showed significant correlations with all the reported PROMs, suggesting its potential as a valid and reliable assessment tool for evaluating ACLR outcomes. The ROC curve analysis indicated a good area under the curve for identifying natural joint perception using various PROMs. According to the PJP, nearly 20% of patients reported natural joint perception. CONCLUSION This study evaluates PJP as a reliable tool for assessing patient outcomes following ACLR. Its significant correlation with other established PROMs underscores its potential as a valuable addition to the existing array of PROMs in ACLR. LEVEL OF EVIDENCE Level III.
Collapse
Affiliation(s)
- Peyman Mirghaderi
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Poursalehian
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Eshraghi
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - S M Javad Mortazavi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Heß T, Milani TL, Kilper A, Mitschke C. Immediate Effects of Wearing an Ankle Bandage on Fine Coordination, Proprioception, Balance and Gait in the Subacute Phase of Ankle Sprains. Life (Basel) 2024; 14:810. [PMID: 39063565 PMCID: PMC11277678 DOI: 10.3390/life14070810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
Ankle sprains are the most frequently occurring musculoskeletal injuries among recreational athletes. Ankle support through bandages following the initial orthotic treatment might be beneficial for rehabilitation purposes. However, the literature is sparse regarding the use of an ankle support directly after the acute phase of an ankle sprain. Therefore, this study investigates the hypothesis that wearing an ankle bandage immediately after an acute ankle sprain improves motor performance, stability and reduces pain. In total, 70 subjects with acute unilateral supination trauma were tested. Subjects were tested five weeks post-injury to assess immediate effects of the ankle bandage. On the testing day, subjects completed rating questionnaires and underwent comprehensive biomechanical assessments. Biomechanical investigations included fine coordination and proprioception tests, single leg stances, the Y-Balance test, and gait analysis. All biomechanical investigations were conducted for the subject's injured leg with and without a bandage (MalleoTrain® Bauerfeind AG, Zeulenroda-Triebes, Germany) and the healthy leg. Results indicated moderate to strong improvements in ankle stability and pain relief while wearing the bandage. Wearing the bandage significantly normalized single leg stance performance (p < 0.001), stance phase duration (p < 0.001), and vertical ground reaction forces during walking (p < 0.05). However, the bandage did not have a clear effect on fine coordination and proprioception. The findings of our study suggest that ankle bandages may play a crucial role in early-stage rehabilitation by enhancing motor performance and reducing pain.
Collapse
Affiliation(s)
- Tobias Heß
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
| | - Thomas L. Milani
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
| | - Anica Kilper
- Medical Center of Chemnitz, Department of Orthopaedics, Trauma and Hand Surgery, 09116 Chemnitz, Germany
| | - Christian Mitschke
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
| |
Collapse
|
3
|
Çalik M, Erdoğanoğlu Y, Çalik M, Vural M. Shoulder proprioception changes in postmastectomy patients: an observational study. Support Care Cancer 2024; 32:444. [PMID: 38896143 DOI: 10.1007/s00520-024-08651-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE Breast cancer surgery can cause changes in the anatomical structure of the shoulder and in shoulder mobility, leading to the increased possibility of long-term arm morbidity such as lymphedema. This study aims to evaluate the active shoulder joint position sense (AJPS) with and without lymphedema in postmastectomy patients. METHODS A total of 66 women, including 22 patients with lymphedema, 22 patients without lymphedema, and 22 healthy controls, were enrolled in the study. Pain severity was evaluated with the Numeric Pain Scale and edema severity was measured with circumferentially at 10 cm intervals. The normal range of motion of the shoulder joint was evaluated with the universal goniometer and the AJPS was assessed by active position repetition testing at 55°, 90°, and 125° shoulder flexion targets using the smartphone application "Clinometer." RESULTS AJPS at 55°, 90°, and 125° shoulder flexion target angles with and without lymphedema were different in all target angles compared to healthy controls (p < 0.01). There was a difference between the absolute error value of AJPS at 55° flexion (p < 0.05), and no difference at 90° and 125° flexion between the with and without lymphedema groups (p > 0.05). CONCLUSION This study shows that the AJPS was negatively affected in with and without lymphedema postmastectomy patients compared to healthy controls. This result emphasizes the importance of adding personalized methods for the restoration of joint position sense in addition to rehabilitation programs generally applied to the patient group.
Collapse
Affiliation(s)
- Meryem Çalik
- Bakırköy Dr Sadi Konuk Training Hospital, Physical Therapy and Rehabilitation Department, Lymphedema Unit, University of Health Sciences, Zuhuratbaba Mah. Tevfik Sağlam Cad. No:11, Bakırköy, Istanbul, Turkey.
| | - Yıldız Erdoğanoğlu
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Antalya Bilim University, Çıplaklı Mah. Akdeniz Bulvarı, No: 290/A, Döşemealtı, Antalya, Turkey
| | - Mahmut Çalik
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department İstanbul, Haliç University, Levent Mahallesi, 15 Temmuz Şehitler Caddesi, No: 14/12, Eyüpsultan, İstanbul, Turkey
| | - Meltem Vural
- Bakırköy Dr Sadi Konuk Training Hospital, Physical Therapy and Rehabilitation Department, Lymphedema Unit, University of Health Sciences, Zuhuratbaba Mah. Tevfik Sağlam Cad. No:11, Bakırköy, Istanbul, Turkey
| |
Collapse
|
4
|
Jebreen M, Maffulli N, Migliorini F, Arumugam A. Known-group validity of passive knee joint position sense: a comparison between individuals with unilateral anterior cruciate ligament reconstruction and healthy controls. J Orthop Surg Res 2023; 18:525. [PMID: 37481595 PMCID: PMC10363318 DOI: 10.1186/s13018-023-03996-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/10/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Knee 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. METHODS This 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. RESULTS Mean 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. CONCLUSION The 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.
Collapse
Affiliation(s)
- Mustafa Jebreen
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Physiotherapy and Rehabilitation Department, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, SA, Italy
- Faculty of Medicine, School of Pharmacy and Bioengineering, Keele University, Stoke on Trent, England
- Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, London, England
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital of Aachen, 52074, Aachen, Germany.
- Department of Orthopaedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy.
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Science and Engineering, University of Sharjah, Sharjah, United Arab Emirates
- Department of Physiotherapy, Adjunct Faculty, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
5
|
Jebreen M, Sole G, Arumugam A. Test-Retest Reliability of a Passive Joint Position Sense Test After
ACL Reconstruction: Influence of Direction, Target Angle, Limb, and Outcome
Measures. Orthop J Sports Med 2023; 11:23259671231157351. [PMID: 36970320 PMCID: PMC10034299 DOI: 10.1177/23259671231157351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/13/2022] [Indexed: 03/24/2023] Open
Abstract
Background: The joint position sense (JPS) is an element of proprioception and defined as
an individual’s ability to recognize joint position in space. The JPS is
assessed by measuring the acuity of reproducing a predetermined target
angle. The quality of psychometric properties of knee JPS tests after
anterior cruciate ligament reconstruction (ACLR) is uncertain. Purpose/Hypothesis: The purpose of this study was to evaluate the test-retest reliability of a
passive knee JPS test in patients who underwent ACLR. We hypothesized that
the passive JPS test would produce reliable absolute error, constant error,
and variable error estimates after ACLR. Study Design: Descriptive laboratory study. Methods: Nineteen male participants (mean age, 26.3 ± 4.4 years) who had undergone
unilateral ACLR within the previous 12 months completed 2 sessions of
bilateral passive knee JPS evaluation. JPS testing was conducted in both the
flexion (starting angle, 0°) and the extension (starting angle, 90°)
directions in the sitting position. The absolute error, constant error, and
variable error of the JPS test in both directions were calculated at 2
target angles (30° and 60° of flexion) by using the angle reproduction
method for the ipsilateral knee. The standard error of measurement (SEM),
smallest real difference (SRD), and intraclass correlation coefficients
(ICCs) with 95% Cis were calculated. Results: ICCs were higher for the JPS constant error (operated and nonoperated knee,
0.43-0.86 and 0.32-0.91, respectively) compared with the absolute error
(0.18-0.59 and 0.09-0.86, respectively) and the variable error (0.07-0.63
and 0.09-0.73, respectively). The constant error of the 90°-60° extension
test showed moderate to excellent reliability for the operated knee (ICC,
0.86 [95% CI, 0.64-0.94]; SEM, 1.63°; SRD, 4.53°), and good to excellent
reliability for the nonoperated knee (ICC, 0.91 [95% CI, 0.76-0.96]; SEM,
1.53°; SRD, 4.24°). Conclusion: The test-retest reliability of the passive knee JPS tests after ACLR varied
depending on the test angle, direction, and outcome measure (absolute error,
constant error, or variable error). The constant error appeared to be a more
reliable outcome measure than the absolute error and the variable error,
mainly during the 90°-60° extension test. Clinical Relevance: As constant errors have been found reliable during the 90°-60° extension
test, investigating these errors—in addition to absolute and variable
errors—to reflect bias in passive JPS scores after ACLR is warranted.
