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Horváth Á, Ferentzi E, Schwartz K, Jacobs N, Meyns P, Köteles F. The measurement of proprioceptive accuracy: A systematic literature review. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:219-225. [PMID: 35390537 PMCID: PMC10105016 DOI: 10.1016/j.jshs.2022.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/19/2022] [Accepted: 02/18/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Proprioceptive accuracy refers to the individual's ability to perceive proprioceptive information, that is, the information referring to the actual state of the locomotor system, which originates from mechanoreceptors located in various parts of the locomotor system and from tactile receptors located in the skin. Proprioceptive accuracy appears to be an important aspect in the evaluation of sensorimotor functioning; however, no widely accepted standard assessment exists. In this systematic review, our goal was to identify and categorize different methods that are used to assess different aspects of proprioceptive accuracy. METHODS A literature search was conducted in 5 different databases (PubMed, SPORTDiscus, PsycINFO, ScienceDirect, and SpringerLink). RESULTS Overall, 1139 scientific papers reporting 1346 methods were included in this review. The methods assess 8 different aspects of proprioception: (a) the perception of joint position, (b) movement and movement extent, (c) trajectory, (d) velocity, and the sense of (e) force, (f) muscle tension, (g) weight, and (h) size. They apply various paradigms of psychophysics (i.e., the method of adjustment, constant stimuli, and limits). CONCLUSION As the outcomes of different tasks with respect to various body parts show no associations (i.e., proprioceptive accuracy is characterized by site-specificity and method-specificity), the appropriate measurement method for the task needs to be chosen based on theoretical considerations and/or ecological validity.
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Affiliation(s)
- Áron Horváth
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Kazinczy street 23-27, Budapest 1075, Hungary; Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Prielle Kornélia Street 47-49, Budapest 1117, Hungary.
| | - Eszter Ferentzi
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Prielle Kornélia Street 47-49, Budapest 1117, Hungary
| | - Kristóf Schwartz
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Kazinczy street 23-27, Budapest 1075, Hungary; Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Prielle Kornélia Street 47-49, Budapest 1117, Hungary
| | - Nina Jacobs
- Rehabilitation Research (REVAL), Faculty of Rehabilitation Sciences, University of Hasselt, Martelarenlaan 42, Hasselt 3500, Belgium
| | - Pieter Meyns
- Rehabilitation Research (REVAL), Faculty of Rehabilitation Sciences, University of Hasselt, Martelarenlaan 42, Hasselt 3500, Belgium
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Prielle Kornélia Street 47-49, Budapest 1117, Hungary
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Lai Z, Lee S, Chen Y, Wang L. Comparison of whole-body vibration training and quadriceps strength training on physical function and neuromuscular function of individuals with knee osteoarthritis: A randomised clinical trial. J Exerc Sci Fit 2021; 19:150-157. [PMID: 33680003 PMCID: PMC7895843 DOI: 10.1016/j.jesf.2021.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 01/03/2023] Open
Abstract
Background Knee osteoarthritis (KOA) is one of the leading causes of global disability, which causes knee pain, stiffness and swelling. Impaired neuromuscular function may cause joint instability, alignment changes and knee stress, which leads to the progression of KOA. Whole-body vibration (WBV) training is considered to improve pain and functional mobility effectively. However, few studies have investigated the therapeutic effect of WBV on neuromuscular function in KOA. Material and methods A single-blinded, randomised, controlled trial was performed on 81 participants diagnosed with KOA. The participants were randomised into three groups: (1) WBV group, in which participants performed strength training (ST) with vibration exposure for 8 weeks; (2) ST group, in which participants performed ST without vibration for 8 weeks; and (3) health education (HE) group, in which participants received a HE for 8 weeks. The visual analogue scale for knee pain, isokinetic muscle strength test, proprioception test, Timed Up and Go test (TUG) and 6-min Walk Distance test (6MWD) were performed before and after the interventions. Results No significant difference was found on pain, proprioception, TUG and 6MWD. A significant interaction effect was found in isokinetic muscle strength between groups. Further analysis showed that compared with the HE group, the WBV group exhibited significantly greater improvement in isokinetic muscle strength (peak torque [PT] of extensors, p < 0.01, 95% CI = 0.11-0.33 Nm/kg; PT of flexors, p = 0.01, 95% CI = 0.02-0.19 Nm/kg; peak work [PW] of extensors, p < 0.01, 95% CI = 0.12-0.75 W/kg). In addition, compared with the ST group, the muscle strength of the WBV group (PT of extensors, p < 0.01, 95% CI = 0.10-0.32 Nm/kg; PW of extensors, p < 0.01, 95% CI = 0.09-0.71 W/kg) improved significantly. Conclusion Our findings suggested that adding WBV training to ST might benefit muscle strength around the knee joint in patients with KOA.
