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"Proprioception"

Original Articles

Brain disorders

The Effectiveness of Goal-Oriented Dual Task Proprioceptive Training in Subacute Stroke: A Retrospective Observational Study
Rita Chiaramonte, Salvatore D’Amico, Salvatore Caramma, Giuseppina Grasso, Simona Pirrone, Maria Giovanna Ronsisvalle, Marco Bonfiglio
Ann Rehabil Med 2024;48(1):31-41.   Published online February 28, 2024
DOI: https://doi.org/10.5535/arm.23086
Objective
To show the effectiveness of goal-oriented proprioceptive training in subacute stroke for balance, autonomy, and fall risk.
Methods
Out a total of 35 patients, consistent in age (75.31±8.65 years), type of stroke (ischemic, 3 to 11 weeks before), and motor impairment, 18 patients underwent solely proprioceptive rehabilitation, the other 17 dual task exercises. The study assessed autonomy using Barthel Index, fall risk with Timed Up and Go Test (TUG), balance through Berg Balance Scale (BBS) and Tinetti test.
Results
After two months, significant improvements were recorded in Barthel Index, BBS (p<0.0001), Tinetti test (p<0.0001 in dual task group, p=0.0029 in single task group), and TUG (p=0.0052 in dual task group, p=0.0020 in single task group) in both groups. Comparing the two groups, dual task group showed a significant difference in Tinetti balance assessment (p=0.0052), between the total score of Tinetti test and TUG in single (p=0.0271), and dual task (p=0.0235). Likewise, Tinetti gait test was significantly related to TUG in single (p=0.0536), and dual task (p=0.0466), while Tinetti balance test to Barthel Index (p=0.0394), BBS (p<0.0001), and TUG in single (p=0.0219), and dual task (p=0.0196). Lastly, there is a positive correlation of the use of aids with BBS (p=0.0074), and total score of Tinetti test (p=0.0160).
Conclusion
In subacute stroke, goal-oriented proprioceptive training improved balance, but only partially autonomy. Furthermore, the use of aids after dual-task exercises improved recovery of balance, but did not reduced falls.