Collapse
Affiliation(s)
- Mustafa Jebreen
- Department of Physiotherapy, College of Health Sciences, University
of Sharjah, Sharjah, United Arab Emirates
- Physiotherapy and Rehabilitation Department, Sheikh Shakhbout
Medical City, Abu Dhabi, United Arab Emirates
| | - Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of
Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University
of Sharjah, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, Research
Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United
Arab Emirates
- Sustainable Engineering Asset Management Research Group, Research
Institute of Sciences and Engineering, University of Sharjah, Sharjah, United Arab
Emirates
- Department of Physiotherapy, Manipal College of Health Professions,
Manipal Academy of Higher Education, Manipal, Karnataka, India
- Ashokan Arumugam, MPT, PhD, Department of Physiotherapy, College
of Health Sciences, University of Sharjah, PO Box 27272, Sharjah, United Arab
Emirates (;
)
| |
Collapse
|
6
|
Ozyalvac ON, Aydin CG, Akpinar E, Bayhan AI, Yildirim T. Isokinetic Analysis of Flexible Flatfoot: Is It a Weakness of Proprioception and Muscle Strength? J Am Podiatr Med Assoc 2022; 112:20-045. [PMID: 36525326 DOI: 10.7547/20-045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although flexible flatfoot (FF) in children is a foot deformity that is frequently encountered in daily orthopedics practice, its etiology is still controversial. The aim of this study was to determine whether there is a weakness in muscle strength and proprioception in patients with FF. METHODS The study group consisted of 16 cases with FF, and the control group consisted of 25 volunteers with normal feet. An isokinetic dynamometer was used to assess muscle strength and proprioception of movement directions of plantarflexion, dorsiflexion, eversion (EV), and inversion (INV) in both groups. RESULTS There was no statistically significant difference between the groups in strength of plantarflexion and dorsiflexion muscles, whereas in the control group, proprioception of all four movement directions and strengths of the EV and INV muscles were found to be statistically significantly higher (P < .05). CONCLUSIONS There is weakness in EV and INV muscle strength and proprioception disorder in patients with FF. We recommend conducting further studies that validate muscle weakness and proprioception disorders with different study designs and evaluate the effectiveness of improving muscle strength and proprioception weakness in FF.
Collapse
Affiliation(s)
| | - Canan Gonen Aydin
- *Baltalimani Bone Diseases Training and Research Center, İstanbul, Turkey
| | - Evren Akpinar
- *Baltalimani Bone Diseases Training and Research Center, İstanbul, Turkey
| | - Avni Ilhan Bayhan
- *Baltalimani Bone Diseases Training and Research Center, İstanbul, Turkey
| | - Timur Yildirim
- *Baltalimani Bone Diseases Training and Research Center, İstanbul, Turkey
| |
Collapse
|
7
|
Proprioceptive Cervicogenic Dizziness: A Narrative Review of Pathogenesis, Diagnosis, and Treatment. J Clin Med 2022; 11:jcm11216293. [DOI: 10.3390/jcm11216293] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 01/17/2023] Open
Abstract
Basic science and clinical evidence suggest that cervical spine disorders can lead to dizziness. The cervical spine has highly developed proprioceptive receptors, whose input information is integrated with the visual and vestibular systems in the central nervous system, acting on the neck and eye muscles to maintain the coordinative motion of the head, eyes, neck, and body through various reflex activities. When the cervical proprioceptive input changes due to the mismatch or conflict between vestibular, visual, and proprioceptive inputs, cervicogenic dizziness may occur. The diagnosis of cervicogenic dizziness can be determined based on clinical features, diagnostic tests, and the exclusion of other possible sources of dizziness. The cervical torsion test appears to be the best diagnostic method for cervicogenic dizziness. Based on the available evidence, we first developed the diagnostic criteria for cervicogenic dizziness. Treatment for cervicogenic dizziness is similar to that for neck pain, and manual therapy is most widely recommended.
Collapse
|
8
|
Xie HM, Xing ZT, Chen ZY, Zhang XT, Qiu XJ, Jia ZS, Zhang LN, Yu XG. Regional brain atrophy in patients with chronic ankle instability: A voxel-based morphometry study. Front Neurosci 2022; 16:984841. [PMID: 36188473 PMCID: PMC9519998 DOI: 10.3389/fnins.2022.984841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/22/2022] [Indexed: 11/23/2022] Open
Abstract
The objective of this study was to investigate whether brain volume changes occur in patients with chronic ankle instability (CAI) using voxel-based morphometry and assessing correlations with clinical tests. Structural magnetic resonance imaging data were prospectively acquired in 24 patients with CAI and 34 healthy controls. CAI symptoms and pain intensity were assessed using the Foot and Ankle Ability Measure (FAAM), Cumberland Ankle Instability Tool (CAIT), American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and visual analog scale (VAS). The gray matter volume (GMV) of each voxel was compared between the two groups while controlling for age, sex, weight, and education level. Correlation analysis was performed to identify associations between abnormal GMV regions and the FAAM score, AOFAS score, VAS score, disease duration, and body mass index. Patients with CAI exhibited reduced GMV in the right precentral and postcentral areas, right parahippocampal area, left thalamus, left parahippocampal area, and left postcentral area compared to that of healthy controls. Furthermore, the right parahippocampal (r = 0.642, p = 0.001), left parahippocampal (r = 0.486, p = 0.016), and left postcentral areas (r = 0.521, p = 0.009) were positively correlated with disease duration. The left thalamus was positively correlated with the CAIT score and FAAM activities of daily living score (r = 0.463, p = 0.023 and r = 0.561, p = 0.004, respectively). A significant positive correlation was found between the local GMV of the right and left parahippocampal areas (r = 0.487, p = 0.016 and r = 0.763, p < 0.001, respectively) and the AOFAS score. Neural plasticity may occur in the precentral and postcentral areas, parahippocampal area, and thalamus in patients with CAI. The patterns of structural reorganization in patients with CAI may provide useful information on the neuropathological mechanisms of CAI.
Collapse
Affiliation(s)
- Hui-Min Xie
- Medical School of Chinese PLA, Beijing, China
- Department of Rehabilitation Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Zhen-Tong Xing
- Department of Rehabilitation Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, China
| | - Zhi-Ye Chen
- Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, China
| | | | - Xiao-Juan Qiu
- Department of Rehabilitation Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, China
| | - Zi-Shan Jia
- Medical School of Chinese PLA, Beijing, China
| | - Li-Ning Zhang
- Medical School of Chinese PLA, Beijing, China
- Li-Ning Zhang
| | - Xin-Guang Yu
- Medical School of Chinese PLA, Beijing, China
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Xin-Guang Yu
| |
Collapse
|
9
|
Lv S, Chen Y, Liu M, Qin L, Liu Z, Liu W, Cui M, Zhang X, Yan H, Ning F, Zhang H, Xu Y. Progress of Proprioceptive Training in the Treatment of Traumatic Shoulder Instability. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:1429375. [PMID: 35495889 PMCID: PMC9054430 DOI: 10.1155/2022/1429375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 12/03/2022]
Abstract
In individuals with traumatic shoulder instability, there is a loss of proprioception. This paper reviews the academic literature on shoulder instability and functional impairment in recent years and combines it with clinical practice experience to summarize several techniques of proprioceptive regeneration following traumatic shoulder instability. Many issues were discovered, including a lack of literature on the role of sensory input, a lack of basic proprioceptive research, insufficient sample size in proprioceptive research, and a lack of systematic and standardized standards for the evaluation and training of proprioception in clinical practice, among others. In the future, we will need to better understand the mechanism of proprioception and conduct research on various groups of people, with a focus on discussing the optimal intensity, frequency, and duration of various training methods, as well as implementing proprioceptive training in stages throughout the rehabilitation process. The reestablishment of shoulder joint function, the restoration of proprioception, and the enhancement of daily activities are all critical.
Collapse
Affiliation(s)
- Shi Lv
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000 Shandong, China
| | - Yang Chen
- Department of Rehabilitation, Taian Maternal and Child Health Hospital, Taian, 271000 Shandong, China
| | - Mingliang Liu
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000 Shandong, China
| | - Lei Qin
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000 Shandong, China
| | - Ziyuan Liu
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000 Shandong, China
| | - Wenxin Liu
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000 Shandong, China
| | - Mengmeng Cui
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000 Shandong, China
| | - Xinlei Zhang
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000 Shandong, China
| | - Han Yan
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000 Shandong, China
| | - Fangli Ning
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000 Shandong, China
| | - Hanlin Zhang
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000 Shandong, China
| | - Yuzhen Xu
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000 Shandong, China
| |
Collapse
|
10
|
Stocco E, Porzionato A, De Rose E, Barbon S, Caro RD, Macchi V. Meniscus regeneration by 3D printing technologies: Current advances and future perspectives. J Tissue Eng 2022; 13:20417314211065860. [PMID: 35096363 PMCID: PMC8793124 DOI: 10.1177/20417314211065860] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/24/2021] [Indexed: 01/10/2023] Open
Abstract
Meniscal tears are a frequent orthopedic injury commonly managed by conservative
strategies to avoid osteoarthritis development descending from altered
biomechanics. Among cutting-edge approaches in tissue engineering, 3D printing
technologies are extremely promising guaranteeing for complex biomimetic
architectures mimicking native tissues. Considering the anisotropic
characteristics of the menisci, and the ability of printing over structural
control, it descends the intriguing potential of such vanguard techniques to
meet individual joints’ requirements within personalized medicine. This
literature review provides a state-of-the-art on 3D printing for meniscus
reconstruction. Experiences in printing materials/technologies, scaffold types,
augmentation strategies, cellular conditioning have been compared/discussed;
outcomes of pre-clinical studies allowed for further considerations. To date,
translation to clinic of 3D printed meniscal devices is still a challenge:
meniscus reconstruction is once again clear expression of how the integration of
different expertise (e.g., anatomy, engineering, biomaterials science, cell
biology, and medicine) is required to successfully address native tissues
complexities.
Collapse
Affiliation(s)
- Elena Stocco
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, Padova, Italy
| | - Andrea Porzionato
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, Padova, Italy
| | - Enrico De Rose
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
| | - Silvia Barbon
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, Padova, Italy
| | - Raffaele De Caro
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, Padova, Italy
| | - Veronica Macchi
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, Padova, Italy
| |
Collapse
|
11
|
Russell MS, La Delfa NJ, Murphy BA. The effect of neck muscle fatigue on shoulder humeral rotation joint position sense. J Electromyogr Kinesiol 2021; 59:102554. [PMID: 34029973 DOI: 10.1016/j.jelekin.2021.102554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Cervical extensor muscle (CEM) fatigue causes decrements in upper limb proprioceptive accuracy during constrained single-joint tasks. This study used a novel humeral rotation joint position sense (JPS) measurement device to compare JPS accuracy in participants who received acute CEM fatigue vs. non-fatigued controls. METHODS Participants had vision occluded and were passively guided into postures of internal humeral rotation from a baseline posture before and after a CEM fatigue or control protocol. Mixed model repeated measures ANOVAs were used to verify fatigue and compared absolute, constant, and variable JPS error between groups. RESULTS CEM fatigue was verified via pre-post reduction in CEM strength, and myoelectric indicators of fatigue. However, between-group comparisons of absolute, constant, and variable JPS error were not statistically significant, despite having large effect sizes. DISCUSSION Contrary to prevailing literature, unconstrained humeral rotation JPS did not appear to be affected by CEM fatigue in this study. However, between-group differences in JPS error were dwarfed by inter-trial variability, which likely arose due to the unconstrained nature of this task, conflating chances for a Type II error. Future research should perform a kinematic analysis of task constraints to highlight potential compensatory mechanisms obscuring significant findings in this otherwise robust effect.
