Reliability of joint position sense measured in the knee using the level function of the iPhone "Measure" application.
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ABSTRACT:
SUBMITTER: Nakashima Y
PROVIDER: S-EPMC8396779 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:[Purpose] To establish the test-retest reliability of an iPhone application and determine the immediate effect of motor control exercise (MCE) on lumbar position sense. [Participants and Methods] This study used a two-arm, randomized controlled trial design with a blinded assessor. Sixty healthy participants were randomized into the exercise or control group. The exercise group underwent 30-min MCE, whereas the control group rested for 15 min. Lumbar motion measured by two iPhones with goniometer application was used to determine the test-retest reliability. Absolute repositioning errors (pre- and post-test) from the control and exercise groups were used to determine the immediate effect of MCE on lumbar position sense. [Results] The test-retest reliability was 0.67-0.95. A significant interaction effect was found for Angle*Time, main effect of Angle, and main effect of Time. Post-hoc comparison showed a significant improvement in position sense at 45° and 60° in the exercise group. [Conclusion] The findings suggest that a mobile phone application has the ability to detect changes in lumbar position sense between sessions that exceed measurement error following MCE. One session of specific MCE can improve lumbar position sense at high lumbar flexion.
| S-EPMC6642896 | biostudies-literature
Project description:The output of a sensorimotor performance can be measured with the joint position sense (JPS) test. However, investigations of leg dominance, sex and quality measures on this test are limited. Therefore, these potential influencing factors as well as reliability and consistency measures were evaluated for angular reproduction performance and neuromuscular activity during the active knee JPS test in healthy participants. Twenty healthy participants (10 males; 10 females; age 29 ± 8 years; height 165 ± 39 cm; body mass 69 ± 13 kg) performed a seated knee JPS test with a target angle of 50°. Measurements were conducted in two sessions separated by two weeks and consisted of two blocks of continuous angular reproduction (three minutes each block). The difference between reproduced and target angle was identified as angular error measured by an electrogoniometer. During reproduction, the neuromuscular activity of the quadriceps muscle was assessed by surface electromyography. Neuromuscular activity was normalized to submaximal voluntary contraction (subMVC) and displayed per muscle and movement phase. Differences between leg dominance and sex were calculated using Friedman-test (α = 0.05). Reliability measures including intraclass correlation coefficient (ICC), Bland-Altman analysis (bias ± limits of agreement (LoA)) and minimal detectable change (MDC) were analysed. No significant differences between leg dominance and sex were found in angular error and neuromuscular activity. Angular error demonstrated inter-session ICC scores of 0.424 with a bias of 2.4° (± 2.4° LoA) as well as MDC of 6.8° and moderate intra-session ICC (0.723) with a bias of 1.4° (± 1.65° LoA) as well as MDC of 4.7°. Neuromuscular activity for all muscles and movement phases illustrated inter-session ICC ranging from 0.432 to 0.809 with biases between - 2.5 and 13.6% subMVC and MDC from 13.4 to 63.9% subMVC. Intra-session ICC ranged from 0.705 to 0.987 with biases of - 7.7 to 2.4% subMVC and MDC of 2.7 to 46.5% subMVC. Leg dominance and sex seem not to influence angular reproduction performance and neuromuscular activity. Poor to excellent relative reliability paired with an acceptable consistency confirm findings of previous studies. Comparisons to pathological populations should be conducted with caution.
| S-EPMC9813362 | biostudies-literature
Project description:BackgroundAnterior knee pain (AKP) commonly affects both physically active and sedentary individuals and the aetiology is unknown. Altered joint position sense (JPS) impacts accurate motor action and knee joint stability. It is unclear whether people with AKP have altered JPS.ObjectiveThe aim of our study was to investigate JPS in the knees of individuals with AKP.MethodA descriptive cross-sectional study measured JPS in 25 participants with unilateral or bilateral AKP. JPS was measured using active JPS testing during single leg squat (SLS) and active knee extension (AKE) in sitting. Target angles (TA) were self-determined based on each participant's capabilities. The absolute error (AE) was the main outcome measure. Impaired JPS was classified as an AE equal to or greater than five degrees.ResultsThere were no significant differences in JPS when comparing the affected and unaffected knees in participants with AKP (p > 0.05). However, a subgroup of participants with altered knee JPS was identified. There was a tendency towards greater knee flexion in the TAs of knees without AKP.ConclusionOur results showed that JPS is not significantly more impaired in knees with AKP compared with knees without AKP in a group of individuals with AKP. A subgroup with altered JPS in knees with and without AKP was identified. This finding could be because of compensatory gait patterns and the precision of the Vicon 3D motion analysis system.Clinical implicationsJoint position sense should be assessed bilaterally in individuals with AKP.