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Affiliation(s)
- Zhangqi Lai
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Seullee Lee
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yiyang Chen
- Department of Kinesiology and Physical Education, McGill University, Montreal, Canada
| | - Lin Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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Al-Dadah O, Shepstone L, Donell ST. Proprioception deficiency in articular cartilage lesions of the knee. Knee Surg Relat Res 2020; 32:25. [PMID: 32660559 PMCID: PMC7251730 DOI: 10.1186/s43019-020-00042-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/29/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose The purpose of this study is to investigate the proprioceptive function of patients with isolated articular cartilage lesions of the knee as compared to normal controls. Methods The Cartilage group consisted of eight subjects with radiologically and arthroscopically confirmed, isolated, unilateral, articular cartilage lesions of the knee (Outerbridge grade III or IV). They were compared to 50 normal controls. Knee proprioception was assessed by dynamic postural stabilometry using the Biodex Balance SD System. Patient-reported outcome measures (PROMs) were used to evaluate all subjects. Results Proprioception of the injured knee of the Cartilage group was significantly poorer compared to that of the control group (p < 0.001). A significant proprioceptive deficit also was observed when the uninjured knees of the Cartilage group were compared to those in the Control group (p = 0.003). There was no significant proprioceptive difference between the injured and the contra-lateral uninjured knee of the Cartilage group (p = 0.116). A significant correlation was found between the proprioception measurements of the injured and uninjured knee of the Cartilage group (r = 0.76, p = 0.030). A significant difference was observed in all PROMs (p < 0.001) between the Cartilage and Control groups. Conclusions Patients with isolated articular cartilage lesions of the knee had a significant proprioceptive deficit as compared to normal controls. The deficiency was profound and even affected the proprioceptive function of the contra-lateral uninjured knee. This study has shown that articular cartilage lesions have a major influence on knee proprioception. However, it remains uncertain as to whether a proprioceptive deficit leads to osteoarthritis or is a consequence of it.
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Affiliation(s)
- Oday Al-Dadah
- Translational and Clinical Research Institute, Newcastle University, Framlington Place, Newcastle-upon-Tyne, NE2 4HH, UK. .,Department of Trauma and Orthopaedic Surgery, South Tyneside Hospital, Harton Lane, South Tyneside, NE34 0PL, UK.
| | - Lee Shepstone
- Norwich Medical School, University of East Anglia, Earlham Road, Norwich, NR4 7TJ, UK
| | - Simon T Donell
- Norwich Medical School, University of East Anglia, Earlham Road, Norwich, NR4 7TJ, UK
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Goślińska J, Wareńczak A, Miedzyblocki M, Hejdysz K, Adamczyk E, Sip P, Chlebuś E, Gośliński J, Owczarek P, Woźniak A, Lisiński P. Wireless Motion Sensors-Useful in Assessing the Effectiveness of Physiotherapeutic Methods Used in Patients with Knee Osteoarthritis-Preliminary Report. SENSORS (BASEL, SWITZERLAND) 2020; 20:E2268. [PMID: 32316331 PMCID: PMC7219042 DOI: 10.3390/s20082268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/11/2022]
Abstract
Osteoarthritis of the knee (OAK) is characterized by pain, limitation of joint mobility, and significant deterioration of proprioception resulting in functional decline. This study assessed proprioception in OAK patients following two ten-day rehabilitation programs using the Orthyo® system. Fifty-four study participants with clinical symptoms and radiological signs of OAK were randomly divided into an exercise group (n = 27) or a manual therapy group (n = 27). The control group consisted of 27 volunteers with radiological signs of OAK, but with no clinical symptoms or prior history of rehabilitation. The following parameters were assessed: knee proprioception using inertial sensors and a mobile application, patients' function using Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and pain intensity using the visual analog scale (VAS). Following rehabilitation, knee proprioception tests did not improve in either study group. Both study groups showed significant improvement of the WOMAC-assessed function (exercise group: p < 0.01, manual therapy group: p = 0.01) and a significant decrease (p < 0.01) of VAS-assessed pain following rehabilitation, but the post-therapy results did not differ significantly between the aforementioned groups. The Orthyo® system provided a quick and accurate assessment of the knee joint position sense. There was no direct relationship between functionality, pain, and proprioception threshold in the knee joint.