Collapse
Affiliation(s)
- Matthew S Russell
- Faculty of Health Sciences (Kinesiology), Ontario Tech University, Oshawa, Ontario, Canada; Department of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Nicholas J La Delfa
- Faculty of Health Sciences (Kinesiology), Ontario Tech University, Oshawa, Ontario, Canada
| | - Bernadette A Murphy
- Faculty of Health Sciences (Kinesiology), Ontario Tech University, Oshawa, Ontario, Canada.
| |
Collapse
|
12
|
Seitz AM, Murrmann M, Ignatius A, Dürselen L, Friemert B, von Lübken F. Neuromapping of the Capsuloligamentous Knee Joint Structures. Arthrosc Sports Med Rehabil 2021; 3:e555-e563. [PMID: 34027469 PMCID: PMC8129484 DOI: 10.1016/j.asmr.2020.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/29/2020] [Indexed: 11/26/2022] Open
Abstract
Purpose To investigate neuromuscular electromyographic response of the of the upper and lower leg muscles after the application of an intraoperative, isolated mechanical stimulus of the capsuloligamentous structures, including the anterior (ACL) and posterior cruciate ligaments (PCL), lateral (LM) and medial menisci (MM), plica mediopatellaris (PM), and Hoffa’s fat pat (HFP). Methods The electromyographic response of the upper and lower leg muscles (M. rectus femoris; M. vastus medialis; M. semitendinosus; M. biceps femoris; M. gastrocnemius lateralis) of 15 male patients were measured after an isolated mechanical stimulus of the capsuloligamentous structures during an arthroscopic intervention using a customized intraoperative setup. Target parameters were the short (SLR; <30 milliseconds) and medium latency responses (MLR; >30 milliseconds) after the mechanically-induced trigger. Results The ACL, PCL, LM, and MM displayed high interindividual reproducibility of >76%. The MM was the only structure indicating both an SLR and MLR for all muscles. Although signals could be detected, there was no reproducibility in electromyographic signal activation for the HFP. The most rapid MLR was observed for the PM (quadriceps: 37 milliseconds). Conclusions Each stimulated structure displayed an individual MLR response, which allowed us to create neuromapping combining the anatomical and quantitative representations of the individual muscular activation patterns after isolated mechanical stimulation of the capsuloligamentous knee joint structures, corroborating our hypothesis. Level of Evidence Diagnostic - Level II.
Collapse
Affiliation(s)
- Andreas Martin Seitz
- Institute of Orthopedic Research and Biomechanics Institute of Orthopedic Research and Biomechanics Center for Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Miriam Murrmann
- Institute of Orthopedic Research and Biomechanics Institute of Orthopedic Research and Biomechanics Center for Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Anita Ignatius
- Institute of Orthopedic Research and Biomechanics Institute of Orthopedic Research and Biomechanics Center for Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Lutz Dürselen
- Institute of Orthopedic Research and Biomechanics Institute of Orthopedic Research and Biomechanics Center for Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Benedikt Friemert
- Department of Trauma and Orthopedic Surgery, Hospital of the Federal Armed Forces Ulm, Ulm, Germany
| | - Falk von Lübken
- Department of Trauma and Orthopedic Surgery, Hospital of the Federal Armed Forces Ulm, Ulm, Germany
| |
Collapse
|
13
|
Sochacki KR, Varshneya K, Safran MR, Abrams GD, Donahue J, Wang T, Sherman SL. Reoperation Rates Following Meniscus Transplantation Using the Truven Database. Arthroscopy 2020; 36:2731-2735. [PMID: 32645340 DOI: 10.1016/j.arthro.2020.06.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/21/2020] [Accepted: 06/28/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to determine the (1) reoperation rate and (2) 30-day complication rate in a large insurance database. METHODS The Truven Database was queried for subjects that underwent meniscus allograft transplantation (Current Procedural Terminology code 29868) in the outpatient setting with minimal 2-year follow-up. Patients without confirmed laterality and patients that underwent concomitant ligament reconstruction were excluded. Reoperation was defined by ipsilateral knee procedure after the index surgery. The 30-day postoperative complication rates were assessed using International Classification of Diseases, 9th Revision, Clinical Modification codes. RESULTS A total of 284 patients (mean age of 26.2 ± 10.4 years; 49.6% females) were included in this study with mean follow up of 43.2 ± 19.2 months. One hundred and sixty-seven subjects (58.8%) undergoing meniscus allograft transplantation underwent reoperation at an average of 11.9 ± 12.2 months postoperatively. There was a low number of subjects that required ipsilateral unicompartmental knee arthroplasty and total knee arthroplasty postoperatively (0.7% and 1.1%, respectively). The overall 30-day complication rate following meniscus allograft transplantation was 1.4%. CONCLUSIONS Patients undergoing meniscus allograft transplantation have a 58.8% reoperation rate at final follow up with low (1.4%) 30-day complication rates in a large insurance database. LEVEL OF EVIDENCE Level IV, case series.
Collapse
Affiliation(s)
- Kyle R Sochacki
- Department of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, California, U.S.A..
| | - Kunal Varshneya
- Department of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, California, U.S.A
| | - Marc R Safran
- Department of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, California, U.S.A
| | - Geoffrey D Abrams
- Department of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, California, U.S.A
| | - Joseph Donahue
- Department of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, California, U.S.A
| | - Tim Wang
- Department of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, California, U.S.A
| | - Seth L Sherman
- Department of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, California, U.S.A
| |
Collapse
|
14
|
Upper Limb Proprioceptive Acuity Assessment Based on Three-Dimensional Position Measurement Systems. Motor Control 2020; 24:605-623. [PMID: 32916660 DOI: 10.1123/mc.2020-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/09/2020] [Accepted: 07/14/2020] [Indexed: 11/18/2022]
Abstract
The aim of the current work was to verify three-dimensional directional effects on the reproduction error precision of the human upper limb position. Thirty male subjects without history of upper limb pathology were recruited from Renmin University of China. A three-dimensional position reproduction task in six directions (up, down, left, right, far, and near) was performed by each subject. The results suggested that the proprioceptive sense of upper limb position depends on the direction, with smaller absolute errors in Directions 4 (right) and 5 (far) than in Directions 1 (up), 2 (down), 3 (left), and 6 (near). Proprioception near the end of the elbow joint range of motion may be more reliable and sensitive. Subjects reproduced fewer ranges in the horizontal plane (Directions 3, 5, and 6) and they overshot the target position along the z-axis (vertical direction) except for Direction 6. Overestimations of position in the z-axis may be caused by overestimations of force.
Collapse
|
15
|
Short-term effect of delayed-onset muscle soreness on trunk proprioception during force reproduction tasks in a healthy adult population: a crossover study. Eur J Appl Physiol 2019; 120:181-190. [PMID: 31728623 DOI: 10.1007/s00421-019-04262-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/06/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effects of lumbar muscle delayed-onset muscle soreness (DOMS) on the ability of the trunk muscles to reproduce different levels of force. METHODS Twenty healthy adults (10 males and 10 females) were recruited for this study. Force reproduction in trunk extension and flexion was assessed at 50 and 75% of participants' maximal isometric voluntary contraction in flexion and extension before and after a lumbar muscle DOMS protocol. Trunk proprioception was evaluated and compared between these conditions using different variables such as constant errors (CE), absolute errors (AE), variable errors (VE) and time to peak force (TPF). For each variable, repeated measure ANOVAs were conducted. RESULTS AE were higher when participants had to reach the target post-DOMS protocol in extension compared to flexion and in the presence of higher demand of force (p = 0.02). For VE, results showed that participants were more variable in extension than in flexion when the required force was higher (p = 0.04). CE variable was higher when participants had to reach the force target in extension compared to flexion under the effect of DOMS (p = 0.02). Results also showed that participants took less time to reach the force target post-DOMS protocol in extension (0.62 ± 0.20 s) and in flexion (0.53 ± 0.19 s) than pre-DOMS protocol in extension (0.55 ± 0.15) and in flexion (0.50 ± 0.20) (p < 0.001). CONCLUSION Lumbar muscle DOMS affects trunk proprioception during force reproduction tasks especially in trunk extension and at higher force.
Collapse
|
16
|
Abstract
INTRODUCTION Reorganized force control may be an important adaptation following painful traumas. In this study, force control adaptations were assessed in elbow pain patients. Increasing the contraction demand may overcome pain interference on the motor control and as such act as an internal control. It was hypothesized that elbow pain patients compared with controls would present greater change in the direction of force when increasing the demand of the motor task. METHODS Elbow pain patients (n=19) and asymptomatic participants (n=21) performed isometric wrist extensions at 5% to 70% of maximum voluntary contraction. Pressure pain thresholds were recorded at the lateral epicondyle and tibialis anterior muscle. Contraction force was recorded using a 3-directional force transducer. Participants performed contractions according to visual feedback of the task-related force intensity (main direction of wrist extension) and another set of contractions with feedback of the 3 force directions. Going from the simple to the detailed force feedback will increase the demand of the motor task. Force steadiness in all 3 dimensions and force directions were extracted. RESULTS Compared with controls, elbow pain patients presented lower pressure pain thresholds at both sites (P<0.05). Force steadiness was not significantly different between groups or feedback methods. The change in force direction when providing simple visual feedback in contrast with feedback of all force components at all contraction levels was greater for patients compared with controls (P<0.05). CONCLUSION The larger change in force direction in pain patients implies redistribution of loads across the arm as an associated effect of pain.
