Purpose: The cane is one of the most popular assistive devices for stroke patients. Clinical complaints of sensorimotor functions on the ipsilateral upper limb were appealed in stroke patients who had used a cane for a long period. Therefore, we investigated whether cane usage for a long-term period affected sensoriomotor dysfunctions on the non-affected upper limb, in terms of pain presence, shoulder joint sense, a nine-hole pegboard test, and a tracking task. Methods: We recruited 12 stroke patients, who were divided into the cane-using (CU) group or the non-cane using (NCU) group, according to cane usage experience. We evaluated joint position sense for the integrity of proprioceptive reposition sense in the shoulder joint, used a nine-hole pegboard test for upper limb dexterity evaluation, and a tracking task for visuomotor coordination. Results: Four patients in the CU group had complained of shoulder pain none did in the NCU group. In addition, the CU group showed more reposition errors on the shoulder joint than the NCU group did. In addition, the CU group had more difficulty in proprioceptive sense perception and in performance of the nine-hole pegboard teat and tracking task, compared with the NCU group. Conclusion: Our findings suggest that cane usage for a long period in stroke patients could give rise to trigger joint pain and decrease proprioceptive sense. In addition, complex motor performance in the ipsilateral upper limb could deteriorate. In stroke patients who had used acane for long period, careful observation and proper intervention will be necessary.
Purpose : The purpose of this article was to review the literature on change of knee position sense after total knee replacement intervention in knee rehabilitation. Methods : This review outlines scientific findings regarding different literature data in knee rehabilitation, and discusses proprioceptive change of knee joints after total knee replacement intervention. Result : Severe pain and diminished joint sensation may precipitate degenerative changes of knees joint, and a strong association between decreased proprioception and function has been identified in elderly patients with knee osteoarthritis. Total knee replacement(TKR) of the knee joint are effective surgical procedures in osteoarthritis patients, resulting in decreased pain, and improved physical function and quality of life in patients. After total knee replacement, joint position sensation is partially recovered, which may improve functional stability of the knee, but aspects of physical functioning are not fully restored to preoperative status. Conclusions : Thus, recovery rate in proprioception after TKR also is considered to be important because it may be a significant risk factor in failure of total knee replacement and knee rehabilitation intervention.
Purpose: To recognize the change in the proprioception under conditions that activate the local muscles, this study found the difference in the proprioception on a fixed and swing chair. Methods: Healthy adults (7 males, 13 females) in their twenties were evaluated lumbar position sense on fixed and swing chair. And the difference of the position sense between the fixed and swing chair were analyzed. Results: The joint position senses were compared between the fixed and swing chair. As a result, there was a significant difference from all motions. Conclusion: This study found that the improvement of proprioception using swing chair means that the local muscle is activated. Therefore, to use a swing chair, which was designed in this study, is able to replace the general chair either at work or during studies. Thus, this method is easily accessible for busy modern people who are exposed to low back pain or spinal disorders due to a pattern of inactivity.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.28
no.1
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pp.39-51
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2022
Background: The purpose of this study is to investigate the effect of neck and shoulder self-stretching exercise using audiovisual media on neck pain, postural alignment, and joint position error in women with chronic neck pain. Methods: The subjects included 20 women that gave consent to participate in the study voluntarily. They performed the self-stretching exercises using audiovisual media was carried out 20 minutes 5 times a week during 3 weeks. Neck disability index (NDI) and visual analogue scale (VAS) were used to measure the functional disability and pain, A pressure pain threshold was measured using an algometer, and a cervical range of motion (CROM) measurement tool was used to measure the range of motion and error of proprioceptive position sense of the cervical spine. To assess posture alignment, forward head angle (FHA), forward shoulder angle (FSA) were measured using image J software. Results: The neck pain intensity was statistically significantly within group (p<.05). Neck and shoulder functional disability were a statistically significant difference within group (p<.05). Splenius capitis and upper trapezius pressure pain threshold were statistically significant difference in within group (p<.05). The postural alignment was statistically significantly within group (p<.05). The cervical range of motion in neck extension, right and left lateral flexion were statistically significantly within group (p<.05). The joint position error in neck flexion, extension, right and left lateral flexion decreased statistically significantly within group (p<.05). Conclusion: Self-stretching exercise using audiovisual media increased the mobility of the neck, decreased neck pain and joint position error, and improved posture alignment. As a result, there was a positive effect by applying the self-stretching exercise using audiovisual media to people with neck pain. Based on this, it is thought that it can be used as the basis for research related to home training programs for healthy self-management.
