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Ager AL, Roy JS, Dubé MO, Cools AM, Borms D. Relationship between pain and proprioception among individuals with rotator cuff-related shoulder pain. J Hand Ther 2024; 37:224-233. [PMID: 38350810 DOI: 10.1016/j.jht.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/06/2023] [Accepted: 10/14/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND Individuals with rotator cuff-related shoulder pain (RCRSP) have altered proprioception. The relationship between shoulder pain and proprioception is not well understood. PURPOSE This study aimed to investigate the relationship between shoulder pain and proprioception. STUDY DESIGN This was a cross-sectional comparative study. METHODS Twenty-two participants with RCRSP (mean age 27.6 ± 4.8 years) and 22 matched pain-free participants (23.4 ± 2.5 years) performed two upper limb active joint position sense tests: (1) the Upper Limb Proprioception Reaching Test (PRO-Reach; reaching toward seven targets) in centimeters and (2) Biodex System at 90% of maximum internal rotation in degrees. Participants performed three memorization and three reproduction trials blindfolded. The proprioception error (PE) is the difference between the memorized and estimation trials. Pain levels were captured pre- and post-evaluation (11-point Likert Numerical Pain Rating Scale). Relationships between PE and pain were investigated using independent t-tests and Spearman rank correlations. RESULTS Overall, 22.7% RCRSP participants indicated an increase in pain following the PRO-Reach (X̅ increase of 1.4 ± 1.5 points), while 59% did so with the Biodex (X̅ increase of 2.3 ± 1.8 points), reflecting a clinically important increase in pain. Weak-to-moderate correlations between pain and PEs were found with the Biodex (r = 0.39-0.53) and weak correlations with the PRO-Reach (r = -0.26 to 0.38). Concerning PEs, no significant differences were found between groups with the Biodex (p = 0.32, effect size d = -0.31 [-0.90 to 0.29]). The RCRSP participants demonstrated lower PEs with the PRO-Reach in elevation compared to pain-free participants (global X̅ = 4.6 ± 1.2 cm vs 5.5 ± 1.5 cm; superior 3.8 ± 2.1 cm vs 5.7 ± 2.9 cm; superior-lateral nondominant targets 4.3 ± 2.2 cm vs 6.1 ± 2.8 cm; p = 0.02-0.05, effect size d = 0.72-0.74 [0.12-1.3]). CONCLUSIONS Individuals with RCRSP demonstrated better upper limb proprioception in elevation, suggesting a change to interoception (sensory reweighting) in the presence of pain.
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Affiliation(s)
- Amanda L Ager
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Jean-Sébastien Roy
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.
| | - Marc-Olivier Dubé
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.
| | - Ann M Cools
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Dorien Borms
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
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Ager AL, Roy JS, Hébert LJ, Roos M, Borms D, Cools AM. Measuring upper limb active joint position sense: Introducing a new clinical tool - The Upper Limb Proprioception Reaching Test. Musculoskelet Sci Pract 2023; 66:102829. [PMID: 37473497 DOI: 10.1016/j.msksp.2023.102829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Proprioception is our sense of body awareness, including the sub-category of active joint position sense (AJPS). AJPS is fundamental to joint stability and movement coordination. Despite its importance, there remain few confident ways to measure upper limb AJPS in a clinic. OBJECTIVE To assess a new AJPS clinical tool, the Upper Limb Proprioception Reaching Test (PRO-Reach; seven targets), for discriminant validity, intra-rater and absolute reliability. DESIGN Cross-sectional measurement study. METHODS Seventy-five healthy participants took part in a single session with 2 consecutive evaluations (E1 and E2) (within-day reliability). Twenty participants were randomly selected to perform a dominant shoulder fatigue protocol (discriminant validity), whereafter a third evaluation was repeated (E3). The PRO-Reach was analyzed with paired t tests (discriminant validity), intra-class correlation coefficients (ICCs) and minimal detectable change [MDC]) (intra-rater: within-day and between-trial relative and absolute reliability). RESULTS The PRO-Reach supports moderate (mostly superior targets) to excellent (mostly inferior targets) reliability. Between-trial ICCs (T1/T2/T3) varied between 0.72 and 0.90, and within-day (E1/E2) ICCs between 0.45 and 0.72, with associated MDC95 values (3.9-5.0 cm). The overall scores (seven targets) supported the strongest within-day reliability (ICC = 0.77). The inferior targets demonstrated the highest between-trial and within-day reliability (ICCs = 0.90 and 0.72). A fatigue effect was found with the superior and superior-lateral targets (P < .05). CONCLUSIONS The inferior targets and overall scores demonstrate the strongest reliability. The use of the PRO-Reach tool may be suitable for clinical use upon further psychometric testing amongst pathological populations. LEVEL OF EVIDENCE Level III cross-sectional study.