Collapse
|
17
|
Li L, Zhang S, Dobson J. The contribution of small and large sensory afferents to postural control in patients with peripheral neuropathy. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:218-227. [PMID: 31193300 PMCID: PMC6523875 DOI: 10.1016/j.jshs.2018.09.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/24/2018] [Accepted: 09/14/2018] [Indexed: 05/13/2023]
Abstract
Peripheral neuropathy (PN) is a multifarious disorder that is caused by damage to the peripheral nerves. Although the symptoms of PN vary with the etiology, most cases are characterized by impaired tactile and proprioceptive sensation that progresses in a distal to proximal manner. Balance also tends to deteriorate as the disorder becomes more severe, and those afflicted are substantially more likely to fall while walking compared with those who are healthy. Most patients with PN walk more cautiously and with greater stride variability than age-matched controls, but the majority of their falls occur when they must react to a perturbation such as a slippery or uneven surface. The purpose of this study was to first describe the role of somatosensory feedback in the control of posture and then discuss how that relationship is typically affected by the most common types of PN. A comprehensive review of the scientific literature was conducted using MEDLINE, and the relevant information was synthesized. The evidence indicates that the proprioceptive feedback that is conveyed primarily through larger type I afferents is important for postural control. However, the evidence indicates that the tactile feedback communicated through smaller type II afferents is particularly critical to the maintenance of balance. Many forms of PN often lead to chronic tactile desensitization in the soles of the feet and, although the central nervous system seems to adapt to this smaller type II afferent dysfunction by relying on more larger type I afferent reflex loops, the result is still decreased stability. We propose a model that is intended both to help explain the relationship between stability and the smaller type II afferent and the larger type I afferent feedback that may be impaired by PN and to assist in the development of pertinent rehabilitative interventions.
Collapse
Affiliation(s)
- Li Li
- College of Physical Education, Hunan Normal University, Changsha 410012, China
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA 30460, USA
- Corresponding author.
| | - Shuqi Zhang
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL 60115, USA
| | - John Dobson
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA 30460, USA
| |
Collapse
|
18
|
Guo H, Santner TJ, Lerner AL, Maher SA. Reducing uncertainty when using knee-specific finite element models by assessing the effect of input parameters. J Orthop Res 2017; 35:2233-2242. [PMID: 28059475 PMCID: PMC5500444 DOI: 10.1002/jor.23513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 12/28/2016] [Indexed: 02/04/2023]
Abstract
Little is known about knee-specific factors that influence contact mechanics. Finite Element (FE) models offer a powerful tool to study contact mechanics, but there often exists ambiguity in the exact values of the inputs (e.g., tissue properties), which can result in a range of output values. Our objective was to quantify the reduction in the range of output values (defined herein as "uncertainty") from FE models of the human knee joint when known pre-defined values are used for clinically measurable inputs. To achieve this goal, we applied a statistically augmented FE approach to three human cadaveric knees for which full geometric and kinematic data were available. Two sets of conditions were simulated: All model inputs, clinically measurable or not, were varied to represent a "normal" patient population (Condition 1); subsets of clinically measurable variable inputs were fixed at specific values (called "patient derived inputs," or PDIs) while the other variables were varied over "normal" values (Condition 2). We found that by fixing body mass index and the anterior-posterior position of the meniscal-bony insertion points, model output uncertainty was reduced by one- to three-fifths. The magnitude of uncertainty reduction was strongly influenced by the individual knee. It was observed that knees with great anterior-posterior translation during gait had greater reductions in uncertainty when PDIs were used. This study represents the first step in developing FE models of the human knee joint based on inputs that can be derived from patients in a clinical setting. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2233-2242, 2017.
Collapse
Affiliation(s)
- Hongqiang Guo
- Department of Biomechanics, Hospital for Special Surgery, New York, NY 10021 United States,Tissue Engineering, Regeneration and Repair Program, Hospital for Special Surgery, New York, NY 10021 United States
| | - Thomas J. Santner
- Department of Statistics, The Ohio State University, Columbus, OH 43210 United States
| | - Amy L. Lerner
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14627 United States
| | - Suzanne A. Maher
- Department of Biomechanics, Hospital for Special Surgery, New York, NY 10021 United States,Tissue Engineering, Regeneration and Repair Program, Hospital for Special Surgery, New York, NY 10021 United States
| |
Collapse
|
19
|
Mtibaa K, Thomson A, Nichols D, Hautier C, Racinais S. Hyperthermia-induced Neural Alterations Impair Proprioception and Balance. Med Sci Sports Exerc 2017; 50:46-53. [PMID: 28863075 DOI: 10.1249/mss.0000000000001418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Hyperthermia has been shown to affect both central and peripheral nervous systems. However, the consequences of these alterations on the proprioceptive mechanisms underlying human movement control remain unclear. The aim of this study was to investigate the effect of passive hyperthermia on various measures of proprioception and balance, two key components of injury prevention and movement efficiency. METHODS After a familiarization session, 14 volunteers (8 males, 6 females) completed two experimental sessions in temperate (CON, 24°C) and hot (HOT, 44°C-50°C) conditions, in a counterbalanced order. Participants were tested for neural function (electrically evoked M-wave and Hoffman reflex, Soleus), active movement discrimination (five positions, 50 trials, dorsiflexion), dynamic balance (Star Excursion Balance Test, three directions), and static balance (single-leg stance). RESULTS Both rectal (39.0°C ± 0.3°C vs 36.9°C ± 0.6°C) and mean skin (37.9°C ± 1.0°C vs 32.0°C ± 2.7°C) temperatures were significantly higher in HOT than CON (P < 0.05). Hyperthermia significantly reduced the Hoffman reflex (P < 0.05) but not the M-wave (P > 0.05) amplitudes, increased the mean error for active movement discrimination (0.58°± 0.13° vs 0.50° ± 0.11°, +17%, P < 0.05), decreased the average distance reached in the posteromedial direction during dynamic balance (88.6 ± 7.9 cm vs 90.9 ± 6.1 cm, P < 0.05), and increased the contact area of the foot (126 ± 14 cm vs 122 ± 13 cm, +2.7%, P < 0.05) and the center of pressure excursion (64 ± 14 vs 57 ± 9 cm, +11.1%, P < 0.10) during single-leg stance. CONCLUSIONS The current study suggests that hyperthermia impairs the proprioception and balance parameters measured. These observations might be due to heat-induced alterations in efferent and afferent signals to and from the muscle.
Collapse
Affiliation(s)
- Khouloud Mtibaa
- 1Sport Science Program, College of Arts and Sciences, Qatar University, Doha, QATAR; 2Inter-university Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, Villeurbanne, FRANCE; and 3Aspetar Orthopaedic and Sports Medicine Hospital, Doha, QATAR
| | | | | | | | | |
Collapse
|
20
|
Effects of joint stabilizers on proprioception and stability: A systematic review and meta-analysis. Phys Ther Sport 2017; 25:65-75. [DOI: 10.1016/j.ptsp.2016.05.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 03/31/2016] [Accepted: 05/10/2016] [Indexed: 11/19/2022]
|
21
|
Lusi CM, Davies HM. The Connectivity and Histological Structure of the Equine Ergot—A Preliminary Study. J Equine Vet Sci 2017. [DOI: 10.1016/j.jevs.2017.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
22
|
Hincapie OL, Elkins JS, Vasquez-Welsh L. Proprioception retraining for a patient with chronic wrist pain secondary to ligament injury with no structural instability. J Hand Ther 2017; 29:183-90. [PMID: 27264903 DOI: 10.1016/j.jht.2016.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 02/26/2016] [Accepted: 03/03/2016] [Indexed: 02/09/2023]
Abstract
STUDY DESIGN Case report. INTRODUCTION Previously published studies demonstrate the importance of the sensory innervation of the carpal ligaments and the implication for the sensorimotor control of the wrist. In addition, this case considers key rehabilitation concepts to include the dart-throwing motion and the stabilizing effect of the forearm muscles. PURPOSE OF THE STUDY To describe the rehabilitation program for a patient with chronic wrist pain, diagnosed with a partial tear of the dorsal intercarpal ligament and a sprain of the scapholunate ligament of the right wrist. METHODS The patient participated in a staged treatment plan over a 3-month period (20 sessions), which began with a focus on proprioceptive awareness and joint position sense retraining. The treatment progressed to strengthening of specific muscles to enhance stability of the wrist joint. The patient completed the Quick Disabilities of the Arm, Shoulder and Hand and the patient-rated wrist evaluation on initial evaluation, re-evaluation at ninth session, and discharge at 20th session. RESULTS Raw scores in the Quick Disabilities of the Arm, Shoulder and Hand and the patient-rated wrist evaluation improved from 33 and 61.5 on initial evaluation to 18 and 17.5 on discharge, respectively. CONCLUSIONS Sensorimotor techniques including proprioceptive retraining may improve pain, neuromuscular control, and functional outcomes in patients with chronic wrist pain due to ligament injury. The effectiveness of proprioceptive retraining needs to be evaluated in a well-designed randomized controlled trial recruiting this patient population. LEVEL OF EVIDENCE 5.
Collapse
Affiliation(s)
- Olga L Hincapie
- NYU Langone Medical Center, Center for Musculoskeletal Care, Hand Therapy Service, New York, NY, USA.
| | - Jeananne S Elkins
- Northeastern University, College of Professional Studies, Boston, MA, USA
| | - Laura Vasquez-Welsh
- NYU Langone Medical Center, Center for Musculoskeletal Care, Hand Therapy Service, New York, NY, USA
| |
Collapse
|
23
|
Chopra P, Tinkle B, Hamonet C, Brock I, Gompel A, Bulbena A, Francomano C. Pain management in the Ehlers-Danlos syndromes. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2017; 175:212-219. [DOI: 10.1002/ajmg.c.31554] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
24
|
Halim-Kertanegara S, Raymond J, Hiller CE, Kilbreath SL, Refshauge KM. The effect of ankle taping on functional performance in participants with functional ankle instability. Phys Ther Sport 2017; 23:162-167. [DOI: 10.1016/j.ptsp.2016.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 02/24/2016] [Accepted: 03/24/2016] [Indexed: 12/26/2022]
|
25
|
Wang H, Ji Z, Jiang G, Liu W, Jiao X. Correlation among proprioception, muscle strength, and balance. J Phys Ther Sci 2016; 28:3468-3472. [PMID: 28174475 PMCID: PMC5276784 DOI: 10.1589/jpts.28.3468] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 09/07/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To study the correlation among proprioception, muscle strength, and balance.