Purpose : The purpose of this study was to investigate the effects of proprioceptive exercise (PE) using a trampoline and a balance board on a balance ability after stroke. Method : Sixteen chronic stroke patients participated. Participants were randomly assigned to the PE group or control group (8 experimental, 8 control). All of participants were in-patients at local rehabilitation centre and had been receiving a traditional rehabilitation program, five days a week. The PE group have additionally undergone for four weeks, three days a week, the PE using a trampoline and a balance board under supervision by a physical therapist but control group was not received any additional program except the traditional rehabilitation program. The position sense test used to assess a proprioceptive sense at a knee joint. The Berg Balance Scale (BBS) and the Timed Up & Go (TUG) test to measure the balance ability were carried out before and after the training. Result : After the training the error of position sense at knee joint of PE group significantly decreased compared to the control group. The PE group demonstrated a significant improvement in the scores of the BBS and TUG. Conclusion : The present study suggests that the PE program using a trampoline and balance board may become a useful tool for enhancing a balance ability in chronic stroke patients through the ennced proprioceptive position senses.
Kim, Seo-hyun;Yi, Chung-hwi;Lim, Jin-seok;Lim, One-bin
Physical Therapy Korea
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v.29
no.2
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pp.124-130
/
2022
Background: During postural control, older adults are more dependent on proprioception than are young adults. Ankle proprioception, which plays an important role in maintaining postural balance, decreases with age. Published studies are insufficient to establish a significant age difference in postural sway resulting from the known age-related decrease in ankle proprioception and do not examine various detailed test conditions. Objects: The present study aimed to compare ankle proprioception between older and younger groups along dimensions of position vs. force proprioception and dorsiflexion vs. plantarflexion. The present study also aimed to compare postural sway between young and older women during quiet standing under two sensory conditions. Methods: We recruited seven young women aged 21-24 and seven older women aged 60-63. Ankle proprioception was assessed as the accuracy of the joint position sense (JPS) and the force sense (FS). Postural sway was assessed using center-of-pressure measurements recorded during quiet standing under two sensory positions: eyes open and eyes closed with head tilted back. Results: Older women had lower JPS in dorsiflexion and lower FS in plantarflexion than did younger women. We found no significant age differences in JPS in plantarflexion or in FS in dorsiflexion. We observed a main effect of group on postural sway in two sway parameters out of three. We observed significant differences in JPS with dorsiflexion, and in FS with plantarflexion. Conclusion: Proprioception for ankle plantar flexor decreased more significantly with aging than did that for ankle dorsiflexor, accounting for the impaired postural balance observed in older women.
In the present paper the current clinical knowledge about proprioception is given for the shoulder, knee, ankle, elbow and the radiocarpal joint. Proprioceptive capabilities are decreased after knee joint injury such as anterior cruciate ligament. Joint position sense is significantly improved by cruciate reconstruction. Thus, we review of the articles for the proprioception of the anterior cruciate ligament of the knee joint. The present information on proprioception will influence our clinical practice in the future. We should choose surgical procedures that not only reconstruct the anatomy, but also the neurophysiologic feed-back mechanism.