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Affiliation(s)
- Amanda L Ager
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Rehabilitation Institute (Cirris), Québec City, Québec, Canada; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Jean-Sébastien Roy
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Rehabilitation Institute (Cirris), Québec City, Québec, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, Canada
| | - Luc J Hébert
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Rehabilitation Institute (Cirris), Québec City, Québec, Canada; Departments of Rehabilitation and Radiology/Nuclear Medicine, Faculty of Medicine, Université Laval, Québec, Canada
| | - Marianne Roos
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Rehabilitation Institute (Cirris), Québec City, Québec, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, Canada
| | - Dorien Borms
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ann M Cools
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
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Lee KW, Kang SH, Lim SC. Simple and Reliable Position Sense Assessment under Different External Torques: Toward Developing a Post-stroke Proprioception Evaluation Device. IEEE Trans Neural Syst Rehabil Eng 2022; 30:823-832. [PMID: 35324443 DOI: 10.1109/tnsre.2022.3161948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Evaluation of position sense post-stroke is essential for rehabilitation. Position sense may be an output of a process needing position information, external torque, and the sense of effort. Even for healthy individuals, it is unclear whether external torque affects position sense. Thus, evaluation of position sense under different external torques in clinical settings is strongly needed. However, simple devices for measuring position sense under different external torques in clinical settings are lacking. Technologically advanced devices that may evaluate the elbow position sense under different torques were reported to be infeasible clinically because of device complexity and the need for technical experts when analyzing data. To address the unmet need, in this study, a simple and light elbow position sense measurement device was developed that allows clinicians to measure elbow position sense under different external torques in the form of position matching error objectively without any technical difficulties. The feasibility of the device, including intra-session intra-rater reliability and test-retest reliability over two consecutive days, was verified to be clinically applicable using tests with 25 healthy subjects. Thanks to its ease of use, high reliability, and ease of data analysis, it is expected that the device can help to evaluate the position sense post-stroke comprehensively.
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Effect of a Proprioceptive Exercise Program on Force Sense for Carpometacarpal Joint Osteoarthritis. TOPICS IN GERIATRIC REHABILITATION 2021. [DOI: 10.1097/tgr.0000000000000336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Phillips D, Zahariev A, Karduna A. Shoulder Joint Position Sense Can Be Reduced by Sensory Reference Frame Transformations. Percept Mot Skills 2021; 128:938-951. [PMID: 33593118 DOI: 10.1177/0031512521993040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Joint position sense (JPS) is commonly evaluated using an angle replication protocol with vision occluded. However, multiple sources of sensory information are integrated when moving limbs accurately, not just proprioception. The purpose of this study was to examine different availability of vision during an active JPS protocol at the shoulder. Specifically, the effects of four conditions of vision availability were examined for three target shoulder elevation angles (50°, 70° & 90°): vision occluded continuously (P-P); vision available continuously (VP-VP); vision occluded only during target memorization (P-VP); and vision occluded only during target position replication (VP-P). There were 18 participants (M age = 21, SD = 1 years). We used separate repeated ANOVAs to examine the effect of condition and target angle on participants' absolute error (AE, a measure of accuracy) and constant error (CE, a measure of directional bias). We found a significant main effect for condition and angle for both dependent variables (p < 0.01), and follow-up analysis indicated that participants were most accurate in the VP-VP condition and least accurate in the P-VP condition. Further follow-up analysis showed that accuracy improved with higher target elevation angles, consistent with previous research findings. Constant error results were similar, as there was a prominent tendency to overshoot the target. Unsurprisingly, participants performed best at the angle replication protocol with their eyes open. However, while accuracy was reduced when vision was occluded during target memorization, it was restored during target replication. This finding may have indicated an accuracy cost due to introduced noise when transforming sensory information from a proprioceptive reference frame into a visual reference frame.