[Subjects and Methods] A balance testing system (Biodex Balance System, BBS) and an
isokinetic testing system (Biodex System 4, BS4) were used to test related indexes in 24
healthy young females. [Results] With the knee joint at 15 degree flexion, proprioception
was significantly correlated with Limits of Stability-Time values, and was highly
significantly correlated with Limits of Stability-Overall and Athlete Single Leg
Medial/Lateral values. The sense of force was significantly correlated with Limits of
Stability-Overall and Athlete Single Leg-Overall values. Quadriceps strength was
significantly associated with Limits of Stability-Overall, Athlete Single Leg
Medial/Lateral, and Athlete Double Leg-Overall values. The ratio of Quadriceps to
Hamstring strength was significantly correlated with Athlete Single Leg Medial/Lateral,
and Athlete Single Leg-Overall values. With the knee joint at 45°, proprioception was
highly significantly correlated with dynamic balance, and was significantly correlated
with double foot support under static balance; force sense had a high correlation with
Limits of Stability-Overall, but no correlation with other indexes. Quadriceps strength
had a significant correlation with dynamic and static balance; the ratio of
Quadriceps/Hamstring had a highly significant correlation with Limits of
Stability-Overall, Athlete Single Leg-Anterior/Posterior and Athlete Single Leg-Overall.
[Conclusion] At different knee angles, the correlation differs among proprioception, force
sense, quadriceps strength, the Quadriceps/Hamstring ratio, and balance.
Collapse
Affiliation(s)
- Huihui Wang
- College of Physical Education and Sports, Beijing Normal University, China
| | - Zhongqiu Ji
- College of Physical Education and Sports, Beijing Normal University, China
| | - Guiping Jiang
- College of Physical Education and Sports, Beijing Normal University, China
| | - Weitong Liu
- College of Physical Education and Sports, Beijing Normal University, China
| | - Xibian Jiao
- College of Physical Education and Sports, Beijing Normal University, China
| |
Collapse
|
26
|
Motion Task Selection for Kinematic Evaluation After Anterior Cruciate Ligament Reconstruction: A Systematic Review. Arthroscopy 2016; 32:1453-65. [PMID: 27103604 DOI: 10.1016/j.arthro.2016.01.057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 11/26/2015] [Accepted: 01/15/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To examine the different motion tasks and the protocols used to objectively quantify dynamic stability in terms of knee kinematics at different stages of anterior cruciate ligament reconstruction (ACLR) recovery. METHODS A systematic search was done using OVID in Embase, Cochrane Central Register of Controlled Trials, Medline, PsychINFO, and AMED. A combination of the following keywords and their variations were used: anterior cruciate ligament, motion tasks (e.g., jump, hop, gait), and stability. The inclusion criteria were as follows: (1) ACLR subjects were recruited, (2) at least 1 motion task was performed and kinematics data were recorded, and (3) uninjured subjects or the contralateral uninjured limbs were included as a control group. Exclusion criteria were as follows: (1) non-English language publications, (2) retrospective studies and review articles, (3) animal studies, and (4) cadaveric studies. RESULTS The search returned 2,195 studies, and 56 were included in this review according to the criteria. A total of 1,086 ACLR subjects were included. Pivoting, landing, walking, running, stair negotiation, and squats were assessed using optoelectronic motion capture, electrogoniometry, or video-radiography. CONCLUSIONS The appropriate selection of motion tasks is an integral factor in dynamic stability testing as it evokes different kinematic outcomes in relation to the different stages of ACLR recovery. Stair negotiation and landing tasks are best performed during the early stages of recovery, and landing and pivoting are recommended 6 months after ACLR surgery. LEVEL OF EVIDENCE Level II, systematic review of Level I and II studies.
Collapse
|
27
|
Irving F, Russell J, Smith T. Reliability of knee joint position sense measurement: a comparison between goniometry and image capture methods. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2016. [DOI: 10.3109/21679169.2015.1127418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
28
|
Zhang S, Manor B, Li L. H-index is important for postural control for people with impaired foot sole sensation. PLoS One 2015; 10:e0121847. [PMID: 25807534 PMCID: PMC4373754 DOI: 10.1371/journal.pone.0121847] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 02/18/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION People with Peripheral Neuropathy (PN), especially those with impaired sensory inputs through the small-afferent fiber (type II afferent fibers) reflex loop (SAF), might depend more on the large-afferent fiber (type I afferent fibers) reflex loop (LAF) for postural control. PURPOSE To examine whether the function of the LAF reflex loop, reflected by the H-reflex and ankle joint proprioception, influences postural control when the SAF reflex loop is impaired, as indicated by reduced foot sole cutaneous sensation. METHODS Thirteen participants (8 women, 5 men) diagnosed with PN and 12 age-matched controls (7 women, 5 men) completed the testing protocol. Measures of interest included the H-index, active (AAP) and passive (PAP) ankle proprioception, plantar pressure sensitivity (PPS), average sway velocity (VAVG) and area (A95) during 30 seconds eyes-closed standing, 6-minute walk distance (6MWD) and timed up-and-go duration (TUG). RESULTS Statistically significant group-dependent regression was observed between VAVG and H-index. Compared to the control group, the PN group demonstrated reduced PPS (2.0 ± 1.9 vs. 4.2 ± 1.2, P < .05) and H-index (63.6 ± 10.9 vs. 76.4 ± 16.0, P < .05), greater VAVG (3.5 ± 2.1 vs. 1.6 ± 0.6 cm/s, P < .05) and A95 (10.0 ± 10.1 vs. 2.5 ± 1.5 cm2, P < .05), shorter 6MWD (442.2 ± 93.0 vs. 525.3 ± 68.2 m, P < .05), and longer TUG (9.4 ± 1.6 vs. 6.5 ± 1.3 s, P < .05). Within the PN group, but not the control group, the H-index was correlated with VAVG (r = -.56, P < .05). Moreover, within the PN group only, PAP scores were correlated with 6MWD (r = -.68, P < .05) and TUG (r = -.59, P < .05) performance. No other statistically significant group difference, correlation or group-dependent regression was observed. CONCLUSION VAVG, 6MWD, and TUG correlated with LAF reflex loop function observed among those with impaired functioning of the SAF reflex loop. This observation suggests that the LAF reflex loop may be critical to the control of balance in those individuals suffering from small-fiber PN.
Collapse
Affiliation(s)
- Shuqi Zhang
- Louisiana State University, Baton Rouge, LA, United States of America
- Georgia Southern University, Statesboro, GA, United States of America
| | - Brad Manor
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
- Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States of America
| | - Li Li
- Georgia Southern University, Statesboro, GA, United States of America
- Key Laboratory of Exercise and Health Sciences, Ministry of Education, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
29
|
Merolla G, Cerciello S, Chillemi C, Paladini P, De Santis E, Porcellini G. Multidirectional instability of the shoulder: biomechanics, clinical presentation, and treatment strategies. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2015; 25:975-85. [PMID: 25638224 DOI: 10.1007/s00590-015-1606-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 01/14/2015] [Indexed: 12/18/2022]
Abstract
Multidirectional instability (MDI) of the shoulder is a condition where the dislocation occurs in more than one direction with minimal or no causative trauma. Its pathoanatomy is complex and characterized by a redundant capsule, resulting in increased glenohumeral joint volume. The fact that several further factors may contribute to symptom onset complicates the diagnosis and hampers the identification of a therapeutic approach suitable for all cases. There is general agreement that the initial treatment should be conservative and that surgery should be reserved for patients who have not responded to an ad hoc rehabilitation program. We review the biomechanics, clinical presentation, and treatment strategies of shoulder MDI.
Collapse
Affiliation(s)
- Giovanni Merolla
- Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Cattolica, AUSL della Romagna Ambito Territoriale di Rimini, Cattolica, Italy,
| | | | | | | | | | | |
Collapse
|
30
|
Kim CY, Choi JD, Kim HD. No correlation between joint position sense and force sense for measuring ankle proprioception in subjects with healthy and functional ankle instability. Clin Biomech (Bristol, Avon) 2014; 29:977-83. [PMID: 25238686 DOI: 10.1016/j.clinbiomech.2014.08.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/23/2014] [Accepted: 08/29/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND In general, ankle proprioception is most often evaluated by assessing joint position sense and force sense. However, in contrast to observational studies of joint position sense and force sense, no studies have examined the correlations between joint position sense and force sense. Therefore, the objective of this study was to investigate the correlations between joint position sense and force sense in subjects with healthy and functional ankle instability. METHODS Of the sixty nine subjects enrolled in the cross-sectional laboratory study, 35 had functional ankle instability and 34 were healthy subjects. Angle reproduction and force matching methods were used to quantify joint position sense and force sense of the ankle proprioception. These methods were also measured by using a flexible twin axis electrogoniometer and linear force, respectively. Three trials were performed at each angle and force. And then, absolute errors were calculated. FINDINGS Significant differences between the functional ankle instability and healthy group were found for absolute errors of plantar flexion, dorsiflexion, inversion, and eversion (P<0.05). No significant correlations between the joint position sense and force sense were found in subjects with both healthy, except for absolute errors of the eversion (r=0.652, P<0.05, r(2)=0.425), and functional ankle instability group (P>0.05). INTERPRETATION These findings suggest that it could be explained for deficits of ankle proprioception when angle reproduction and force matching tests to quantify joint position sense and force sense were applied and presented at the same time, not individually.