| S-EPMC8008049 | biostudies-literature
Project description:We determined the effects of wearing an above-knee compression garment (CG) on knee joint position sense. Healthy young adults (n = 24, age = 27.46 ± 4.65 years) performed a passive knee position-matching task on an isokinetic dynamometer with each leg separately. We determined the magnitude of compression by measuring anatomical thigh cross sectional area (CSA) in standing using magnetic resonance imaging. Wearing the CG compressed CSA by 2% (t = 2.91, p = 0.010, Cohen's d = 0.68). Repeated measures ANOVA (rANOVA) with three repetition factors (condition: CG, no CG; leg: right dominant, left non-dominant; and target angles: 30°, 45°, 60°) revealed an effect of angles (p < 0.001), where the matching of knee joint position was more accurate at 60° compared to 30° and 45° (p < 0.001). However, CG did not reduce passive joint position sense errors. In fact, joint position error was less without CG (p = 0.014). In conclusion, while CG does compress the thigh it does not afford the purported benefits for proprioception as measured by a target-matching task in the present study.
| S-EPMC6122810 | biostudies-literature
Project description:BackgroundKnee proprioception is believed to be deficient after anterior cruciate ligament (ACL) injury. Tests of joint position sense (JPS) are commonly used to assess knee proprioception, but their psychometric properties (PMPs) are largely unknown.PurposeTo evaluate the PMPs (reliability, validity, and responsiveness) of existing knee JPS tests targeting individuals with ACL injury.Study designSystematic review; Level of evidence, 4.MethodsPubMed, Allied and Complementary Medicine, CINAHL, SPORTDiscus, Web of Science, Scopus, CENTRAL, and ProQuest databases were searched to identify studies that assessed PMPs of knee JPS tests in individuals with ACL injury. The risk of bias for each included study was assessed and rated at the outcome level for each knee JPS test. Overall quality and levels of evidence for each PMP were rated according to established criteria. Meta-analyses with mean differences were conducted using random effects models when adequate data were available.ResultsIncluded were 80 studies covering 119 versions of knee JPS tests. Meta-analyses indicated sufficient quality for known-groups and discriminative validity (ACL-injured knees vs knees of asymptomatic controls and contralateral noninjured knees, respectively), owing to significantly greater absolute errors for ACL-injured knees based on a strong level of evidence. A meta-analysis showed insufficient quality for responsiveness, which was attributed to a lack of significant change over time after diverse interventions with a moderate level of evidence. Statistical heterogeneity (I 2 > 40%) was evident in the majority of meta-analyses. All remaining PMPs (reliability, measurement error, criterion validity, convergent validity, and other PMPs related to responsiveness) were assessed qualitatively, and they failed to achieve a sufficient quality rating. This was a result of either the study outcomes not agreeing with the statistical cutoff values/hypotheses or the level of evidence being rated as conflicting/unknown or based on only a single study.ConclusionKnee JPS tests appear to have sufficient validity in differentiating ACL-injured knees from asymptomatic knees. Further evidence of high methodologic quality is required to ascertain the reliability, responsiveness, and other types of validity assessed here. We recommend investigations that compare the modifiable methodologic components of knee JPS tests on their PMPs to develop standardized evidence-based tests.
