Effect of a Concurrent Cognitive Demand on Knee Position Matching

The assessment of the cervical spine. Part 1: Range of motion and proprioception

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.

Position-matching in the upper limb: professional ballet dancers perform with outstanding accuracy

OBJECTIVES

To investigate the accuracy in position-matching in the upper limb in two groups of subjects who were physically fit and movement aware.

DESIGN

A mixed-group design was used. Objective measurement of the accuracy in position-matching at the shoulder and elbow in both dominant and nondominant arms consisted of photographic record of the position-matching test, with goniometric measurement.

SETTINGS

Physiotherapy department at the Birmingham Royal Ballet and School of Health Science, University of Birmingham.

SUBJECTS

Two subject groups: physiotherapy students (n = 10), professional ballet dancers (n = 10).

RESULTS

A mixed design analysis of variance found significant differences between the accuracy in position-matching at both the shoulder and elbow joints in the two groups (p < 0.05), with the ballet dancers having greater accuracy then the physiotherapy students. A significant difference in the joint positions tested were demonstrated (p < 0.05) with the positions of abduction at the shoulder and extension of the elbow showing greatest accuracy in matching. There was no significant difference found between the dominant and nondominant upper limb in position-matching.

CONCLUSION

Professional ballet dancers demonstrated greater accuracy in position-matching the upper limb, implying that mass and continuing practice can improve a motor sensory skill.

Measurement of Knee-Joint-Position Sense in Women with Genu Recurvatum

Context:

Proprioception of the knee joint.

Objective:

To determine the difference in knee-joint-angle reproduction in women with and without genu recurvatum (GR).

Design:

Between-subjects.

Setting:

Clinic.

Subjects:

Twenty-four women divided into 2 groups according to their standing knee-extension angle.

Main Outcome Measures:

Each subject's ability to actively reproduce active positioning of 3 knee angles (10, 30, and 60°) was measured. Pearson correlation coefficients were calculated to determine correlation values for standing GR angle and absolute angular error (AAE). A1 -way repeated-measures MANOVA was computed to evaluate differences in group, angle, limb, and trial.

Results:

Standing GR angle correlated significantly to the AAE angle at 10° (r= .48). The high-recurvatum group consistently scored worse, with the highest error rate occurring at 10°.

Conclusion:

Individuals with GR might have diminished proprioceptive sense at end-range extension that could potentially lead to knee injury.

Spinal position sense is independent of the magnitude of movement

STUDY DESIGN

Position sense in the spine was recorded at T1, T7, L1, and S2 in three incremental angular ranges of flexion and on return to upright standing from these movements.

OBJECTIVES

To determine the effect of angular range of movement on position sense. The main purpose was to establish a protocol for whole spine assessment of position sense in healthy and pathologic spines.

SUMMARY OF BACKGROUND DATA

Position sense is one dimension of proprioception, classically assessed by the ability to reproduce preselected target positions. This approach was used in the current study to determine whether spinal position sense is affected by the magnitude of movement traversed in repositioning tasks.

METHODS

Spinal position sense was assessed in 20 healthy subjects during repeated flexion movements carried out in one-third, half, and two thirds of the full range of movement in the sagittal and coronal planes. During each movement, the 3-Space Fastrak (Polhemus Inc., Colchester, VT) was used to record angular movement of the spine at four sensor locations (T1, T7, L1, and S2). The absolute difference in the sensor angles between repeated trials was calculated for each flexed position and on return to upright standing from these. These absolute differences were used as a measure of position sense.

RESULTS

Absolute position sense after one-third angular movements was accurate to within 4.30 degrees +/- 2.84 degrees in flexed positions and 2.70 degrees +/- 2.20 degrees in upright postures. Corresponding results for two-thirds movements were 4.75 degrees +/- 2.63 degrees and 3.33 degrees +/- 2.60 degrees, respectively. Range of movement had no significant influence on the accuracy of position sense.

CONCLUSIONS

1) Healthy individuals are able to reposition their spine accurately under conditions of incremental increases in angular range. 2) Range-related variations in position sense are small and unlikely to be of clinical significance.