• PNF and Movement
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• 제9권1호
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• pp.39-45
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• 2011

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.

• The Journal of Korean Physical Therapy
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• 제26권6호
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• pp.425-429
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• 2014

Purpose: The first purpose of this study was to evaluate whether hand muscle fatigue alters sensorimotor control of the hand in healthy subjects, using hand position sense. The second objective was to assess the repositioning variables during a 7.5-min period after the fatigue protocol. Methods: Participants performed a repeated handgrip movement to induce the fatigue condition as fast as possible, until they could no longer continue. Recordings were performed before (pre-fatigue) and after the completion of the fatigue exercises (immediately: post-fatigue, after a 2.5 min recovery, after a 5 min recovery and after a 7.5 min recovery). Results: The joint reposition test of the MP joint in the post-fatigue condition showed higher reposition errors than the prefatigue condition (p<0.05). Additionally, there was a significant difference in recovery of joint reposition errors after fatiguing exercises of the hand muscle, among groups (p<0.05). Conclusion: The fatigue of the hand muscles affected joint position sense by an alteration of somatosensory and proprioceptive information. Nonetheless, the effect of hand muscle fatigue was short-lived, since joint reposition errors decreased to post-fatigue values after 7.5 min of recovery.

• PNF and Movement
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• 제21권2호
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• pp.265-272
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• 2023

Purpose: The purpose of this study was to investigate tactile sense perception of the lower extremities according to physical function in children with spastic cerebral palsy. Methods: This study was conducted on 15 children diagnosed with spastic cerebral palsy. Physical function measurement items included dynamic balance ability, gross motor function level, and lower extremity ankle spasticity. The lower extremity tactile sensation uses a monofilament to measure the sole of the first metatarsal head, the sole of the fifth metatarsal head, the heel, the anterior part of the shin midway between the patella and the ankle joint, the kneecap, the upper anterior iliac spine, and the knee. A total of six measurements were taken in the mid-femoral region of the bone. Spearman correlation analysis was performed to determine the degree of body function and lower extremity tactile perception. Results: As the physical function of children with spastic cerebral palsy deteriorated, there was a decrease in tactile sensation in the thigh area corresponding to the proximal lower extremity. (p <.05). Conclusion: Children with spastic cerebral palsy and poor physical function have sensory loss not only in the distal part but also in the proximal part, so a treatment approach that recognizes and improves it is necessary.

• 대한정형외과스포츠의학회지
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• 제12권1호
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• pp.29-36
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• 2013

목적: 고유 수용성 감각 기능은 견관절의 안정성에 중요한 역할을 하는 것으로 알려졌으나 회전근개 파열 환자에 대하여는 크게 알려진 바가 없다. 본 연구의 목적은 회전근개 파열 환자의 고유 수용성 감각 기능에 대하여 조사하고자 하였고 특히 파열크기, 견갑하근의 파열 유무 등에 따라 조사하고자 하였다. 대상 및 방법: 2011년 7월부터 2012년 2월까지 회전근개의 파열로 본원에서 수술적 치료가 시행된 76예(남자 28명, 여자 48명)를 대상으로 하였고 평균 나이는 61.7세(범위, 38세~76세)였다. 수술전 고유 수용성 감각 기능 평가를 위하여 외회전 및 내회전에 대한 위치 감각(joint position sense)를 측정하였고 방식은 능동적 재위치법(active re-positioning)을 사용하였다. 정해진 회전 각도와의 편차의 절대값을 측정하였다. 회전근개의 파열 크기, 견갑하근의 파열 유무, 통증(pain visual analogue scale), 견관절 기능 점수(American society of elbow and shoulder score), 견관절 운동 범위를 조사하였으며 이들 변수에 따른 차이를 비교하였다. 결과: 외회전의 경우 정상 관절은 $4.9^{\circ}{\pm}2.9^{\circ}$, 이환된 관절은 $4.9^{\circ}{\pm}3.0^{\circ}$의 절대 편차를 보였고 이는 통계적으로 유의하지 않은 차이를 보였다(p=0.87). 내회전의 경우 정상관절은 $4.0^{\circ}{\pm}2.7^{\circ}$인데 비하여 이환된 관절은 $4.8^{\circ}{\pm}3.7^{\circ}$로 편차가 증가하였으며 이는 통계적으로 유의하였다(p=0.043). 회전근개의 파열 크기에 따라 파열이 더 큰 경우(중파열 이상)가 파열이 더 작은 경우(부분파열 및 소파열)에 비하여 내회전의 고유감각기능 감소가 더 뚜렷한 경향을 보였으며(5.0 vs. 4.0, p=0.061), 견갑하근의 파열이 있는 환자군에서 내회전의 고유감각 기능 감소가 더 뚜렷한 경향을 보였다(4.8 vs. 4.0, p=0.065). 통증이 클수록, 견관절 기능 검사 점수가 낮을수록 내회전에 대한 고유감각기능이 감소하였으며(각각 p=0.04 및 p=0.005) 견관절 운동 범위의 제한이 있는 환자군에서 내회전 고유감각기능이 더욱 감소되는 것이 관찰되었다(5.3 vs. 3.7, p=0.041). 결론: 회전근개 파열 환자에서 내회전에 대한 고유감각기능 감소가 관찰되었으며 특히 이는 회전근개의 파열 정도가 심하고 견갑하근의 파열이 동반된 경우 뚜렷한 경향을 보였다. 또한 통증이 심하거나 견관절 기능 점수가 낮으며 운동 범위의 제한이 있는 경우 내회전에 대한 고유감각기능이 감소하는 것으로 관찰되었다.