| S-EPMC8287371 | biostudies-literature
Project description:Functional proprioceptive information is required to allow an individual to interact with the environment effectively for everyday activities such as locomotion and object manipulation. Specifically, research suggests that application of compression garments could improve proprioceptive regulation of action by enhancing sensorimotor system noise in individuals of different ages and capacities. However, limited research has been conducted with samples of elderly people thus far. This study aimed to examine acute effects of wearing knee-length socks (KLS) of various compression levels on ankle joint position sense in community-dwelling, older adults. A total of 26 participants (12 male and 14 female), aged between 65 and 84 years, were randomly recruited from local senior activity centres in Singapore. A repeated-measures design was used to determine effects on joint position awareness of three different treatments-wearing clinical compression socks (20-30 mmHg); wearing non-clinical compression socks (< 20 mmHg); wearing normal socks, and one control condition (barefoot). Participants were required to use the dominant foot to indicate 8 levels of steepness (2.5°, 5°, 7.5°, 10°, 12.5°, 15°, 17.5°, and 20°), while standing on a modified slope box, in a plantar flexion position. Findings showed that wearing clinical compression KLS significantly reduced the mean absolute errors compared to the barefoot condition. However, there were no significant differences observed between other KLS and barefoot conditions. Among the KLS of various compression levels, results suggested that only wearing clinical compression KLS (20-30 mmHg) improved the precision of estimation of ankle joint plantar flexion movement, by reducing absolute performance errors in elderly people. It is concluded that wearing clinical compression KLS could potentially provide an affordable strategy to ameliorate negative effects of ageing on the proprioception system to enhance balance and postural control in community-dwelling individuals.
| S-EPMC7869987 | biostudies-literature
Project description:BackgroundSeveral water-based sports (swimming, surfing and stand up paddle boarding) require adequate thoracic mobility (specifically rotation) in order to perform the appropriate activity requirements. The measurement of thoracic spine rotation is problematic for clinicians due to a lack of convenient and reliable measurement techniques. More recently, smartphones have been used to quantify movement in various joints in the body; however, there appears to be a paucity of research using smartphones to assess thoracic spine movement. Therefore, the aim of this study is to determine the reliability (intra and inter rater) and validity of the iPhone® app (Compass) when assessing thoracic spine rotation ROM in healthy individuals.MethodsA total of thirty participants were recruited for this study. Thoracic spine rotation ROM was measured using both the current clinical gold standard, a universal goniometer (UG) and the Smart Phone Compass app. Intra-rater and inter-rater reliability was determined with a Intraclass Correlation Coefficient (ICC) and associated 95% confidence intervals (CI). Validation of the Compass app in comparison to the UG was measured using Pearson's correlation coefficient and levels of agreement were identified with Bland-Altman plots and 95% limits of agreement.ResultsBoth the UG and Compass app measurements both had excellent reproducibility for intra-rater (ICC 0.94-0.98) and inter-rater reliability (ICC 0.72-0.89). However, the Compass app measurements had higher intra-rater reliability (ICC = 0.96 - 0.98; 95% CI [0.93-0.99]; vs. ICC = 0.94 - 0.98; 95% CI [0.88-0.99]) and inter-rater reliability (ICC = 0.87 - 0.89; 95% CI [0.74-0.95] vs. ICC = 0.72 - 0.82; 95% CI [0.21-0.94]). A strong and significant correlation was found between the UG and the Compass app, demonstrating good concurrent validity (r = 0.835, p < 0.001). Levels of agreement between the two devices were 24.8° (LoA -9.5°, +15.3°). The UG was found to consistently measure higher values than the compass app (mean difference 2.8°, P < 0.001).ConclusionThis study reveals that the iPhone® app (Compass) is a reliable tool for measuring thoracic spine rotation which produces greater reproducibility of measurements both within and between raters than a UG. As a significant positive correlation exists between the Compass app and UG, this supports the use of either device in clinical practice as a reliable and valid tool to measure thoracic rotation. Considering the levels of agreement are clinically unacceptable, the devices should not be used interchangeably for initial and follow up measurements.