Collapse
Affiliation(s)
- Chang-Yong Kim
- Department of Health Science, The Graduate School, Korea University, Jeongneung 3-dong, Seongbuk-Gu, Seoul 136-703, Republic of Korea.
| | - Jong-Duk Choi
- Department of Physical Therapy, College of Natural Science, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 300-716, Republic of Korea.
| | - Hyeong-Dong Kim
- Department of Physical Therapy, College of Health Science, Korea University, Jeongneung 3-dong, Sungbuk-gu, Seoul 136-703, Republic of Korea.
| |
Collapse
|
31
|
Smith TO, Mann CJV, Donell ST. Does knee joint proprioception alter following medial patellofemoral ligament reconstruction? Knee 2014; 21:21-7. [PMID: 23084729 DOI: 10.1016/j.knee.2012.09.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 09/19/2012] [Accepted: 09/22/2012] [Indexed: 02/02/2023]
Abstract
BACKGROUND This study firstly aimed to determine whether proprioception deficits, as measured by joint position sense (JPS), occur in people following recurrent patellar dislocations. Secondly, to determine whether JPS changes following medial patellofemoral ligament reconstruction (MPFL) reconstruction for patellar instability. METHODS Thirty people following recurrent patellar dislocation were recruited. Pre-operative JPS was assessed using the passive angle reproduction test. Through this, an assessor moved a participant's limb to a target position. This was returned to neutral, before finally moving the limb again, whilst requiring the participant to indicate when they thought the target angle was reached. The actual angular error (AAE) was calculated as the difference between the perceived angle and target angle. Clinical outcomes included the Kujala Patellofemoral Disorder Score, the International Knee Documentation Committee (IKDC) form, pain, knee motion, extensor muscle strength and frequency of patellar dislocation. Outcomes were assessed pre-operative, 6 weeks, 3 and 12 months. RESULTS Mean AAE was 2.2° (inner range) to 3.9° (mid-range); this was not clinically significant. There was no statistically significant difference between the baseline-and-6 week, 6 week-and-3 month or baseline-and-12 month AAE measures (p=0.38 to 1.00). There was a statistically significant improvement in functional outcomes as measured by the Kujala score, IKDC form, reduced pain and increased extension strength from baseline to 12 months (p<0.01). CONCLUSIONS Following recurrent patellar dislocation, patients exhibit minimal deficits in JPS. Whilst MPFL reconstruction significantly improved clinical and functional outcomes for this population, this operation did not significantly alter JPS during the first post-operative year.
Collapse
Affiliation(s)
- T O Smith
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
| | - C J V Mann
- Institute of Orthopaedics, Norfolk and Norwich University Hospital & Faculty of Medicine and Health Sciences, University of East Anglia, UK
| | - S T Donell
- Institute of Orthopaedics, Norfolk and Norwich University Hospital & Faculty of Medicine and Health Sciences, University of East Anglia, UK
| |
Collapse
|
32
|
Subbian V, Meunier JM, Korfhagen JJ, Ratcliff JJ, Shaw GJ, Beyette FR. Quantitative assessment of post-concussion syndrome following mild traumatic brain injury using robotic technology. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2014; 2014:5353-6. [PMID: 25571203 PMCID: PMC4939076 DOI: 10.1109/embc.2014.6944835] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Post-Concussion Syndrome (PCS) is a common sequelae of mild Traumatic Brain Injury (mTBI). Currently, there is no reliable test to determine which patients will develop PCS following an mTBI. As a result, clinicians are challenged to identify patients at high risk for subsequent PCS. Hence, there is a need to develop an objective test that can guide clinical risk stratification and predict the likelihood of PCS at the initial point of care in an Emergency Department (ED). This paper presents the results of robotic-assisted neurologic testing completed on mTBI patients in the ED and its ability to predict PCS at 3 weeks post-injury. Preliminary results show that abnormal proprioception, as measured using robotic testing is associated with higher risk of developing PCS following mTBI. In this pilot study, proprioceptive measures obtained through robotic testing had a 77% specificity (95CI: 46%-94%) and a 64% sensitivity (95CI: 41%-82%).
Collapse
|
33
|
Smith TO, Davies L, Hing CB. A systematic review to determine the reliability of knee joint position sense assessment measures. Knee 2013; 20:162-9. [PMID: 22819143 DOI: 10.1016/j.knee.2012.06.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 06/25/2012] [Accepted: 06/27/2012] [Indexed: 02/02/2023]
Abstract
BACKGROUND The assessment of joint position sense (JPS) is the most widely used measurement of knee proprioceptive capability within the literature. However, it remains unclear what the most reliable method is to assess this. The purpose of this study was to determine the intra- and inter-rater reliability of the various methods used to assess knee JPS. METHODS A systematic review of published and unpublished literature sources was conducted up to June 2012. All studies principally assessing the reliability (intra- or inter-rater) or reproducibility of a JPS of the knee were included. The methodological quality of each study was reviewed using the Critical Appraisal Skills Programme tool. RESULTS A total of 18 studies were eligible, assessing the reliability of JPS with 456 knees. The reliability of four methods of JPS has been recorded: position replication using a model, image recorded angulation, electrogoniometry and dynamometry/angular motion chair. Intra-rater reliability was good for the assessment of JPS using photographs and digital images, and replicating knee position using a paper model, this was good but variable when electrogoniometry was used, and moderate but variable when assessed using dynamometry/angle motion chairs. The assessment of JPS by image recorded angulation, electrogoniometry and dynamometry/angular motion chair has demonstrated good inter-rater reliability. CONCLUSIONS Whilst JPS methods appear to have variable reliability, the four assessment methods should be further assessed with pathological populations such as those following patellar dislocation or anterior cruciate ligament rupture. This will better facilitate the generalisability of JPS assessment methods to inform clinical practice.
Collapse
Affiliation(s)
- Toby O Smith
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
| | | | | |
Collapse
|
34
|
Smith TO, Jerman E, Easton V, Bacon H, Armon K, Poland F, Macgregor AJ. Do people with benign joint hypermobility syndrome (BJHS) have reduced joint proprioception? A systematic review and meta-analysis. Rheumatol Int 2013; 33:2709-16. [PMID: 23728275 DOI: 10.1007/s00296-013-2790-4] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 05/21/2013] [Indexed: 12/26/2022]
Abstract
Joint proprioceptive deficit is documented in a variety of musculoskeletal conditions including osteoarthritis, ligament and meniscal injuries, and individuals with increased joint hypermobility, such as those with Ehlers-Danlos. No systematic reviews have assessed joint proprioception in people with benign joint hypermobility syndrome (BJHS). This study addresses this to determine whether people with BJHS exhibit reduced joint proprioception, and, if so, whether this is evident in all age groups. The search strategy was conducted on 31st January 2013. The published literature was assessed using the databases: AMED, CINAHL, MEDLINE, EMBASE, PubMed and the Cochrane Library. Unpublished literature and trial registries were assessed including: OpenGrey, the WHO International Clinical Trials Registry Platform, Current Controlled Trials, the UK National Research Register Archive. All studies comparing the proprioceptive capability of people with and without BJHS were included. Study methodological quality was assessed using the CASP appraisal tool. Meta-analysis techniques were used when study homogeneity permitted. Five studies including 254 people were identified. People with BJHS demonstrated statistically significantly poorer lower limb joint position sense (JPS) (p < 0.001) and threshold detection to movement (p < 0.001) than those without BJHS. The evidence for upper limb proprioceptive difference was less clear, with no statistically significant difference between the cohorts for shoulder JPS (p = 0.10), but a statistically significant difference in finger JPS (p < 0.001). One study which assessed childhood BJHS reported reduced knee proprioceptive capability in those with BJHS (p < 0.001). To conclude, lower limb joint proprioception is reduced in those with BJHS compared to non-BJHS cohorts, whilst unclear in the upper limb.
Collapse
Affiliation(s)
- Toby O Smith
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK,
| | | | | | | | | | | | | |
Collapse
|
35
|
Bennell KL, Wrigley TV, Hunt MA, Lim BW, Hinman RS. Update on the Role of Muscle in the Genesis and Management of Knee Osteoarthritis. Rheum Dis Clin North Am 2013; 39:145-76. [DOI: 10.1016/j.rdc.2012.11.003] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
36
|
The effectiveness of proprioceptive-based exercise for osteoarthritis of the knee: a systematic review and meta-analysis. Rheumatol Int 2012; 32:3339-51. [DOI: 10.1007/s00296-012-2480-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 07/07/2012] [Indexed: 12/26/2022]
|
37
|
Maier MW, Niklasch M, Dreher T, Wolf SI, Zeifang F, Loew M, Kasten P. Proprioception 3 years after shoulder arthroplasty in 3D motion analysis: a prospective study. Arch Orthop Trauma Surg 2012; 132:1003-10. [PMID: 22402768 DOI: 10.1007/s00402-012-1495-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Indexed: 10/28/2022]
Abstract
BACKGROUND This prospective study evaluated the development of proprioception over the course of 3 years after shoulder arthroplasty. METHODS Twenty-one patients were enrolled who underwent total shoulder arthroplasty (n = 10) or hemiarthroplasty (HEMI) (n = 11) for shoulder osteoarthritis. All patients were examined 1 day before the operation, 6 months and 3 years after surgery in a motion analysis study with an active angle-reproduction (AAR) test. RESULTS Overall proprioception measured by the AAR deteriorated significantly 3 years after surgery [from 6.6° (SD 3.1) to 10.3° (SD 5.7); p = 0.017] and was significantly worse than in the control group [10.3° (SD 5.7) vs. 7.8° (SD 2.3); p = 0.030). In the HEMI subgroup, 3 years after shoulder replacement, there is a significant deterioration of proprioception at 30° of external rotation [from 3.1° (SD 3.5) to 12.8° (SD 10.7); p = 0.031]. On average, in the TSA subgroup proprioception deteriorated from 7.1° (SD 3.1) to 8.6° (SD 1.4) and in the HEMI subgroup from 6.1° (SD 2.1) to 12.4° (SD 8.3). The comparison of postoperative impairment of proprioception between the TSA and HEMI subgroup showed significantly worse proprioception for the HEMI subgroup at 30° of external rotation [9.8° (SD 10.1) vs. 1.6° (SD 6.3) in the TSA group; p = 0.046]. CONCLUSION In conclusion, proprioception that was measured by an AAR test remained unchanged or deteriorated 3 years after shoulder arthroplasty. The postoperative deterioration of proprioception was more distinctive in HEMI than in TSA group.