• PNF and Movement
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• 제14권2호
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• pp.105-112
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• 2016

Purpose: The purpose of this study was to examine the effects of proprioceptive neuromuscular facilitation (PNF) wrist taping, after the application of a rhythmic stabilization (RS) technique, on the decrease of pain and the increase of grip strength in physical therapists who complained of wrist pain and to provide basic data on interventions for wrist pain patients. Methods: The subjects were 15 peoples in their 20s who complained of pain with a visual analogue scale (VAS) at five points or higher due to overuse of their wrists. They were randomly assigned to a control group, to which PNF wrist taping was applied after stretching (n=7), or to an experimental group (n=8), to which PNF wrist taping was applied after application of the RS technique of PNF. The experiment was conducted for four weeks, five times per week. VAS was measured in order to measure pain decrease, and grip strength (GS) was measured using a dynamometer. In order to compare within-group differences before and after the intervention, a paired t-test was performed, and in order to compare differences between the two groups, the analysis of covariance (ANCOVA) was used. All statistically significant levels were set at ${\alpha}=0.05$. Results: There were significant differences in changes of VAS and GS within each group before and after the intervention (p<0.01), but there was no significant difference between the two groups. Conclusion: This study applied PNF wrist taping after the application of stretching or PNF RS to patients who complained of pain beyond a sense of discomfort; these interventions resulted in a decrease in pain and an increase in the grip strength of the subjects. Taping and therapeutic techniques using PNF are considered to be usefully applied as one of the programs to improve wrist pain patients' pain and grip strength.

• 한국전문물리치료학회지
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• 제26권1호
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• pp.19-27
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• 2019

Background: Compared to healthy people, patients with chronic lower back pain have reduced balance abilities which may cause proprioception problems, patients with chronic lower back pain avoid physical activities due to pain, and reduced activity levels lead to muscle weakening, which can further exacerbate pain. Recently, there have been many studies on the use of sensory stimulation; and among these studies, interventions that use vibrational stimulation have shown functional improvements in the patients. Objects: This study examined the effects of a stabilization exercise with vibration stimulation on the balance ability and disability in patients with chronic back pain. Methods: The subjects of the study were 30 persons who were randomly assigned to the experimental group and the control group, with 15 subjects in each. The subjects were evaluated before and after intervention via a balance ability test, the Korean Oswestry disability index (KODI) test, a pain test, and a proprioceptive sensory test. Both groups received general physical therapy. The experimental group performed the stabilization exercise with vibration stimulation, and the control group performed a general stabilization exercise, three times a week for six weeks. Results: After the intervention, both groups showed significant improvements in the balance ability test, the KODI test, the pain test, and the proprioceptive sensory test. The experimental group showed statistically significant, higher improvements than the control group in the balance ability test, the KODI test, and the proprioceptive sensory test. Conclusions: The stabilization exercise with vibration stimulation for patients with chronic back pain has been reported to provide greater functional improvements than the conventional intervention method. Therefore, the stabilization exercise in a vibration stimulation environment could be a useful intervention for patients with chronic back pain.

• 대한물리치료과학회지
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• 제15권2호
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• pp.33-40
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• 2008