Citations

Citations to this article as recorded by  
  • Validez convergente de la escala Tinetti en pacientes con ictus en fase subaguda
    Adrián Arranz–Escudero, Patricia Martín–Casas, Ester Carpio–Calatayud, Ibai López–de–Uralde–Villanueva
    Revista Científica de la Sociedad Española de Enfermería Neurológica.2025; 62: 500168.     CrossRef
  • A scoping review on the body awareness rehabilitation after stroke: are we aware of what we are unaware?
    Davide Cardile, Viviana Lo Buono, Francesco Corallo, Angelo Quartarone, Rocco Salvatore Calabrò
    Frontiers in Neurology.2025;[Epub]     CrossRef
  • Dual tasking as a predictor of falls in post-stroke: A cross-sectional analysis comparing Walking While Talking versus Stops Walking While Talking
    Disha Lamba, Abraham M. Joshua, Vijaya kumar K, Akshatha Nayak, Prasanna Mithra, Rohit Pai, Shivananda Pai, Shyam Krishnan K., Vijayakumar Palaniswamy
    F1000Research.2025; 13: 1395.     CrossRef
  • Effects of Unpredictable Perturbation Training on a Split-Belt Treadmill on Physical Performance in Older Adults: A Randomized Controlled Trial
    Kap-Soo Han, Myoung-Hwan Ko
    Geriatrics.2025; 10(1): 23.     CrossRef
  • AdaptRehab VR: Development of an Immersive Virtual Reality System for Upper Limb Stroke Rehabilitation Designed for Low- and Middle-Income Countries Using a Participatory Co-Creation Approach
    Chala Diriba Kenea, Teklu Gemechu Abessa, Dheeraj Lamba, Bruno Bonnechère
    Bioengineering.2025; 12(6): 581.     CrossRef
  • Making Sense of Proprioception by Bibliometric Research
    Kevser Sevik Kacmaz
    Brain and Behavior.2025;[Epub]     CrossRef
  • Time course for acquiring toileting independence in patients with subacute stroke: a prospective cohort study
    Shin Kitamura, Yohei Otaka, Shintaro Uehara, Yudai Murayama, Kazuki Ushizawa, Yuya Narita, Naho Nakatsukasa, Daisuke Matsuura, Rieko Osu, Kunitsugu Kondo, Sachiko Sakata
    Journal of Rehabilitation Medicine.2025; 57: jrm42390.     CrossRef
  • Eye tracking-based dual task in rehabilitation of motor and cognitive function in post-stroke patients: a literature review
    Marcella Sugianto, Yuda Zhou, Jifang Qiu
    Bulletin of Faculty of Physical Therapy.2025;[Epub]     CrossRef
  • Validity and Reliability of the Berg Balance Scale in Different Tele‐Assessment Methods in Patients With Stroke
    Birol Önal, Nezire Köse, Şeyma Nur Önal, Hatice Yağmur Zengin
    Journal of Evaluation in Clinical Practice.2025;[Epub]     CrossRef
  • Convergent validity of the Tinetti scale in subacute stroke patients
    Adrián Arranz-Escudero, Patricia Martín-Casas, Ester Carpio-Calatayud, Ibai López-de-Uralde-Villanueva
    Revista Científica de la Sociedad de Enfermería Neurológica (English ed.).2025; : 500168.     CrossRef
  • Parameters of dual task walking in patients with stroke: a scoping review
    Katsuya Sakai, Yuichiro Hosoi, Yusuke Harada
    Physical Therapy Reviews.2025; : 1.     CrossRef
  • Influence of taping on joint proprioception: a systematic review with between and within group meta-analysis
    Shashank Ghai, Ishan Ghai, Susanne Narciss
    BMC Musculoskeletal Disorders.2024;[Epub]     CrossRef
  • Application of an Auditory-Based Feedback Distortion to Modify Gait Symmetry in Healthy Individuals
    Le Yu Liu, Samir Sangani, Kara K. Patterson, Joyce Fung, Anouk Lamontagne
    Brain Sciences.2024; 14(8): 798.     CrossRef
  • Time-course for acquiring transfer independence in patients with subacute stroke: a prospective cohort study
    Shin Kitamura, Yohei Otaka, Shintaro Uehara, Yudai Murayama, Kazuki Ushizawa, Yuya Narita, Naho Nakatsukasa, Daisuke Matsuura, Rieko Osu, Kunitsugu Kondo, Sachiko Sakata
    Journal of Rehabilitation Medicine.2024; 56: jrm40055.     CrossRef
  • Efficacy and safety of very early rehabilitation for acute ischemic stroke: a systematic review and meta-analysis
    Ying Lou, Zhongshuo Liu, Yingxiao Ji, Jinming Cheng, Congying Zhao, Litao Li
    Frontiers in Neurology.2024;[Epub]     CrossRef
  • Challenges in Accessing Community-Based Rehabilitation and Long-Term Care for Older Adult Stroke Survivors and Their Caregivers: A Qualitative Study
    Sining Zeng, Min Wu, Ling Xu, Zining Guo, Shufan Chen, Keyu Ling, Haihan Li, Xiaoli Yu, Xiaoping Zhu
    Journal of Multidisciplinary Healthcare.2024; Volume 17: 4829.     CrossRef
  • The Impact of Virtual Reality as a Rehabilitation Method Using TRAVEE System on Functional Outcomes and Disability in Stroke Patients: A Pilot Study
    Claudia-Gabriela Potcovaru, Delia Cinteză, Miruna Ioana Săndulescu, Daniela Poenaru, Ovidiu Chiriac, Cristian Lambru, Alin Moldoveanu, Ana Magdalena Anghel, Mihai Berteanu
    Biomedicines.2024; 12(11): 2450.     CrossRef
  • Synergistic effects of combined motor and language interventions on stroke rehabilitation: a holistic approach
    Reihaneh Saber-Moghadam, Afsaneh Zeinalzadeh, Jamshid Jamali, Mohammad Taghi Farzadfard, Davood Sobhani-Rad
    Frontiers in Human Neuroscience.2024;[Epub]     CrossRef
  • The importance of recovering body awareness in post-stroke rehabilitation: insights from clinical case reports
    Davide Cardile, Viviana Lo Buono, Francesco Corallo, Simona Cammaroto, Caterina Formica, Angelo Quartarone, Rocco Salvatore Calabrò
    Frontiers in Neurology.2024;[Epub]     CrossRef
  • 5,400 View
  • 106 Download
  • 15 Web of Science
  • 19 Crossref
Objective
To investigate the effect of treadmill training with eyes open (TEO) and closed (TEC) on the knee joint position sense (JPS), functional balance and mobility in children with spastic diplegia.
Methods
Forty-five children with spastic diplegia aged 11–13 years participated in this study. They were randomly assigned to three groups of equal number. The control group (CON) underwent designed physical therapy program whereas, the study groups (TEO and TEC) underwent the same program, in addition to treadmill gait training with eyes open and closed, respectively. Outcome measures were the degree of knee joint position error, functional balance and mobility. Measurements were taken before and after 12 weeks of intervention.
Results
After training, the three groups showed statistically significant improvement in all measured outcomes, compared to the baseline with non-significant change in the knee JPS in the CON group. When comparing posttreatment results, the TEC group showed greater significant improvement in all measured outcomes, than the TEO and CON groups.
Conclusion
Treadmill training with eyes open and closed is effective in rehabilitation of children with diplegia, but blocked vision treadmill training has more beneficial effect.