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Affiliation(s)
- David Phillips
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, New Jersey, United States
| | - Albena Zahariev
- Department of Human Physiology, University of Oregon , Eugene, United States
| | - Andrew Karduna
- Department of Human Physiology, University of Oregon , Eugene, United States
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Effects of 2 Different External Loads on Joint Position Sense and the Relationship Between Muscle Strength and Force Sense. J Sport Rehabil 2020; 29:1115-1120. [PMID: 31816596 DOI: 10.1123/jsr.2019-0025] [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: 01/18/2019] [Revised: 08/28/2019] [Accepted: 10/16/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Joint position sense (JPS) tests of proprioception lack ecological validity because the testing conditions are so different from the normal function that they can contribute little to understanding the role proprioception plays in daily and sporting activities. OBJECTIVE To evaluate the effect of low and high external load on the knee JPS and to investigate the relationship between maximum voluntary isometric contraction and force sense (FS). DESIGN Experimental study. SETTING Research laboratory. PARTICIPANTS A total of 47 volunteers with no history of knee pathology. INTERVENTIONS Three active JPS tests performed with no load, low load, and high load were compared at the 45° target angle. For isometric FS test, 50% load was used. For isotonic low load and high load JPS tests, 30% and 70% loads were applied, respectively. MAIN OUTCOME MEASURES To analyze obtained data set 2-way multiple analysis of variance, repeated measures of analysis of variance, paired sample t test, and the Pearson correlation coefficient were used. RESULTS JPS was not affected by gender (male and female) and activity levels (sedentary, recreational, and trained). Results of the repeated measure of analysis of variance demonstrated the significant main effect of loads (P = .001). Significant differences were found between no load, low load, and high load JPS (P = .001). A positive and significant correlation was found between maximum voluntary isometric contraction and FS error values (r = .41, P = .001). CONCLUSIONS The results suggest that as the load level increases, the knee JPS improves. Knee JPS assessed under external load may be a more appropriate alternative to the nature of the sport. Those with higher muscle strength have a worse FS.
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Li L, Li Y, Wang H, Chen W, Liu X. Effect of Force Level and Gender on Pinch Force Perception in Healthy Adults. Iperception 2020; 11:2041669520927043. [PMID: 32547724 PMCID: PMC7249577 DOI: 10.1177/2041669520927043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 04/25/2020] [Indexed: 11/29/2022] Open
Abstract
This study investigated the effects of both force level and gender on pinch force reproduction errors in normal participants during an ipsilateral force reproduction task. In total, 20 healthy participants were asked to generate a range of levels of reference forces ranging from 5% to 60% maximal voluntary isometric contraction (MVIC) in increments of 5% MVIC using the tip pinch and to reproduce these forces using the same hand. The results showed that the males more accurately and consistently reproduced the forces than did the females, and the most accurate estimation occurred at approximately 20% to 35% MVIC. This finding can help us better understand the reasons for the higher rate of musculoskeletal disorders in females than in males and to develop tools and preventive strategies to decrease the rate of hand injuries in both genders.
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Affiliation(s)
- Lin Li
- Department of Physical Education, Renmin University of China
| | - Yanxia Li
- College of Physical Education, Langfang Teachers University, Hebei, China
| | - Huihui Wang
- School of Physical Education, Zunyi Medical University, Guizhou, China
| | - Wenqi Chen
- School of Sociology and Population Studies, Renmin University of China
| | - Xinyu Liu
- School of Sociology and Population Studies, Renmin University of China
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Feng J, Hung TM, Huang R, Hou S, Ren J. Role of Proprioception in Slow and Rapid Movements. Percept Mot Skills 2019; 127:281-298. [PMID: 31856659 DOI: 10.1177/0031512519895632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to compare the contributions of sources of proprioception to the reproduction accuracy of relatively slower and more rapid arm movements. We recruited 34 volunteers and gave them dart throwing tasks under two different durations followed by joint position sense (JPS) tests and force sense (FS) tests at the elbow and the wrist. We found moderately positive correlations between slow movement performance and proprioceptive acuity with FS (wrist) and JPS (elbow), accounting for 52% of the absolute errors ( p < .001), and, with FS (wrist), accounting for 50% of the variable error ( p < .001). Moreover, we observed a smaller correlation between rapid movement performance and proprioceptive acuity, accounting for 17% of absolute errors with JPS (elbow; p = .008) and 11% of variable error ( p = .033). These results suggest that relatively slow movement performance is partly determined by performers’ proprioceptive acuity of the movement-related limbs. Relatively rapid movement performance is also affected by correctional proprioceptive feedback, though to a lesser degree.