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Affiliation(s)
- Jagoda Goślińska
- Department of Rehabilitation and Physiotherapy, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland; (A.W.); (M.M.); (K.H.); (E.A.); (P.S.); (E.C.); (P.L.)
| | - Agnieszka Wareńczak
- Department of Rehabilitation and Physiotherapy, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland; (A.W.); (M.M.); (K.H.); (E.A.); (P.S.); (E.C.); (P.L.)
| | - Margaret Miedzyblocki
- Department of Rehabilitation and Physiotherapy, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland; (A.W.); (M.M.); (K.H.); (E.A.); (P.S.); (E.C.); (P.L.)
| | - Krystyna Hejdysz
- Department of Rehabilitation and Physiotherapy, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland; (A.W.); (M.M.); (K.H.); (E.A.); (P.S.); (E.C.); (P.L.)
| | - Ewa Adamczyk
- Department of Rehabilitation and Physiotherapy, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland; (A.W.); (M.M.); (K.H.); (E.A.); (P.S.); (E.C.); (P.L.)
| | - Paweł Sip
- Department of Rehabilitation and Physiotherapy, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland; (A.W.); (M.M.); (K.H.); (E.A.); (P.S.); (E.C.); (P.L.)
| | - Ewa Chlebuś
- Department of Rehabilitation and Physiotherapy, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland; (A.W.); (M.M.); (K.H.); (E.A.); (P.S.); (E.C.); (P.L.)
| | - Jarosław Gośliński
- Aisens Sp. z o. o., Lubeckiego 23A, 60-348 Poznań, Poland; (J.G.); (P.O.); (A.W.)
| | - Piotr Owczarek
- Aisens Sp. z o. o., Lubeckiego 23A, 60-348 Poznań, Poland; (J.G.); (P.O.); (A.W.)
| | - Adam Woźniak
- Aisens Sp. z o. o., Lubeckiego 23A, 60-348 Poznań, Poland; (J.G.); (P.O.); (A.W.)
| | - Przemysław Lisiński
- Department of Rehabilitation and Physiotherapy, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland; (A.W.); (M.M.); (K.H.); (E.A.); (P.S.); (E.C.); (P.L.)
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A Better Way to Decrease Knee Swelling in Patients with Knee Osteoarthritis: A Single-Blind Randomised Controlled Trial. Pain Res Manag 2019; 2019:8514808. [PMID: 31191790 PMCID: PMC6525802 DOI: 10.1155/2019/8514808] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/22/2019] [Accepted: 03/31/2019] [Indexed: 11/18/2022]
Abstract
Objective In this study, we compared the effects of intermittent pneumatic compression along with conventional treatment with cold-pack treatment along with conventional treatment on clinical outcomes in patients with knee osteoarthritis. Methods Eighty-nine patients with knee osteoarthritis participated in this study. One group received ultrasound, transcutaneous electrical nerve stimulation, electrical stimulation, exercise, and cold packs. The second group received ultrasound, transcutaneous electrical nerve stimulation, electrical stimulation, exercise, and intermittent pneumatic compression. Range of motion, muscle strength, knee swelling, pain intensity, and functional status were measured at baseline and 4th week. Results We found significant improvements in range of motion, muscle strength, pain intensity, and functional status after the treatment in both groups (p < 0.05). When comparing the effects of these two treatment programs, it was observed that the intermittent pneumatic compression treatment group had a better outcome in terms of knee swelling (p=0.028). Conclusions According to the results, we could report that intermittent pneumatic compression therapy in addition to conventional treatment has significant positive effects on clinical outcomes in patients with knee osteoarthritis. We could also report that intermittent pneumatic compression therapy along with conventional treatment is superior to cold-pack therapy along with conventional treatment in terms of knee swelling in patients with knee osteoarthritis. This trial is registered with NCT03806322.