Citations

Citations to this article as recorded by  
  • Multimodal brain-body analysis of prefrontal cortex activity and postural sway with sensory manipulation
    Yasaman Baradaran, Raul Fernandez Rojas, Roland Goecke, Maryam Ghahramani
    Computers in Biology and Medicine.2025; 193: 110338.     CrossRef
  • Combining Intensive Rehabilitation With a Nonfunctional Isokinetic Strengthening Program in Adolescents With Cerebral Palsy: Protocol for a Randomized Controlled Trial
    Mathias Guérin, Benoit Sijobert, Benjamin Zaragoza, Flore Cambon, Laurence Boyer, Karine Patte
    JMIR Research Protocols.2023; 12: e43221.     CrossRef
  • The Effectiveness of Proprioceptive Training for Improving Motor Performance and Motor Dysfunction: A Systematic Review
    Leoni Winter, Qiyin Huang, Jacquelyn V. L. Sertic, Jürgen Konczak
    Frontiers in Rehabilitation Sciences.2022;[Epub]     CrossRef
  • Joint-Position Sense Accuracy Is Equally Affected by Vision among Children with and without Cerebral Palsy
    Flávia de Andrade e Souza Mazuchi, Luis Mochizuki, Joseph Hamill, Patricia Martins Franciulli, Aline Bigongiari, Isabella Tábata de Almeida Martins, Ulysses Fernandes Ervilha
    Journal of Motor Behavior.2021; 53(2): 209.     CrossRef
  • Reduced frontopolar brain activation characterizes concussed athletes with balance deficits
    I. Helmich, J. Coenen, S. Henckert, E. Pardalis, S. Schupp, H. Lausberg
    NeuroImage: Clinical.2020; 25: 102164.     CrossRef
  • Mechanically assisted walking training for walking, participation, and quality of life in children with cerebral palsy
    Hsiu-Ching Chiu, Louise Ada, Theofani A Bania
    Cochrane Database of Systematic Reviews.2020;[Epub]     CrossRef
  • 8,098 View
  • 266 Download
  • 7 Web of Science
  • 6 Crossref
Quantitative Assessment of Proprioception Using Dynamometer in Incomplete Spinal Cord Injury Patients: A Preliminary Study
Won Kee Chang, Yun Suk Jung, Mi-Kyoung Oh, Keewon Kim
Ann Rehabil Med 2017;41(2):218-224.   Published online April 27, 2017
DOI: https://doi.org/10.5535/arm.2017.41.2.218
Objective

To investigate the feasibility of a knee proprioception evaluation using a dynamometer as a tool for evaluating proprioception of the lower extremities in patients with incomplete spinal cord injury (SCI), and to explore its usefulness in predicting the ambulatory outcome.

Methods

A total of 14 SCI patients (10 tetraplegic, 4 paraplegic; all AIS D) were included in this study. The passive repositioning error (PRE) and active repositioning error (ARE) were measured with a dynamometer, along with tibial somatosensory evoked potential (SSEP) and abductor hallucis motor-evoked potential (MEP). Ambulatory capacity was assessed with the Walking Index for Spinal Cord Injury II (WISCI-II), both at the time of the proprioception test (WISCI_i) and at least 6 months after the test (WISCI_6mo).

Results

The PRE showed a negative correlation with WISCI_i (r=-0.440, p=0.034) and WISCI_6mo (r=-0.568, p=0.010). Linear multiple regression showed the type of injury, lower extremities motor score, MEP, and PRE accounted for 75.4% of the WISCI_6mo variance (p=0.080).

Conclusion

Proprioception of the knee can be measured quantitatively with a dynamometer in patients with incomplete SCI, and PRE was related to the outcome of the ambulatory capacity. Along with the neurological and electrophysiological examinations, a proprioception test using a dynamometer may have supplementary value in predicting the ambulatory capacity in patients with incomplete SCI.