Purpose: This study aimed to determine the effects of open kinetic chain exercise (OKCE) and closed kinetic chain exercise (CKCE) using knee reposition sensing on balance, strength, and knee joint reposition sense (JPS) in chronic stroke patients. Methods: Twenty-nine hemiplegic patients participated in this study. Participants were randomly divided into 3 groups, CKCE, OKCE, and controls, with 9, 10, and 10 participants, respectively. The CKCE group completed CKCE using knee reposition sensing, whereas the OKCE group completed OKCE using knee reposition sensing. The control group completed conventional physical therapy. Results: Significant differences between the CKCE and OKCE groups were apparent for all outcomes except the functional reaching test. The CKCE group displayed significant improvements in knee JPS versus the OKCE and control groups (p<0.01). The OKCE group displayed significant improvements in knee extensor muscle strength versus the CKCE and control groups (p<0.05). The CKCE and OKCE groups displayed significantly improvements in static balance versus the control group (p<0.05). Conclusion: CKCE and OKCE improved balance, strength, and knee JPS. Additionally, CKCE might provide a more useful intervention benefit than OKCE for increasing knee JPS, a weight-bearing task. OKCE was sufficient to improve the knee extensor muscle strength.
The purpose of this study was to compare the effects of knee joint position sense following local and general load protocols in 25 healthy male subjects. Proprioception of the knee joint was evaluated by measuring absolute angular errors at matching angles before, after and between 2 different types of load protocols. Proprioception tests(on the dominant knee) were performed in which proprioception of the passivepassive reproduced and active-active reproduced knee position was measured. Local load was provided with maximum isokinetic knee extension-flexion on the isokinetic dynamometer(Cybex), and general load was 10 minutes running on a treadmill. Peak torque(knee extension and flexion) and heart rate(beats per minute) was evaluated as an indicator of local and general fatigue during load protocols. The results were as follows: 1. For pasive-pasive reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol(P<.05). However, no significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol (P>.05), no significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P>.05). 2. For active-active reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol (P<.05). Also, significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol(P<.05), significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P<.05). 3. A significant decrease of peak torque of knee extensors and flexors was seen after local load, although heart rate was significantly increased(P<.05). No significant change of peak torque of knee extensors and flexors was seen after general load(P>.05), although heart rate was also significantly increased(P<.05). The previous study revealed that knee proprioception is significantly altered when the muscle mechanoreceptors are dysfunctional due to muscle fatigue, although the joint mechanoreceptors have no significantly effect on knee proprioception when the presence of knee muscle fatigue. However, the results of this study are different from those of the previous study in that muscle weakness of the knee could not be seen after general load. This study shows that general load may diminish motor control by the central nervous system. Proprioceptional decline without muscle weakness of knee after general load suggests a change in the proprioceptional pathway without influence from muscle mechanoreceptors.
The purpose of this study was to find the effects of the eccentric exercise induced delayed muscle soreness on proprioception, muscle strength, muscle fatigue, and muscle pain of the elbow flexor muscles. Thirty one healthy male subjects were participated in this study. Before resisted eccentric exercise of the elbow flexors and immediately and at 1, 3, 5, and 7 days post-exercise, pain threshold, proprioception, tension tracking, initial median frequency, and fatigue index were measured. Pain pressure threshold and visual analog scale (VAS) was used to measure muscle pain. Proprioception of the elbow joint was measured by using 3 dimension motion analysis system. Maximum isometric contraction was measured by using digital tensiometer. Electromyography and power spectrum analysis was used to measure initial median frequency (IMF) and fatigue index (FI). Immediately post-exercise, a significant decrease pain threshold was observed that continued to 5 days post-exercise. VAS score was significantly increased at 1 and 3 days post-exercise compared to that of immediately post-exercise. Maximum isometric contraction, IMF, tension tracking ability of the exercised elbow joint were significantly decreased at 1, 3, and 5 days post-exercise compared to that of pre-exercise. FI was significantly increased at 1 and 3 days post-exercise compared that of pre-exercise. Proprioception sense of exercised elbow joint was significantly decreased immediately and at 1, 3, and 5 days post-exercise compared to that of pre-exercise. Proprioception sense of the contralateral elbow joint was significantly decreased immediately post-exercise compared to that of pre-exercise. However, proprioception sense that was measured in close chain kinematic position was not significantly difference between pre-exercise and post-exercise. These results could be useful to determine the resume time for exercising and participating sports activities.
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