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Kim D, Park G, Kuo LT, Park W. The effects of pain on quadriceps strength, joint proprioception and dynamic balance among women aged 65 to 75 years with knee osteoarthritis. BMC Geriatr 2018; 18:245. [PMID: 30332992 PMCID: PMC6192068 DOI: 10.1186/s12877-018-0932-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 10/01/2018] [Indexed: 01/12/2023] Open
Abstract
Background Patients with knee osteoarthritis (OA) were reported to have quadriceps weakness, and impaired proprioception, both related to pain and swelling. It is unclear whether pain alone a causal factor to above findings over the knee joint. The purpose of this study was to assess the effects of knee pain alone on the quadriceps strength, proprioception and dynamic balance in subjects with bilateral knee OA without joint swelling. Methods Fourty females with mean age of 68.3 years were involved in this cross-sectional study. The inclusion criteria were bilateral knee OA without joint swelling, with a visual analogue pain scale difference (> 1) between each knee. Patients all underwent assessment of the isokinetic strength of knee muscles, knee proprioceptive acuity, and dynamic balance. Results Patients’ more painful knee had weaker isokinetic quadriceps strength than less painful knee at both 60 °/s and 180 °/s (p = 0.01, p = 0.01, respectively). There were no differences in proprioceptive acuity between both knees in all three knee positions. Meanwhile, there was a significant difference in the dynamic balance index measurement between both knees (more painful versus less painful: 3.88 ± 1.15 vs. 3.30 ± 1.00, p = 0.01). Quadriceps strength was associated with dynamic balance stability (60 °/s, r = − 0.578, p < 0.01; 180 °/s, r = − 0.439, p < 0.01). Conclusions For patients with knee OA, the more painful knee was associated with weaker quadriceps and poor balance ability. To improve lower limb function and balance stability of the older persons having knee OA, physicians should take the optimal pain management strategy. Electronic supplementary material The online version of this article (10.1186/s12877-018-0932-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dokyung Kim
- Department of Sports Medicine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea
| | - Geon Park
- Department of Sports Medicine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea
| | - Liang-Tseng Kuo
- Sports Medicine Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, No. 6 West Sec, Chia-Pu Road, Putz city, Chiayi, 613, Taiwan. .,Chang Gung University of Science and Technology, Chiayi, Taiwan.
| | - Wonhah Park
- Department of Sports Medicine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea
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Abstract
Ankylosing spondylitis is a chronic inflammatory disease that mainly affects axial joints and the changes in the vertebrae cause typical kyphotic posture. In patients with ankylosing spondylitis, the postural changes, including cervical flexion, decreased lumbar lordosis, posterior rotation of pelvis, hip extension, knee flexion, and plantar flexion of ankle along with kyphosis, may occur in the upcoming terms of the disease and may negatively affect balance. Joint and eye involvements; muscular, vestibular and proprioceptional changes can also affect balance. This review evaluates the ankylosing spondylitis-equilibrium relationship together with posture and other parameters of balance.