Citations

Citations to this article as recorded by  
  • A new balance assessment tool for quantifying balance impairment in patients with motor incomplete spinal cord injury: Pilot study
    Tae Sung Park, Myung-Jun Shin, Yong Beom Shin, Sang Hun Kim
    The Journal of Spinal Cord Medicine.2023; 46(6): 941.     CrossRef
  • Comparison of Trunk Flexion Proprioception Between Healthy Athletes and Athletes With Patellofemoral Pain
    Reza Heydari Armaki, Keramatollah Abbasnia, Alireza Motealleh
    Journal of Sport Rehabilitation.2021; 30(3): 430.     CrossRef
  • Associations between upper extremity functioning and kinematics in people with spinal cord injury
    Lamprini Lili, Katharina S Sunnerhagen, Tiina Rekand, Margit Alt Murphy
    Journal of NeuroEngineering and Rehabilitation.2021;[Epub]     CrossRef
  • Ankle proprioception during gait in individuals with incomplete spinal cord injury
    Charline Dambreville, Benoit Pairot de Fontenay, Andreanne K. Blanchette, Jean‐Sebastien Roy, Catherine Mercier, Laurent Bouyer
    Physiological Reports.2019;[Epub]     CrossRef
  • Mechanism of Activating the Proprioceptive NT-3/TrkC Signalling Pathway by Reverse Intervention for the Anterior Cruciate Ligament–Hamstring Reflex Arc with Electroacupuncture
    Lei Zhang, Yan Zeng, Ji Qi, Taiyuan Guan, Xin Zhou, Yancheng He, Guoyou Wang, Shijie Fu
    BioMed Research International.2018; 2018: 1.     CrossRef
  • 6,273 View
  • 60 Download
  • 5 Web of Science
  • 5 Crossref
Changes in Balancing Ability of Athletes With Chronic Ankle Instability After Foot Orthotics Application and Rehabilitation Exercises
Hong-Jae Lee, Kil-Byung Lim, Tae-Ho Jung, Dug-Young Kim, Kyung-Rok Park
Ann Rehabil Med 2013;37(4):523-533.   Published online August 26, 2013
DOI: https://doi.org/10.5535/arm.2013.37.4.523
Correction in: Ann Rehabil Med 2013;37(5):755
Objective

To compare the effect of foot orthotics and rehabilitation exercises by assessing balancing ability and joint proprioception in athletes who have chronic ankle instability.

Methods

Forty-one athletes who visited hospitals due to chronic ankle instability were randomly assigned to two groups. One group had ankle rehabilitation exercises while the other group had the same rehabilitation exercises as well as foot orthotics. Joint position sense of the ankle joint was examined by using an isokinetic exercise machine. Balancing abilities categorized into static, dynamic and functional balance abilities were evaluated by using computerized posturography. We tested the subjects before and after the four-week rehabilitation program.

Results

After the four-week treatment, for joint reposition sense evaluation, external 75% angle evaluation was done, revealing that the group with the application of foot orthotics improved by -1.07±1.64 on average, showing no significant difference between the two groups (p>0.05). Static, dynamic and functional balancing abilities using balance masters were evaluated, revealing that the two groups improved in some items, but showing no significant difference between them (p>0.05).

Conclusion

This study found that athletes with chronic ankle instability who had foot orthotics applied for four weeks improved their proprioceptive and balancing abilities, but did not show additional treatment effects compared with rehabilitation exercise treatment.