| S-EPMC5845564 | biostudies-literature
Project description:BackgroundMeasurement of lumbar spine range of motion (ROM) is often considered to be an essential component of lumbar spine physiotherapy and orthopedic assessment. The measurement can be carried out through various instruments such as inclinometers, goniometers, and etc. Recent smartphones have been equipped with accelerometers and magnetometers, which, through specific software applications (apps) can be used for inclinometric functions.PurposeThe main purpose was to investigate the reliability and validity of an iPhone(®) app (TiltMeter(©) -advanced level and inclinometer) for measuring standing lumbar spine flexion-extension ROM in asymptomatic subjects.DesignA cross-sectional study was carried out.SettingThis study was conducted in a physiotherapy clinic located at School of Rehabilitation Sciences, Iran University of Medical Science and Health Services, Tehran, Iran.SubjectsA convenience sample of 30 asymptomatic adults (15 males; 15 females; age range = 18-55 years) was recruited between August 2015 and December 2015.MethodsFollowing a 2-minute warm-up, the subjects were asked to stand in a relaxed position and their skin was marked at the T12-L1 and S1-S2 spinal levels. From this position, they were asked to perform maximum lumbar flexion followed by maximum lumbar extension with their knees straight. Two blinded raters each used an inclinometer and the iPhone (®) app to measure lumbar spine flexion-extension ROM. A third rater read the measured angles. To calculate total lumbar spine flexion-extension ROM, the measurement from S1-S2 was subtracted from T12-L1. The second (2 hours later) and third (48 hours later) sessions were carried out in the same manner as the first session. All of the measurements were conducted 3 times and the mean value of 3 repetitions for each measurement was used for analysis. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used to determine the intra-rater and inter-rater reliability, respectively. The Pearson correlation coefficients were used to establish concurrent validity of the iPhone(®) app. Furthermore, minimum detectable change at the 95% confidence level (MDC95) was computed as 1.96 × standard error of measurement × [Formula: see text].ResultsGood to excellent intra-rater and inter-rater reliability were demonstrated for both the gravity-based inclinometer with ICC values of ?0.84 and ?0.77 and the iPhone(®) app with ICC values of ?0.85 and ?0.85, respectively. The MDC95 ranged from 5.82°to 8.18°for the intra-rater analysis and from 7.38°to 8.66° for the inter-rater analysis. The concurrent validity for flexion and extension between the 2 instruments was 0.85 and 0.91, respectively.ConclusionsThe iPhone(®)app possesses good to excellent intra-rater and inter-rater reliability and concurrent validity. It seems that the iPhone(®) app can be used for the measurement of lumbar spine flexion-extension ROM.Level of evidenceIIb.
| S-EPMC5012335 | biostudies-literature
Project description:BackgroundThe anterior cruciate ligament (ACL) rupture can lead to impaired knee function. Reconstruction decreases the mechanical instability but might not have an impact on sensorimotor alterations.ObjectiveEvaluation of the sensorimotor function measured with the active joint position sense (JPS) test in anterior cruciate ligament (ACL) reconstructed patients compared to the contralateral side and a healthy control group.MethodsThe databases MEDLINE, CINAHL, EMBASE, PEDro, Cochrane Library and SPORTDiscus were systematically searched from origin until April 2020. Studies published in English, German, French, Spanish or Italian language were included. Evaluation of the sensorimotor performance was restricted to the active joint position sense test in ACL reconstructed participants or healthy controls. The Preferred Items for Systematic Reviews and Meta-Analyses guidelines were followed. Study quality was evaluated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data was descriptively synthesized.ResultsTen studies were included after application of the selective criteria. Higher angular deviation, reaching significant difference (p < 0.001) in one study, was shown up to three months after surgery in the affected limb. Six months post-operative significantly less error (p < 0.01) was found in the reconstructed leg compared to the contralateral side and healthy controls. One or more years after ACL reconstruction significant differences were inconsistent along the studies.ConclusionsAltered sensorimotor function was present after ACL reconstruction. Due to inconsistencies and small magnitudes, clinical relevance might be questionable. JPS testing can be performed in acute injured persons and prospective studies could enhance knowledge of sensorimotor function throughout the rehabilitative processes.
| S-EPMC8232438 | biostudies-literature
Project description:Inter-joint coordination and gait variability in knee osteoarthritis (KOA) has not been well investigated. Hip-knee cyclograms can visualize the relationship between the hip and knee joint simultaneously. The aim of this study was to elucidate differences in inter-joint coordination and gait variability with respect to KOA severity using hip-knee cyclograms. Fifty participants with KOA (early KOA, n = 20; advanced KOA, n = 30) and 26 participants (≥ 50 years) without KOA were recruited. We analyzed inter-joint coordination by hip-knee cyclogram parameters including range of motion (RoM), center of mass (CoM), perimeter, and area. Gait variability was assessed by the coefficient of variance (CV) of hip-knee cyclogram parameters. Knee RoM was significantly reduced and total perimeter tended to be decreased with KOA progression. KOA patients (both early and advanced) had reduced stance phase perimeter, swing phase area, and total area than controls. Reduced knee CoM and swing phase perimeter were observed only in advanced KOA. Both KOA groups had a greater CV for CoM, knee RoM, perimeter (stance phase, swing phase and total) and swing phase area than the controls. Increased CV of hip RoM was only observed in advanced KOA. These results demonstrate that hip-knee cyclograms can provide insights into KOA patient gait.
| S-EPMC7815829 | biostudies-literature