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Affiliation(s)
- Alper Uckun
- Department of Physical Medicine and Rehabilitation, Mut State Hospital, Mersin, Turkey
| | - Ilhan Sezer
- Department of Rheumatology, Health Sciences University, Antalya Training and Research Hospital, Antalya, Turkey
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Predictors of self-reported knee instability among patients with knee osteoarthritis: results of the Amsterdam osteoarthritis cohort. Clin Rheumatol 2016; 35:3007-3013. [DOI: 10.1007/s10067-016-3411-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 09/02/2016] [Accepted: 09/08/2016] [Indexed: 11/26/2022]
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Gade V, Allen J, Cole JL, Barrance PJ. Upright Magnetic Resonance Imaging Tasks in the Knee Osteoarthritis Population: Relationships Between Knee Flexion Angle, Self-Reported Pain, and Performance. Arch Phys Med Rehabil 2016; 97:1107-14. [PMID: 26723855 DOI: 10.1016/j.apmr.2015.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/30/2015] [Accepted: 12/04/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To characterize the ability of patients with symptomatic knee osteoarthritis (OA) to perform a weight-bearing activity compatible with upright magnetic resonance imaging (MRI) scanning and how this ability is affected by knee pain symptoms and flexion angles. DESIGN Cross-sectional observational study assessing effects of knee flexion angle, pain level, and study sequence on accuracy and duration of performing a task used in weight-bearing MRI evaluation. Visual feedback of knee position from an MRI compatible sensor was provided. Pain levels were self-reported on a standardized scale. SETTING Simulated MRI setup in a research laboratory. PARTICIPANTS Convenience sample of individuals (N=14; 9 women, 5 men; mean, 69±14y) with symptomatic knee OA. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Averaged absolute and signed angle error from target knee flexion for each minute of trial and duration tolerance (the duration that subjects maintained position within a prescribed error threshold). RESULTS Absolute targeting error increased at longer trial durations (P<.001). Duration tolerance decreased with increasing pain (mean ± SE, no pain: 3min 19s±11s; severe pain: 1min 49s±23s; P=.008). Study sequence affected duration tolerance (first knee: 3min 5s±9.1s; second knee: 2min 19s±9.7s; P=.015). CONCLUSIONS The study provided evidence that weight-bearing MRI evaluations based on imaging protocols in the range of 2 to 3 minutes are compatible with patients reporting mild to moderate knee OA-related pain.
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Affiliation(s)
- Venkata Gade
- Human Performance and Engineering Research, Kessler Foundation, West Orange, NJ
| | - Jerome Allen
- Human Performance and Engineering Research, Kessler Foundation, West Orange, NJ
| | - Jeffrey L Cole
- Kessler Institute for Rehabilitation, West Orange, NJ; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ
| | - Peter J Barrance
- Human Performance and Engineering Research, Kessler Foundation, West Orange, NJ; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ.
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Proprioception in musculoskeletal rehabilitation. Part 2: Clinical assessment and intervention. ACTA ACUST UNITED AC 2015; 20:378-87. [DOI: 10.1016/j.math.2015.01.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/04/2015] [Accepted: 01/15/2015] [Indexed: 01/14/2023]
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Röijezon U, Clark NC, Treleaven J. Proprioception in musculoskeletal rehabilitation. Part 1: Basic science and principles of assessment and clinical interventions. ACTA ACUST UNITED AC 2015; 20:368-77. [DOI: 10.1016/j.math.2015.01.008] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 12/18/2014] [Accepted: 01/15/2015] [Indexed: 10/24/2022]
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Hulya TD, Sevi YSS, Serap A, Ayse OE. Factors affecting the benefits of a six-month supervised exercise program on community-dwelling older adults: interactions among age, gender, and participation. J Phys Ther Sci 2015; 27:1421-7. [PMID: 26157233 PMCID: PMC4483411 DOI: 10.1589/jpts.27.1421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 01/17/2015] [Indexed: 01/30/2023] Open
Abstract
[Purpose] This study determined the effects of age, gender, and participation on the
benefits of a 6-month supervised exercise program on older adults. [Subjects and Methods]
Eighty-five (37 women, 48 men) community-dwelling older adults participated. The chair
sit-and-reach test, the 8-foot up-and-go test, the 6-minute walk test, the Berg Balance
Scale, lower-body flexibility, dynamic balance, aerobic endurance, balance, metabolic
rate, muscle strength, and position sense were evaluated. Repeated-measures of analysis of
variance was performed including dependent variables of age, gender, and participation in
the exercise program as dependent inter-subject factors and time of assessment as an
intra-subject factor. [Results] Mean exercise participation was 29.88 ± 1.29 sessions.
Flexibility, balance, position sense, and strength showed a significant main effect of
time. There was a significant gender interaction for right shoulder flexion strength and
knee extension strength, a significant gender-participation interaction for
pre-/post-intervention measures of functional mobility, and a significant
age-participation interaction for flexibility. [Conclusion] Exercise training improved
outcomes after 6 months of supervised exercise, but the changes were similar regardless of
participation level. Changes in strength were more pronounced in men than women.