Citations

Citations to this article as recorded by  
  • Effects of short- or long-term use of orthotic interventions on functional performance in individuals with chronic ankle instability: A systematic review
    Kazem Malmir, Majid Ashrafganjooie
    Journal of Bodywork and Movement Therapies.2024; 40: 1370.     CrossRef
  • Effects of Resistance and Proprioceptive Training on an Athletic Population with Chronic Ankle Instability: A Scoping Review
    Konstantinos Kasimis, Paris Iakovidis, Dimitrios Lytras, Georgios Koutras, Antonis Fetlis, Ioannis S. Myrogiannis
    Critical Reviews in Physical and Rehabilitation Medicine.2024; 36(1): 1.     CrossRef
  • Kinesiology taping improves balance in football players with chronic ankle instability
    Pedro Harry-Leite, Manuel Paquete, Telmo Parada, José António Fraiz, Fernando Ribeiro
    Journal of Bodywork and Movement Therapies.2024; 40: 455.     CrossRef
  • Influence of compression garments on proprioception: A systematic review and meta‐analysis
    Shashank Ghai, Finn Nilson, Johanna Gustavsson, Ishan Ghai
    Annals of the New York Academy of Sciences.2024; 1536(1): 60.     CrossRef
  • Efecto del vendaje neuromuscular a corto plazo sobre el equilibro y la marcha en la enfermedad de Parkinson: estudio piloto
    J. Merino-Andrés, F. Molina-Rueda, I.M. Alguacil-Diego
    Rehabilitación.2022; 56(1): 39.     CrossRef
  • The Effectiveness of Proprioceptive Training for Improving Motor Performance and Motor Dysfunction: A Systematic Review
    Leoni Winter, Qiyin Huang, Jacquelyn V. L. Sertic, Jürgen Konczak
    Frontiers in Rehabilitation Sciences.2022;[Epub]     CrossRef
  • Can Therapeutic Exercises Improve Proprioception in Chronic Ankle Instability? A Systematic Review and Network Meta-analysis
    Jia Han, Lijiang Luan, Roger Adams, Jeremy Witchalls, Phillip Newman, Oren Tirosh, Gordon Waddington
    Archives of Physical Medicine and Rehabilitation.2022; 103(11): 2232.     CrossRef
  • Exudative otitis media in children: the main causes. Part I
    I. V. Savenko, M. Yu. Boboshko
    Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics).2021; 66(4): 32.     CrossRef
  • Effects of 12 Weeks of Tai Chi Intervention in Patients With Chronic Ankle Instability: A Randomized Controlled Trial
    David Cruz-Díaz, Kyung-Min Kim, Fidel Hita-Contreras, Marco Bergamin, Agustin Aibar-Almazán, Antonio Martínez-Amat
    Journal of Sport Rehabilitation.2020; 29(3): 326.     CrossRef
  • Síndromes dolorosos de retropié y tobillo
    Juan Català-de-las-Marinas, Elena Navarro, Enrique Navarrete-Faubel
    Journal of Orthopaedic Surgery and Traumatology.2020; : 1.     CrossRef
  • Motoneuron Function Does not Change Following Whole-Body Vibration in Individuals With Chronic Ankle Instability
    Dana M. Otzel, Chris J. Hass, Erik A. Wikstrom, Mark D. Bishop, Paul A. Borsa, Mark D. Tillman
    Journal of Sport Rehabilitation.2019; 28(6): 614.     CrossRef
  • The effectiveness of rearfoot medial wedge intervention on balance for athletes with chronic ankle instability
    Hsiao-Yun Chang, Yun-Chi Chang, Shih-Chung Cheng, Chun-Hou Wang
    Medicine.2019; 98(26): e16217.     CrossRef
  • Effect of Elastic and Non-elastic Taping on Pain, Balance, and Left / Right Step Time Difference in Patients with Acute Ankle Sprain
    Yong-Ho Cho, Jin-Ho Choi, Sun-Wook Park
    Journal of The Korean Society of Physical Medicine.2018; 13(3): 67.     CrossRef
  • The effect of combined mechanism ankle support on postural control of patients with chronic ankle instability
    Mohammad Hadadi, Ismaeil Ebrahimi, Mohammad Ebrahim Mousavi, Gholamreza Aminian, Ali Esteki, Mehdi Rahgozar
    Prosthetics & Orthotics International.2017; 41(1): 58.     CrossRef
  • Effects of joint stabilizers on proprioception and stability: A systematic review and meta-analysis
    Shashank Ghai, Matthew Driller, Ishan Ghai
    Physical Therapy in Sport.2017; 25: 65.     CrossRef
  • Effects of Dual Task Training on Balance and Functional Performance in High School Soccer Players with Functional Ankle Instability
    Kwang-Il Kwak, Bum-Jin Choi
    The Journal of Korean Physical Therapy.2016; 28(4): 254.     CrossRef
  • Effect of Kinesiology Tape on Measurements of Balance in Subjects With Chronic Ankle Instability: A Randomized Controlled Trial
    Carlos de-la-Torre-Domingo, Isabel M. Alguacil-Diego, Francisco Molina-Rueda, Antonio López-Román, Josué Fernández-Carnero
    Archives of Physical Medicine and Rehabilitation.2015; 96(12): 2169.     CrossRef
  • 6,068 View
  • 74 Download
  • 17 Crossref
Reliability of Passive Knee Joint Position Sense Test.
Kim, Se Hwan , Seo, Kyung Mook , Kim, Don Kyu , Kang, Si Hyun
J Korean Acad Rehabil Med 2010;34(5):560-564.
Objective
To investigate the optimal number of repetition trials and to evaluate the test-retest reliability of passive knee joint position sense test. Method: Thirty healthy subjects were tested with isokinetic machine. The knee joints were placed in starting angle of 0o for flexion test and 90o for extension test. To memorize the target angle, the knees were passively positioned to the target angle (30o in flexion test and 60o in extension test) and left hold for 10 seconds, and returned to starting position. After these processes, knee joints were passively moved toward target angles. The subjects were instructed to press button when the memorized angles were estimated to be reproduced. The tests were performed 6 times for each test angle. After 48 hours, the tests were repeated. Intra-class correlation coefficients (ICC) were calculated with the values of test and retest. Results: There were no significant differences in absolute angular errors (AAE) between dominant and non-dominant side. The ICC value of above five repetitions of test showed excellent reliability (0.807) whereas three and four repetitions showed moderate reliabilities (0.536∼0.709). Conclusion: From the results of this study, we suggest that five repetitions of test could be appropriate for the passive joint position sense test. (J Korean Acad Rehab Med 2010; 34: 560-564)