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Affiliation(s)
- Jie Feng
- School of Kinesiology, Shanghai University of Sport, China.,Department of Sport and Physical Education, Hong Kong Baptist University, China
| | - Tsung-Min Hung
- Department of Physical Education, National Taiwan Normal University, Taiwan
| | - Rui Huang
- School of Kinesiology, Shanghai University of Sport, China
| | - Shuang Hou
- China Table Tennis College, Shanghai University of Sport, China
| | - Jie Ren
- China Table Tennis College, Shanghai University of Sport, China
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Ballardini G, Ponassi V, Galofaro E, Carlini G, Marini F, Pellegrino L, Morasso P, Casadio M. Interaction between position sense and force control in bimanual tasks. J Neuroeng Rehabil 2019; 16:137. [PMID: 31703703 PMCID: PMC6839077 DOI: 10.1186/s12984-019-0606-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/10/2019] [Indexed: 12/03/2022] Open
Abstract
Background Several daily living activities require people to coordinate the motion and the force produced by both arms, using their position sense and sense of effort. However, to date, the interaction in bimanual tasks has not been extensively investigated. Methods We focused on bimanual tasks where subjects were required:
(Experiment 1) to move their hands until reaching the same position – equal hand position implied identical arm configurations in joint space - under different loading conditions; (Experiment 2) to produce the same amount of isometric force by pushing upward, with their hands placed in symmetric or asymmetric positions.
The arm motions and forces required for accomplishing these tasks were in the vertical direction. We enrolled a healthy population of 20 subjects for Experiment 1 and 25 for Experiment 2. Our primary outcome was the systematic difference between the two hands at the end of each trial in terms of position for Experiment 1 and force for Experiment 2. In both experiments using repeated measure ANOVA we evaluated the effect of each specific condition, namely loading in the former case and hand configuration in the latter. Results In the first experiment, the difference between the hands’ positions was greater when they were concurrently loaded with different weights. Conversely, in the second experiment, when subjects were asked to exert equal forces with both arms, the systematic difference between left and right force was not influenced by symmetric or asymmetric arm configurations, but by the position of the left hand, regardless of the right hand position. The performance was better when the left hand was in the higher position. Conclusions The experiments report the reciprocal interaction between position sense and sense of effort inbimanual tasks performed by healthy subjects. Apart for the intrinsic interest for a better understanding of basic sensorimotor processes, the results are also relevant to clinical applications, for defining functional evaluation and rehabilitative protocols for people with neurological diseases or conditions that impair the ability to sense and control concurrently position and force.
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Affiliation(s)
- Giulia Ballardini
- Department of Informatics, Bioengineering, Robotics, and Systems Engineering, University of Genoa, Genoa, Italy.
| | - Valentina Ponassi
- Department of Informatics, Bioengineering, Robotics, and Systems Engineering, University of Genoa, Genoa, Italy
| | - Elisa Galofaro
- Department of Informatics, Bioengineering, Robotics, and Systems Engineering, University of Genoa, Genoa, Italy
| | - Giorgio Carlini
- Department of Informatics, Bioengineering, Robotics, and Systems Engineering, University of Genoa, Genoa, Italy
| | | | - Laura Pellegrino
- Department of Informatics, Bioengineering, Robotics, and Systems Engineering, University of Genoa, Genoa, Italy
| | | | - Maura Casadio
- Department of Informatics, Bioengineering, Robotics, and Systems Engineering, University of Genoa, Genoa, Italy
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Kaynak H, Altun M, Tok S. Effect of Force Sense to Active Joint Position Sense and Relationships between Active Joint Position Sense, Force Sense, Jumping and Muscle Strength. J Mot Behav 2019; 52:342-351. [PMID: 31204891 DOI: 10.1080/00222895.2019.1627280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We aimed to investigate the effect of external load on the joint position sense (JPS) accuracy and its relation to the target jump height. The present study also aimed to explore the relationship between force sense (FS) and maximum voluntary isometric contraction (MVIC). Participants' MVIC levels were determined during the 45-degree knee extension task. Then, participants were asked to execute a knee JPS task with external load (EL-JPS) and with no-load (EL-JPS). To assess jumping accuracy participants were instructed to jump with their 50% of maximum jump height. Results indicated that EL-JPS error values were lower than NL-JPS. EL-JPS was correlated to jumping errors. However, the relationship between NL-JPS and jumping errors was not significant. A significant correlation was found between MVIC and FS errors.
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Affiliation(s)
- Haydar Kaynak
- Manisa Celal Bayar University Sport Sciences Faculty, Manisa, Turkey
| | - Muammer Altun
- Manisa Celal Bayar University Sport Sciences Faculty, Manisa, Turkey
| | - Serdar Tok
- Manisa Celal Bayar University Sport Sciences Faculty, Manisa, Turkey
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