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Affiliation(s)
| | | | - Acar Serap
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Turkey
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Rhon D, Deyle G, Gill N, Rendeiro D. Manual physical therapy and perturbation exercises in knee osteoarthritis. J Man Manip Ther 2013; 21:220-8. [PMID: 24421635 PMCID: PMC3822322 DOI: 10.1179/2042618613y.0000000039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objectives: Knee osteoarthritis (OA) causes disability among the elderly and is often associated with impaired balance and proprioception. Perturbation exercises may help improve these impairments. Although manual physical therapy is generally a well-tolerated treatment for knee OA, perturbation exercises have not been evaluated when used with a manual physical therapy approach. The purpose of this study was to observe tolerance to perturbation exercises and the effect of a manual physical therapy approach with perturbation exercises on patients with knee OA. Methods: This was a prospective observational cohort study of 15 patients with knee OA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC), global rating of change (GROC), and 72-hour post-treatment tolerance were primary outcome measures. Patients received perturbation balance exercises along with a manual physical therapy approach, twice weekly for 4 weeks. Follow-up evaluation was done at 1, 3, and 6 months after beginning the program. Results: Mean total WOMAC score significantly improved (P = 0.001) after the 4-week program (total WOMAC: initial, 105; 4 weeks, 56; 3 months, 54; 6 months, 57). Mean improvements were similar to previously published trials of manual physical therapy without perturbation exercises. The GROC score showed a minimal clinically important difference (MCID)≥+3 in 13 patients (87%) at 4 weeks, 12 patients (80%) at 3 months, and 9 patients (60%) at 6 months. No patients reported exacerbation of symptoms within 72 hours following each treatment session. Discussion: A manual physical therapy approach that also included perturbation exercises was well tolerated and resulted in improved outcome scores in patients with knee OA.
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Affiliation(s)
- Daniel Rhon
- Madigan Army Medical Center, Department of Physical Medicine, Tacoma, WA, USA
| | - Gail Deyle
- Brooke Army Medical Center, San Antonio, TX, USA
| | - Norman Gill
- Brooke Army Medical Center, San Antonio, TX, USA
| | - Daniel Rendeiro
- Occupational and Physical Therapy Service, Warrior Transition Brigade, Fort Hood, TX, USA
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Bennell KL, Wrigley TV, Hunt MA, Lim BW, Hinman RS. Update on the Role of Muscle in the Genesis and Management of Knee Osteoarthritis. Rheum Dis Clin North Am 2013; 39:145-76. [DOI: 10.1016/j.rdc.2012.11.003] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Bockstahler BA, Prickler B, Lewy E, Holler PJ, Vobornik A, Peham C. Hind limb kinematics during therapeutic exercises in dogs with osteoarthritis of the hip joints. Am J Vet Res 2013; 73:1371-6. [PMID: 22924718 DOI: 10.2460/ajvr.73.9.1371] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess joint kinematics in dogs with osteoarthritis of the hip joints during walking up an incline or down a decline and over low obstacles and to compare findings with data for nonlame dogs. ANIMALS 10 dogs with osteoarthritis of the hip joints (mean ± SD age, 6.95 ± 3.17 years; mean body weight, 34.33 ± 13.58 kg) and 8 nonlame dogs (3.4 ± 2.0 years; 23.6 ± 4.6 kg). PROCEDURES Reflective markers located on the limbs and high-speed cameras were used to record joint kinematics during walking up an incline or down a decline and over low obstacles. Maximal flexion, extension, and range of motion of the hip joints were calculated. RESULTS Osteoarthritis of the hip joints reduced extension of both hip joints and flexion of the contralateral hind limb, compared with flexion of the lame hind limb, during walking down a decline. Walking up an incline resulted in decreased extension of the stifle joint in both hind limbs of osteoarthritic dogs; extension was significantly decreased for the lame hind limb. During walking over low obstacles, maximal flexion of the stifle joint was increased significantly for the contralateral hind limb. Maximal flexion was increased in both tarsal joints. CONCLUSIONS AND CLINICAL RELEVANCE Osteoarthritis of the hip joints led to complex changes in the gait of dogs, which involved more joints than the affected hip joint alone. Each exercise had specific effects on joint kinematics that must be considered when planning a rehabilitation program.
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Affiliation(s)
- Barbara A Bockstahler
- Movement Science Group Vienna, Clinic for Surgery and Ophthalmology, Section for Physiotherapy and Acupuncture, Clinical Department of Small Animals and Horses, Vetmeduni Vienna, A1210 Vienna, Austria.