  • 1,573 View
  • 14 Download
Upper Extremity Proprioceptive Assessment Test Using Virtual Environment Technique in Patients with Stroke.
Lee, Ki Hoon , Ku, Jeounghun , Jo, Sang Woo , Kim, Sun I , Song, Je Young , Park, Young Jin , Kim, Hyun Jung , Kang, Youn Joo
J Korean Acad Rehabil Med 2010;34(2):141-149.
Objective
To examine the reliability of upper extremity proprioceptive assessment test using virtual environment technique (VET) in patients with stroke with test-retest paradigm and define criterion for normal value by comparing with unimpaired control group. Method: Thirty stroke patients and 30 control groups were recruited. The VET apparatus is consisted of virtual reality upper extremity tester (VRUPT), encoder, and head-mounted display (HMD). VET-based test is composed of two tasks. Angle assessment task is required matching of imposed joint positions without visual feedback for checking angle error. Reaching assessment task is required matching of imposed cylinder with visual feedback for checking time, number of click, total interaction error. Results: In the test-retest analysis, correlation coefficients ranged from 0.73 to 0.99 (p<0.01). Significant differences consistently found between affected upper extremity joint of stroke group and corresponding upper extremity joint of control group for the major variables (p<0.05). The cut off value in shoulder, elbow, wrist joints were calculated as 8.24o, 8.41o, 10.31o and the frequency of proprioceptive abnormalities based on these cut off value of angle error in shoulder, elbow, wrist joints showed 60%, 67%, 83% respectively, in our stroke group. Conclusion: This VET-based proprioceptive assessment test shows promise in assessing proprioception in patients with stroke more objectively and quantitatively. (J Korean Acad Rehab Med 2010; 34: 141-149)
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Effects of Muscle Fatigue on Shoulder Proprioception.
Park, Seung Buhm , Cho, Dong Soo , Kee, Hoi Sung , Park, Rae Young , Yoon, Seo Ra , Jung, Kwang Ik
J Korean Acad Rehabil Med 2010;34(1):54-58.
Objective
To investigate the changes of shoulder proprioception in normal subjects, according to the direction of the evoked fatigue on the shoulder muscle group. Method: 20 healthy volunteers (14 males and 6 females, age 20∼35 years) with entirely normal shoulders participated in this study. Before fatigue exercises, the proprioception tests were performed during active reposition (ARP) and passive reposition (PRP) of dominant shoulder, using isokinetic dynamometer, System 3 Pro (Biodex medical system, New York, USA). Three trials each of active and passive repositioning (2°/sec) were recorded. We also estimated the results of the peak torque shoulder movements. The subjects performed maximal efforts with five repetitions on the direction of flexion, abduction, internal rotation and external rotation. The mean values of maximal concentric voluntary contraction (MVC: peak torque of each muscle group contraction) were recorded. We repeated fatigue exercises until the peak torque dropped to 30% three times consistently, then retested the proprioception of shoulder joints. We compared the proprioceptive changes of the shoulder with pre-fatigue test and post-fatigue test on the direction of shoulder movements. Results: There were significant differences of shoulder proprioception between pre-fatigue test and post-fatigue test of ARP in shoulder abduction and external rotation (p< 0.05). Conclusion: In our study, the proprioception of shoulder joint decreased more prominently on external rotation and abduction movements under severely provoked muscle fatigue around the shoulder joint. (J Korean Acad Rehab Med 2010; 34: 54-58)
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Measurement of Proprioception of the Knee in Hemiplegic Patients Using an Isokinetic Dynamometer.
Hwang, Ji Sun , Lee, Dong Seok , Cho, Yun Jeong , Han, Na Mi , Kim, Hyun Dong
J Korean Acad Rehabil Med 2010;34(1):27-33.
Objective
To measure knee joint proprioception quantitatively in hemiplegic patients after brain injury using an isokinetic dynamometer. Method: Thirty healthy subjects and 24 hemiplegic patients participated in this study. Joint position sense was evaluated with passive angle reproduction of 30o and 60o of knee flexion and kinesthesia was evaluated with the threshold for detection of passive movementfrom 45o of knee flexion. We used toe-"up or down"-test for conventional clinical method. Results: Significant proprioceptive deficit was observed not only in paretic knees of both right and left hemiplegic patients (p<0.05) but also in nonparetic knee in right hemiplegic patients (p<0.05). Both interrater and intrarater reliability of the quantitative measurement were significantly high. A significant difference was found between proprioception deficit defined with current clinical test and quantitative test in the nonparetic knee (p<0.05), but not in the paretic knee (p>0.05). Conclusion: The quantitative test using an isokinetic dynamometer is a reliable method to measure knee proprioception, and it is possible to detect proprioceptive deficit in hemiplegic patients. Conventional clinical assessments are poor for predicting the results of the quantitative measure in the nonparetic knee. This quantitative method may be useful in diagnosis and follow-up of knee proprioception of hemiplegic patients after brain injury. (J Korean Acad Rehab Med 2010; 34: 27-33)