Collapse
Affiliation(s)
- Michael W Maier
- Department of Orthopedics, Trauma Surgery and Paraplegiology, University of Heidelberg, Schlierbacher Landstraße 200a, Heidelberg, Germany.
| | | | | | | | | | | | | |
Collapse
|
38
|
Balke M, Liem D, Dedy N, Thorwesten L, Balke M, Poetzl W, Marquardt B. The laser-pointer assisted angle reproduction test for evaluation of proprioceptive shoulder function in patients with instability. Arch Orthop Trauma Surg 2011; 131:1077-84. [PMID: 21350968 DOI: 10.1007/s00402-011-1285-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Over the last decade, proprioceptive function gained increasing attention in joint disorders such as instability of the shoulder. Common tests for evaluation of proprioception are limited by their complexity and high technical demands. Thus, they are hardly applicable during daily routine. Our hypothesis was that the simplified "laser-pointer assisted angle reproduction test" (LP-ART) presented here allows for clinically feasible assessment of proprioceptive shoulder function. METHODS Active angle reproduction capability as an aspect of sensorimotor function was evaluated with the new method in patients with shoulder instability (n = 24) and healthy controls (n = 24). 15 patients had traumatic, 9 non-traumatic anterior instability (6 bilateral), 17 were treated surgically, 13 non-operatively. Tests were performed in flexion and abduction in different angles (55°, 90°, 125°) in randomized order. RESULTS Angle reproduction capability was worst below shoulder level (55°) in all groups. Best results were achieved at shoulder level (90°). Healthy controls showed overall better results than patients with instability. Patients after surgical stabilization had better results in 55° and 90° abduction compared to instability patients before surgery. CONCLUSIONS The new LP-ART presented here is a technically simple, yet effective instrument for evaluation of the proprioceptive function of the shoulder. In contrast to former test setups it is feasible in daily routine. Compared to healthy controls, patients with unstable shoulder joints show significant proprioceptive disorders that can be quantified by the LP-ART.
Collapse
Affiliation(s)
- Maurice Balke
- Department of Trauma and Orthopedic Surgery, University of Witten-Herdecke, Cologne-Merheim Medical Center, Ostmerheimer Strasse 200, Cologne, Germany.
| | | | | | | | | | | | | |
Collapse
|
39
|
Knoop J, Steultjens MPM, van der Leeden M, van der Esch M, Thorstensson CA, Roorda LD, Lems WF, Dekker J. Proprioception in knee osteoarthritis: a narrative review. Osteoarthritis Cartilage 2011; 19:381-8. [PMID: 21251988 DOI: 10.1016/j.joca.2011.01.003] [Citation(s) in RCA: 147] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 12/16/2010] [Accepted: 01/03/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To give an overview of the literature on knee proprioception in knee osteoarthritis (OA) patients. METHOD A literature search was performed and reviewed using the narrative approach. RESULTS (1) Three presumed functions of knee proprioception have been described in the literature: protection against excessive movements, stabilization during static postures, and coordination of movements. (2) Proprioceptive accuracy can be measured in different ways; correlations between these methods are low. (3) Proprioceptive accuracy in knee OA patients seems to be impaired when compared to age-matched healthy controls. Unilateral knee OA patients may have impaired proprioceptive accuracy in both knees. (4) Causes of impaired proprioceptive accuracy in knee OA remain unknown. (5) There is currently no evidence for a role of impaired proprioceptive accuracy in the onset or progression of radiographic osteoarthritis (ROA). (6) Impaired proprioceptive accuracy could be a risk factor for progression (but not for onset) of both knee pain and activity limitations in knee OA patients. (7) Exercise therapy seems to be effective in improving proprioceptive accuracy in knee OA patients. CONCLUSIONS Recent literature has shown that proprioceptive accuracy may play an important role in knee OA. However, this role needs to be further clarified. A new measurement protocol for knee proprioception needs to be developed. Systematic reviews focusing on the relationship between impaired proprioceptive accuracy, knee pain and activity limitations and on the effect of interventions (in particular exercise therapy) on proprioceptive accuracy in knee OA are required. Future studies focusing on causes of impaired proprioceptive accuracy in knee OA patients are also needed, taking into account that also the non-symptomatic knee may have proprioceptive impairments. Such future studies may also provide knowledge of mechanism underlying the impact of impaired proprioceptive accuracy on knee pain and activity limitations.
Collapse
Affiliation(s)
- J Knoop
- Reade, Centre of Rehabilitation and Rheumatology (formerly Jan van Breemen Instituut), Department of Rehabilitation Research, Amsterdam, the Netherlands.
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Angoules AG, Mavrogenis AF, Dimitriou R, Karzis K, Drakoulakis E, Michos J, Papagelopoulos PJ. Knee proprioception following ACL reconstruction; a prospective trial comparing hamstrings with bone-patellar tendon-bone autograft. Knee 2011; 18:76-82. [PMID: 20149662 DOI: 10.1016/j.knee.2010.01.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2009] [Revised: 01/13/2010] [Accepted: 01/21/2010] [Indexed: 02/07/2023]
Abstract
We prospectively studied knee proprioception following ACL reconstruction in 40 patients (34 men and six women; mean age 31 years). The patients were allocated into two equal groups; group A underwent reconstruction using hamstrings autograft, and group B underwent reconstruction using bone-patellar tendon-bone autograft. Proprioception was assessed in flexion and extension by the joint position sense (JPS) at 15°, 45° and 75°, and time threshold to detection of passive motion (TTDPM) at 15° and 45°, preoperatively and at 3, 6 and 12 months postoperatively. The contralateral healthy knee was used as internal control. No statistical difference was found between the ACL-operated and the contralateral knees in JPS 15°, 45° and 75° at 6 and 12 months, in both study groups. No statistical difference was found between the ACL-operated and the contralateral knees in TTDPM 15° at 6 and 12 months, nor regarding TTDPM 45° at 3, 6 and 12 months, in group A. No statistical difference was found in JPS and TTDPM between the two grafts, at any time period. Knee proprioception returned to normal with ACL reconstruction at 6 months postoperatively, without any statistically significant difference between the autografts used.
Collapse
Affiliation(s)
- A G Angoules
- Department of Orthopaedics, Asclepeion Hospital of Voula, Greece.
| | | | | | | | | | | | | |
Collapse
|
41
|
Zinder SM, Granata KP, Shultz SJ, Gansneder BM. Ankle bracing and the neuromuscular factors influencing joint stiffness. J Athl Train 2010; 44:363-9. [PMID: 19593418 DOI: 10.4085/1062-6050-44.4.363] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Health care professionals commonly prescribe external stabilization to decrease the incidence and severity of ankle sprains. The mechanism for this decrease is not clearly understood. Examining the effects of ankle bracing on biomechanical stability and influencing factors may provide important information regarding the neuromuscular effects of bracing. OBJECTIVE To study the effects of 2 different ankle braces on the neuromuscular factors influencing ankle stiffness. DESIGN Mixed-model repeated-measures design. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-eight physically active participants composing 2 groups: 14 with unilateral functional ankle instability (age = 26.19 +/- 6.46 years, height = 166.07 +/- 12.90 cm, mass = 69.90 +/- 13.46 kg) and 14 with bilaterally stable ankles (age = 23.76 +/- 5.82 years, height = 174.00 +/- 11.67 cm, mass = 68.60 +/- 13.12 kg). INTERVENTION(S) Participants were fitted with surface electromyography electrodes over the peroneus longus, peroneus brevis, tibialis anterior, and soleus muscles. Each participant received transient motion oscillations to his or her ankle on a custom-built medial-lateral swaying cradle in each of 3 conditions: no ankle brace (NB), lace-up brace (LU), and semirigid brace (SR). MAIN OUTCOME MEASURE(S) Ankle stiffness as measured by the cradle and preactivation levels (percentage of maximal voluntary isometric contraction) of the 4 test muscles. RESULTS Stiffness levels increased across brace conditions (NB = 24.79 +/- 6.59 Nm/rad, LU = 28.29 +/- 7.05 Nm/rad, SR = 33.22 +/- 8.78 Nm/rad; F(2,52) = 66.185, P < .001). No differences were found between groups for rotational stiffness (stable = 27.36 +/- 6.17 Nm/rad, unstable = 30.18 +/- 8.21 Nm/rad; F(1,26) = 1.084, P = .307). Preactivation levels did not change for any of the tested muscles with the application of an ankle brace (F(2,52) = 1.326, P = .275). CONCLUSIONS The increase in ankle rotational stiffness with the addition of an ankle brace and the lack of any demonstrable neuromuscular changes suggested ankle braces passively contributed to the stability of the system.
Collapse
Affiliation(s)
- Steven M Zinder
- University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | | | | | | |
Collapse
|
42
|
Clayton HM, White AD, Kaiser LJ, Nauwelaerts S, Lavagnino M, Stubbs NC. Hindlimb response to tactile stimulation of the pastern and coronet. Equine Vet J 2010; 42:227-33. [PMID: 20486979 DOI: 10.2746/042516409x478505] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Lightweight tactile stimulators attached to the hind pasterns increase the height of the hind hoof flight arc but details of the induced changes in swing phase kinematics and kinetics have not been investigated. HYPOTHESES Stimulators on the hind pasterns are associated with increased hindlimb joint flexions and increased positive work performed by the hip and tarsal musculature. MATERIALS AND METHODS Nine nonlame horses trotted 4 times with and without 55 g tactile stimulators loosely attached around the hind pasterns. Height of the flight arc and peak flexion angles of the hindlimb joints were measured and net positive and negative work performed across each joint during the swing phase were calculated using inverse dynamics analysis and compared across paired conditions. RESULTS Speed and stride duration did not change but stimulators were associated with a reduction in hind stance duration. The flight arc was higher with stimulators due to increased flexions of the stifle, tarsal, metatarsophalangeal and distal interphalangeal joints. Positive work increased in the tarsal musculature, but not in the hip musculature, and negative work increased across the stifle, metatarsophalangeal and distal interphalangeal joints. POTENTIAL RELEVANCE The effects of tactile stimulation of the hind pasterns on joint motion and muscle activation may be used in physiotherapy and rehabilitation to restore or increase flexion of the hindlimb joints with the exception of the hip joint. The ability to stimulate concentric activity of the tarsal musculature may have therapeutic applications in conditions such as toe dragging.