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Knoop J, Dekker J, Klein JP, van der Leeden M, van der Esch M, Reiding D, Voorneman RE, Gerritsen M, Roorda LD, Steultjens MPM, Lems WF. Biomechanical factors and physical examination findings in osteoarthritis of the knee: associations with tissue abnormalities assessed by conventional radiography and high-resolution 3.0 Tesla magnetic resonance imaging. Arthritis Res Ther 2012; 14:R212. [PMID: 23039323 PMCID: PMC3580524 DOI: 10.1186/ar4050] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 10/05/2012] [Indexed: 01/11/2023] Open
Abstract
Introduction We aimed to explore the associations between knee osteoarthritis (OA)-related tissue abnormalities assessed by conventional radiography (CR) and by high-resolution 3.0 Tesla magnetic resonance imaging (MRI), as well as biomechanical factors and findings from physical examination in patients with knee OA. Methods This was an explorative cross-sectional study of 105 patients with knee OA. Index knees were imaged using CR and MRI. Multiple features from CR and MRI (cartilage, osteophytes, bone marrow lesions, effusion and synovitis) were related to biomechanical factors (quadriceps and hamstrings muscle strength, proprioceptive accuracy and varus-valgus laxity) and physical examination findings (bony tenderness, crepitus, bony enlargement and palpable warmth), using multivariable regression analyses. Results Quadriceps weakness was associated with cartilage integrity, effusion, synovitis (all detected by MRI) and CR-detected joint space narrowing. Knee joint laxity was associated with MRI-detected cartilage integrity, CR-detected joint space narrowing and osteophyte formation. Multiple tissue abnormalities including cartilage integrity, osteophytes and effusion, but only those detected by MRI, were found to be associated with physical examination findings such as crepitus. Conclusion We observed clinically relevant findings, including a significant association between quadriceps weakness and both effusion and synovitis, detected by MRI. Inflammation was detected in over one-third of the participants, emphasizing the inflammatory component of OA and a possible important role for anti-inflammatory therapies in knee OA. In general, OA-related tissue abnormalities of the knee, even those detected by MRI, were found to be discordant with biomechanical and physical examination features.
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Rutherford DJ, Hubley-Kozey CL, Stanish WD. Knee effusion affects knee mechanics and muscle activity during gait in individuals with knee osteoarthritis. Osteoarthritis Cartilage 2012; 20:974-81. [PMID: 22698444 DOI: 10.1016/j.joca.2012.05.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 05/18/2012] [Accepted: 05/29/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To test the hypothesis that knee effusion presence in those with knee osteoarthritis (OA) alters knee joint muscle activation patterns and sagittal plane mechanics during gait. METHODS Thirty-five patients with medial compartment knee OA were assessed for the presence of effusion using a brush test. Based on the results, they were assigned to the knee effusion (n = 17) and no knee effusion (n = 18) groups. Electromyograms from seven lower extremity muscles (lateral and medial gastrocnemius, vastus lateralis and medialis, rectus femoris and the lateral and medial hamstrings), leg motion and ground reaction forces were recorded during self-selected walking. Isometric knee extensor, plantar flexor and knee flexor strength were measured. Discrete measures from angular knee motion and net external moment of force waveforms were identified. Principal component analysis extracted electromyographic waveform features. Analysis of variance models tested for main effects (group, muscle) and interactions (α = 0.05). Bonferroni post-hoc testing was employed. RESULTS No differences in age, body mass index, knee pain, Western Ontario McMaster Osteoarthritis Index scores, gait velocity and muscle strength were found between groups (P > 0.05). Individuals with effusion had a greater overall quadriceps activation and prolonged hamstring activation into mid-stance (P < 0.05). Knee joint flexion angles were higher (P < 0.05) and net external knee extension (KE) moments in mid to late stance lower in the effusion group. CONCLUSION Quadriceps and hamstrings activation during walking were altered when effusions were present. Increased knee flexion (KF) angles and decreased KE moment in mid-late stance provide a mechanical explanation for the effect of joint effusion on muscle activation in those with knee OA.
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Affiliation(s)
- D J Rutherford
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada.
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