Background: The purpose of this study is to examine the effect of resistance exercise on static and dynamic proprioception by applying elastic bands to the knee flexor, which can be performed earlier than proprioception, a weight bearing pattern. Proprioceptive training may be applied to the early period of recuperation training along with resistance exercise to prevent damage to the knees and the joints in the lower body, as well as the reoccurrence of injury, which is expected to improve the effect of static and dynamic proprioceptive training. Methods: The subjects of this study were 32 men and women in their 20s who volunteered to participate in the experiment which was carried out over the course of 6 weeks from March 14 to April 24 at K Hospital located in Yongin City. They were tested in two groups: the elastic band resistance exercise group (RE: Resistance Excercise Group, n＝17) and the joint motion range exercise group(ROM: Range of Motion Group, n＝15). In this experiment, static and dynamic proprioceptive tests were given to both groups before and after the test. In this study, SPSS Win ver.12.0 was utilized to perform a T-test on the independent samples in order to validate the identical features of subjects in the RE and ROM Group and substantiate the significance as to the difference between both groups before and after the test. Also, a paired T-test was conducted to compare the static and dynamic proprioception of both groups before and after the test. The statistical significance levels were ${\alpha}$＝.05. Results: 1.The static proprioception in both groups, RE and ROM, increased in a statistically significant way after the test(p<.05). 2.The static propriocetion of the RE group increased in a statistically significant way after the test(p<.05). However, the increase of the static proprioception in the ROM group was not statistically significant. 3.Static and dynamic proprioception of the RE group increased significantly more than that of the ROM group after the test(p<.05). Conclusion: The resistance exercise using elastic bands improved the static and dynamic proprioception more than the joint motion range exercise did, reducing the risk of injury by enhancing the location sense of the joints and the sense of motion and shortening the period of recovery from injury. The outcome of the experiment may provide basic data for developing an effective way to reduce the risk of injury among ordinary people and athletes.

• 대한임상전기생리학회지
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• 제3권1호
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• pp.71-84
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• 2005

This study had performed with purposes to analyze the influence of the change of vestibular sens, visual and proprioceptive sense to the postural sway, so as to supply the necessary clinical materials through developing the physical therapeutic interventions and assessment format for the diabetic neuropathy patients. The sample consisted of fifteen diabetic neuropathy patients with sensory disorder in their lower limbs and fifteen age-matched normal control group. Then the effect of the GVS and the visual cue open and closed to the postural sway were measured by CoP. The summary of the comparison results were obtained below. In the comparison of diabetes neuropathy patients group and age matched normal control group, however diabetes neuropathy patients group had a decrease in superficial tactile sense(p<.001) and nerve conduction velocity(p<.001), they were able to control the posture and walk. So it is, diabetes neuropaty patients had more disturbance compared with AMC group on at a hard surface, particularly in the visual cue open(p<.001) and visual cue closed(p<.01). Moreover, since diabetes neuropathy patients group had more differences in visual cue open and closed(p<. 01), GVS(p<.01), it meant that they're affected largely by vestibular sense, visual sense. In addition, since there're the largest change in doubled sense disturbance such as visual cue open and closed under GVS, it meant that compensation of other senses were quite important for the diabetes neuropathy patients' postural control. In the conclusion, diabetes neuropathy patients who decrease or lose the somatosensory system, sensory training of visual and vestibular system are likely to be quite essential to control the posture and balance.

• 한국전문물리치료학회지
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• 제10권3호
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• pp.63-70
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• 2003

The purpose of this study was to compare the difference of joint position sense between measurements. Fourteen healthy male subjects were recruited for this study. The elbow joint position senses were measured using angle reproduction test. The elbow joint position sense was assessed with three experimental conditions: ipsilateral reproduction test in open-chain condition, contralateral reproduction test in open-chain condition, ipsilateral reproduction test with weight in open-chain condition and ipsilateral reproduction test in closed-chain condition. The angular difference between stimulus position and the reproduced position (angular error) was calculated in all testing conditions to examine the accuracy of the joint position sense. One way ANOVA was used to compare the error angles in all experimental conditions. The error angles between measurements were significantly different in elbow joint. The error angles was smallest in ipsilateral reproduction test with weight in open-chain condition and was greatest in the contralateral reproduction test in open-chain condition. Findings of this study indicate that testing methods, types of task, existence of resistance should be considered in clinical assessment for the joint position sense.

• The Journal of Korean Physical Therapy
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• 제24권2호
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• pp.151-156
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• 2012

Purpose: The purpose of this study was to investigate the adverse effects of sensorimotor function at the shoulder joint according to long-term cane usage in stroke patients without apraxic behavior, in terms of the presence of shoulder joint pain, accuracy of tracking task, proprioceptive joint position sense, and nine-hole pegboard. Methods: Nineteen stroke patients with long-term cane usage (cane usage group) and nineteen stroke patients without cane usage (non-cane usage group) were recruited. All subjects were tested in pain presence, a tracking task for visuomotor function, joint reposition, and nine-hole pegboard in the shoulder joint regarding the non-affected side. Results: In the accuracy index for tracking task and the nine-hole pegboard test, significant differences were observed between the cane usage group and the non-cane usage group. However, although a higher emergence of shoulder pain and a lower accuracy for joint reposition sense were detected in the cane usage group in comparison to the non-cane usage group, there were no significant differences between the two groups. Conclusion: Our findings suggest that long-term cane usage could induce to decrease in delicate movement and coordination in the non-affected upper arm in stroke patients. In addition, they could experience high frequency of shoulder pain and poor joint reposition sense. Therefore, careful evaluation and observation will be required concerning stroke patients with long-term cane usage.