Collapse
Affiliation(s)
- H M Clayton
- Mary Anne McPhail Equine Performance Center, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan 48824, USA
| | | | | | | | | | | |
Collapse
|
43
|
Meurer MC, Pacheco AM, Pacheco I, Silva MF. Análise da influência da bandagem funcional de tornozelo no tempo de reação do fibular longo em sujeitos saudáveis. REV BRAS MED ESPORTE 2010. [DOI: 10.1590/s1517-86922010000300008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVOS: O objetivo deste estudo foi analisar a influência da bandagem funcional de tornozelo no tempo de reação do fibular longo de indivíduos sadios. MÉTODOS: A amostra foi composta por oito indivíduos do gênero masculino, fisicamente ativos, sem histórias prévias de lesões de tornozelo e, com os resultados negativos aos testes de instabilidade articular de tornozelo. Foram usados como instrumentos da pesquisa, a bandagem funcional de tornozelo tipo bota fechada, para realizar o teste uma plataforma capaz de inclinar 30o no plano frontal simulando a entorse lateral do tornozelo e um eletromiógrafo de oito canais (Bortec Electronics Incorporation, Canadá) para aquisições dos sinais eletromiográficos. Os sinais EMG foram coletados juntamente com o sinal da plataforma (sincronismo). A coleta dos dados foi realizada em dois momentos, primeiramente sem a bandagem e logo após com a bandagem. RESULTADOS: Os indivíduos tinham idade média de 23,3 anos (± 2,8), massa corpórea de 74,4kg (± 9,4), estatura de 1,7m (± 0,4) e IMC de 23,7kg/m2 (± 2,4). O estudo encontrou diferença estatisticamente significativa p = 0,018 na situação da bandagem funcional de tornozelo com diminuição do tempo de reação do fibular longo. CONCLUSÃO: Acreditamos que esta melhora se deva ao íntimo contato da bandagem com os receptores cutâneos do tornozelo, aumentando a ativação do reflexo fibular, com consequente ganho proprioceptivo e, assim, aumentando a habilidade dos sujeitos em responder a situações súbitas de entorses. O estudo demonstrou diminuição no tempo de reação do fibular longo de indivíduos sadios com o uso da bandagem funcional de tornozelo quando submetidos à inclinação lateral súbita do tornozelo.
Collapse
Affiliation(s)
| | | | - Ivan Pacheco
- Clínica SOS Esportes; Federação Gaúcha de Futebol
| | | |
Collapse
|
44
|
Static and Dynamic Postural Balance After Successful Mobile-Bearing Total Ankle Arthroplasty. Arch Phys Med Rehabil 2010; 91:519-22. [DOI: 10.1016/j.apmr.2009.12.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Revised: 12/18/2009] [Accepted: 12/26/2009] [Indexed: 11/19/2022]
|
45
|
|
46
|
Kocak FU, Ulkar B, Özkan F. Effect of Proprioceptive Rehabilitation on Postural Control Following Anterior Cruciate Ligament Reconstruction. J Phys Ther Sci 2010. [DOI: 10.1589/jpts.22.195] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Bulent Ulkar
- Department of Sports Medicine, Ankara University School of Medicine
| | - Figen Özkan
- Department of Sports Medicine, Ankara University School of Medicine
| |
Collapse
|
47
|
Strimpakos N. The assessment of the cervical spine. Part 1: Range of motion and proprioception. J Bodyw Mov Ther 2009; 15:114-24. [PMID: 21147427 DOI: 10.1016/j.jbmt.2009.06.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 05/29/2009] [Accepted: 06/05/2009] [Indexed: 02/02/2023]
Abstract
Neck pain and headache of cervical origin are complaints affecting an increasing number of the general population. Mechanical factors such as sustained neck postures or movements and long-term "abnormal" physiologic loads on the neck are believed to affect the cervical structures and compromise neck function. A comprehensive assessment of neck function requires evaluation of its physical parameters such as range of motion, proprioception, strength and endurance/fatigue. The complicated structure of the cervical spine however, makes it difficult for any clinician to obtain reliable and valid results. The aim of the first part of this systematic critical review is to identify the factors influencing the assessment of range of motion and proprioception of the cervical spine.
Collapse
Affiliation(s)
- Nikolaos Strimpakos
- Department of Physiotherapy, TEI Lamias, 3rd Km Old National Road Lamia-Athens, Lamia 35100, Greece.
| |
Collapse
|
48
|
Reduced scapular muscle control and impaired shoulder joint position sense in subjects with chronic shoulder stiffness. J Electromyogr Kinesiol 2009; 20:206-11. [PMID: 19524454 DOI: 10.1016/j.jelekin.2009.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Revised: 03/04/2009] [Accepted: 04/20/2009] [Indexed: 11/23/2022] Open
Abstract
The purpose of the present study was to determine (1) if joint position sense (JPS) in subjects with shoulder stiffness (SS) differs from that in controls; (2) if, when JPS is reduced in SS, it is related to scapular muscular activities in the mid/end ranges of motion; and (3) if a person's function is associated with his or her level of JPS. Eighteen subjects with unilateral SS and 18 controls were included. Each subject performed abduction by self-selecting an end/mid range position. The electromagnetic motion-capturing system collected kinematic data while surface electromyography collected muscle activities (upper trapezius, lower trapezius, and serratus anterior muscles). Subjects were asked to move the upper limb to the target position (end/mid range) accurately without visual guidance. Reduced JPS was observed in subjects with SS (2.7 degrees in mid range, p<0.05). The JPS was enhanced by an increased scapula muscular activation level in the end range of motion (R=-0.61 for SS and -0.41 for controls) and by coordination among muscles' activation in the mid-range of motion (R=-0.87 for SS and R=-0.53 for controls). Impaired JPS was also related to self-reported functional status (R=-0.56) in subjects with SS. Shoulder JPS in subjects with chronic SS is impaired in comparison with controls. In the mid-range motion, the coordination of scapula muscular activation is related to shoulder JPS. Impaired JPS is also function-related in subjects with SS. These findings suggest that the coordination among scapula muscles' activation were important to consider in the rehabilitation of patients with chronic SS.
Collapse
|
49
|
Killian ML, Isaac DI, Haut RC, Déjardin LM, Leetun D, Donahue TLH. Traumatic anterior cruciate ligament tear and its implications on meniscal degradation: a preliminary novel lapine osteoarthritis model. J Surg Res 2009; 164:234-41. [PMID: 19577765 DOI: 10.1016/j.jss.2009.03.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Revised: 02/19/2009] [Accepted: 03/03/2009] [Indexed: 01/31/2023]
Abstract
BACKGROUND Injury patterns of the meniscus following impact trauma resulting in anterior cruciate ligament (ACL) rupture are not well understood. This study explored the spatial and temporal distribution of meniscal tears in a novel in vivo lapine model. METHODS Skeletally mature Flemish Giant rabbits were subjected to either tibiofemoral impaction resulting in ACL rupture or surgical ACL transection. Meniscal damage was assessed acutely and after 12 wk for traumatically torn, and after 12 wk in ACL transected animals. Morphological grading was assessed using previously established criteria, and descriptions of meniscal damage were diagnosed by a Board certified orthopedist. Histological assessment was also made on 12 wk traumatically torn and ACL transected animals using Fast-Green/Safranin-O staining. RESULTS Traumatic ACL rupture resulted in acute tears predominately in the lateral menisci. Animals subjected to both surgical transection and traumatic ACL rupture experienced degradation of the lateral and medial menisci 12 wk after injury. However, traumatic ACL rupture resulted in acute lateral damage and chronic degradation of the menisci, as well as more severe degradation of the menisci 12 wk after injury. CONCLUSIONS This study showed that unconstrained high-intensity impacts on the tibiofemoral joint lead to meniscal damage in conjunction with ACL ruptures. Both acute and chronic changes to the menisci following traumatic impaction were observed. This research has implications for the future use of lapine models for osteoarthritis, as it incorporates traumatic loading as a more realistic mode contributing to the progression of osteoarthritis (OA) compared to surgically transected models.
Collapse
Affiliation(s)
- Megan L Killian
- Soft Tissue Mechanics Laboratory, Mechanical Engineering-Engineering Mechanics, Michigan Technological University, Houghton, Michigan 49931, USA
| | | | | | | | | | | |
Collapse
|
50
|
Bennell KL, Hunt MA, Wrigley TV, Lim BW, Hinman RS. Muscle and exercise in the prevention and management of knee osteoarthritis: an internal medicine specialist's guide. Med Clin North Am 2009; 93:161-77, xii. [PMID: 19059027 DOI: 10.1016/j.mcna.2008.08.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This article outlines the influence of muscle activity on knee-joint loading, describes the deficits in muscle function observed in people with knee osteoarthritis, and summarizes available evidence pertaining to the role of muscle in the development and progression of knee osteoarthritis. The article focuses on whether muscle deficits can be modified in knee osteoarthritis and whether improvements in muscle function lead to improved symptoms and joint structure. This article concludes with a discussion of exercise prescription for muscle rehabilitation in knee osteoarthritis.
Collapse
Affiliation(s)
- Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, The University of Melbourne, 200 Berkeley Street, Carlton, Victoria 3010, Australia
| | | | | | | | | |
Collapse
|