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  • 39 Download
Passive Knee Joint Proprioception Test in Normal Adults.
Park, Heon Jong , Kim, Don Kyu , Seo, Kyung Mook , Kang, Si Hyun , Seo, Jong Hyun
J Korean Acad Rehabil Med 2009;33(6):698-703.
Objective
To establish appropriate test angle of passive knee proprioception test and to compare with active knee proprioception test. Method: Thirty one healthy volunteers were tested in seated position on isokinetic machine. For passive test, the knee joints were placed in starting angle of 0o, 30o in flexion test and 90o, 60o in extension test. To memorize target angle, they were passively positioned to the target angle and left hold for 10 seconds, and returned to starting position. After these processes, knee joints were passively moved toward flexion and extension target angle. The subjects were instructed to press stop button when the memorized angles were reproduced. The tests were performed 3 times for each 6 different test angle. The active test were performed with the same memorized process but the subjects moved actively to reproduce target angles. The absolute angular errors (AAE) between target angle and produced angle were measured and compared. Results: In passive proprioception test, the AAEs were increased according to the test angle differences were increased from 30o to 60o. In the same target angle difference, there were no differences between starting positions. When the results of passive test were compared with active test, there were no significant differences in the flexion test, but larger angular error were measured in extension test. Conclusion: The passive knee proprioception test could be useful for patients with lower extremity weakness. Considering the possible error of large angular difference, the testing angular differences should be properly selected. (J Korean Acad Rehab Med 2009; 33: 698-703)
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  • 15 Download
The Effects of Transcutaneous Electrical Nerve Stimulation for Standing Balance in Patients with Hemiplegia.
Kim, Sang Hyun , Seok, Hyun , Lee, Hyuck , Lee, Hyuk Jin , Suh, Jung Woo
J Korean Acad Rehabil Med 2009;33(2):159-164.
Objective
To evaluate the effects of transcutaneous elec-trical nerve stimulation (TENS) applied at lower extre-mity for standing balance in patients with hemiplegia. Method: Twenty-two hemiplegic patients were tested while standing on balance trainer under eight stimulation modes (No TENS, bilateral TENS, hemiplegic TENS, and una-ffected TENS. These four conditions were applied both with and without vision). All patients were able to stand inde-pendently more than five minutes. TENS was applied with pulse width 200µs, frequency of 100 Hz, amplitude set at the sensory detection threshold of each patients. TENS was applied thirty seconds for each stimulation modes, and res-ting period was 10 minutes. Postural sway was determined during the testing period by the sum of anterior-posterior (AP) center of pressure (COP) sway, medio-lateral (ML) COP sway, and total sum of COP sway. Also postural sway was determined by proportion of time of COP in three circles, which semidiameters are 10 mm, 20 mm, 30 mm each. Results: When patients were applied with TENS eyes closed at the unaffected lower extremity, AP, ML, and total sum of COP sway decreased significantly. Conclusion: In hemiplegic patients with independent standing, TENS application at the unaffected leg over five minutes can be helpful standing balance enhancement. (J Korean Acad Rehab Med 2009; 33: 159-164)
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The Effect of Knee Osteoarthritis and Unilateral Total Knee Arthroplasty on Balance.
Cho, Hyung Jun , Cho, Dong Soo , Park, Seung Buhm , Yun, Seo Ra , Jung, Kwang Ik
J Korean Acad Rehabil Med 2007;31(6):725-729.
Objective
To assess the effect of knee osteoarthritis (OA) and unilateral total knee arthroplasty (TKA) on balance. Method: Fifteen patients with bilateral knee OA and fifteen patients with unilateral TKA and fifteen healthy adults were assessed by computerized dynamic posturography. The posturography test was performed 3 times at 6 different simulated conditions. We evaluated anteroposterior sway of center of gravity and strategy score of OA group, TKA group and healthy adults group. We compared the equilibrium scores of each group with normal data reported previously. We also compared strategy scores of each group.Results: Patients with bilateral knee OA and unilateral TKA showed lower equilibrium scores than normal one at the condition 4, 5, 6. But patients with unilateral TKA did not show significant equilibrium score difference as compared with bilateral knee OA patients. Patients with bilateral knee OA and unilateral TKA showed significantly lower strategy scores than normal one at the condition 4, 5, 6 (p<0.05). But patients with unilateral TKA did not show significant strategy score difference as compared with bilateral knee OA patients. Conclusion: Patients with bilateral knee OA showed deficit of dynamic postural control due to proprioceptive dysfunction. And TKA did not affect proprioceptive change in knee osteoarthritis. (J Korean Acad Rehab Med 2007; 31: 725-729)
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Postural Stability in Patients with Chronic Ankle Sprain.
Hwang, Ji Hye , Kim, Sang Yong , Kim, Hyeon Sook , Lee, Kang Woo , Kim, Seung Ho
J Korean Acad Rehabil Med 2000;24(4):776-783.

Objective: To investigate the deficit of static and dynamic postural control in patients with chronic ankle sprain using dynamic posturography.

Method: Twenty patients with unilateral recurrent ankle sprain and functional instability were assessed by Samsung medical center ankle injury score and by computerized dynamic posturography (EquiTest system, Neurocom, international, INC; USA).

The posturography test was performed 3 times at 6 different simulated conditions such as fixed of force platform/open eyes/fixed of screen (condition 1), fixed/closed/fixed (condition 2), fixed/open/movement (condition 3), sway/open/fixed (condition 4), sway/closed/fixed (condition 5), sway/open/movement (condition 6). We evaluated anteroposterior sway of center of gravity of the patients and calculated equilibrium scores. We compared the equilibrium scores of patient group and normal data reported previously. We also compared the equilibrium scores of two subgroups of the patients according to severity of ankle injury.

Results: Patients showed significantly low equilibrium scores than normal one at the condition 4, 5 and 6 (p<0.05). The group B with severe ankle injury revealed low equilibrium scores at the condition 4, 5 and 6. Especially the group B showed statistically significance at condition 5 (p<0.05).

Conclusion: Patients with chronic ankle sprain showed the deficit of dynamic postural control due to the proprioceptive dysfunction of injured ankle than normal person.

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Effects of Muscle Fatigue on Knee Proprioception.
Kwon, Oh Yun , Park, Dong Sik
J Korean Acad Rehabil Med 1998;22(4):960-965.

Objective: To determine whether muscle fatigue affects knee joint proprioception.

Method: Thirty healthy subjects (18 male and 12 female) with an average age of 22.1 years were selected for this study. Angular errors were measured to test propriocetive function in the knee joint. In a sitting position, the subject's dominant leg was passively positioned to the 45o knee flexion stimulus point for 2∼4 second, while the subject concentrated on this position, the leg was passively returned to the 90o flexion position, afterward the subject was asked to duplicate the stimulus point actively. The difference, in degrees between the stimulus point and the reproduced point is an angular error. All subjects were blindfolded and underwent proprioception measurement before and after the muscle fatigue. Isokinetic exercises performed at 180 degree/sec on the Cybex Orthotron II(Cybex, a division of Lumex, Inc. USA) were used to induce the muscle fatigue. All subjects performed an isokinetic exercise with their dominant leg. Exercise was continued until 50% of the initial peak torque was reached. When the subjects were fatigued to less than 50% of the initial peak torque, the isokinetic exercises were discontinued. Then we immediately retested the proprioception using the same method.

Results: The mean and standard deviation of the angular error increased from 2.79⁑1.17o to 6.40⁑3.42o after muscle fatigue.

Conclusion: The proprioception significantly decreased after the muscle fatigue(p<0.001). This result suggests that the muscle fatigue must be considered when an injured professional athlete a patient with fatigable disease is set in a rehabilitation program. Further studies are required to determine the physiological mechanisms of the role of muscle fatigue for the decreasing proprioception.

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