Effect of a neoprene sleeve on knee joint position sense during sitting open kinetic chain and supine closed kinetic chain tests

Whole leg compression garments influence lower limb kinematics and associated muscle synergies during running

The utilization of compression garments (CGs) has demonstrated the potential to improve athletic performance; however, the specific mechanisms underlying this enhancement remain a subject of further investigation. This study aimed to examine the impact of CGs on running mechanics and muscle synergies from a neuromuscular control perspective. Twelve adult males ran on a treadmill at 12 km/h, while data pertaining to lower limb kinematics, kinetics, and electromyography were collected under two clothing conditions: whole leg compression garments and control. The Non-negative matrix factorization algorithm was employed to extract muscle synergy during running, subsequently followed by cluster analysis and correlation analysis. The findings revealed that the CGs increased knee extension and reduced hip flexion at foot strike compared with the control condition. Moreover, CGs were found to enhance stance-phase peak knee extension, while diminishing hip flexion and maximal hip extension during the stance-phase, and the ankle kinematics remained unaltered. We extracted and classified six synergies (SYN1-6) during running and found that only five SYNs were observed after wearing CGs. CGs altered the structure of the synergies and changed muscle activation weights and durations. The current study is the first to apply muscle synergy to discuss the effect of CGs on running biomechanics. Our findings provide neuromuscular evidence for the idea of previous studies that CGs alter the coordination of muscle groups, thereby affecting kinematic characteristics during running.

Influence of taping on force sense accuracy: a systematic review with between and within group meta-analysis

Taping is a common technique used to address proprioceptive deficits in both healthy and patient population groups. Although there is increasing interest in taping to address proprioceptive deficits, little is known about its effects on the kinetic aspects of proprioception as measured by force sense accuracy. To address this gap in the literature, the present systematic review and meta-analysis was conducted to evaluate the impact of taping on force sense accuracy. A search for relevant literature was conducted following PRISMA guidelines across seven databases and one register. Eleven studies with 279 participants were included in the review out of 7362 records. In the between-group analyses, we found a significant improvement in absolute (p < 0.01) and relative (p = 0.01) force sense accuracy with taping compared to no comparator. Likewise, a significant improvement in absolute (p = 0.01) force sense accuracy was also observed with taping compared to placebo tape. In the within group analysis, this reduction in the absolute (p = 0.11) force sense accuracy was not significant. Additional exploratory subgroup analyses revealed between group improvement in force sense accuracy in both healthy individuals and individuals affected by medial epicondylitis. The findings of this meta-analysis should be interpreted with caution due to the limited number of studies and a lack of blinded randomized controlled trials, which may impact the generalizability of the results. More high-quality research is needed to confirm the overall effect of taping on force sense accuracy.

Valgus Control Feedback and Taping Improves the Effects of Plyometric Exercises in Women With Dynamic Knee Valgus

BACKGROUND

Female athletes are more predisposed to anterior cruciate ligament (ACL) injuries in comparison with their male counterparts. Research on ACL injury prevention strategies has demonstrated beneficial effects of plyometric exercises and feedback (FB) during the exercises. FB has resulted in reductions in vertical ground-reaction force and kinematic risk factors associated with ACL injury. Furthermore, taping (TP) may draw attention to the restriction created by the tape and serve as real-time biofeedback. The additional influence of FB and TP on plyometric exercises has not been determined.

HYPOTHESIS

FB and TP interventions delivered during plyometric exercises would result in positive changes in biomechanics and muscle onset in female athletes displaying dynamic knee valgus.

DESIGN

Controlled trial.

SETTING

University research laboratory.

LEVEL OF EVIDENCE

Level 2.

METHODS

Forty-eight active female athletes were divided into 3 groups: control (n = 16), plyometric training with FB (n = 16), and plyometric training with TP (n = 16). The 2 experimental groups performed a 6-week exercise program with either FB or TP. The control group continued its regular team schedule. Knee joint position sense, landing error scoring system (LESS), and the onset of muscle activation (the point at which muscle activation exceeds 3 standard deviations over baseline and continued above this threshold for at least 25 ms) before landing for the rectus femoris, vastus medialis, vastus lateralis, gluteus medius, semitendinosus, and biceps femoris during pre- and posttests were measured.

RESULTS

The vastus lateralis onset later in the TP group compared with the FB group (d [95% CI] = 0.64 [0.35-0.82], P = 0.01). Joint position sense accuracy improved only in the TP group (d = -0.63, P = 0.001). Both the FB (d = -0.85, P = 0.001), and TP (d = -0.82, P = 0.001) groups improved in LESS scores.

CONCLUSION

The results of the present study showed that plyometric exercises with FB or TP affect LESS and the onset of the vastus lateralis in active uninjured women with dynamic knee valgus, while TP improves joint position sense. Therefore, when more accurate joint position sense is desired, practitioners may use plyometric with TP. If an improved LESS score is desired, plyometrics with either TP or FB are acceptable.

CLINICAL RELEVANCE

Our findings indicate that female athletes may benefit more when completing a plyometric training program with a TP versus an FB. Trainers, coaches, and clinicians should consider utilizing instructions that promote an external focus when implementing plyometric training programs with male athletes.

Indirect Vibration of the Upper Limbs Alters Transmission Along Spinal but Not Corticospinal Pathways

The use of upper limb vibration (ULV) during exercise and rehabilitation continues to gain popularity as a modality to improve function and performance. Currently, a lack of knowledge of the pathways being altered during ULV limits its effective implementation. Therefore, the aim of this study was to investigate whether indirect ULV modulates transmission along spinal and corticospinal pathways that control the human forearm. All measures were assessed under CONTROL (no vibration) and ULV (30 Hz; 0.4 mm displacement) conditions while participants maintained a small contraction of the right flexor carpi radialis (FCR) muscle. To assess spinal pathways, Hoffmann reflexes (H-reflexes) elicited by stimulation of the median nerve were recorded from FCR with motor response (M-wave) amplitudes matched between conditions. An H-reflex conditioning paradigm was also used to assess changes in presynaptic inhibition by stimulating the superficial radial (SR) nerve (5 pulses at 300Hz) 37 ms prior to median nerve stimulation. Cutaneous reflexes in FCR elicited by stimulation of the SR nerve at the wrist were also recorded. To assess corticospinal pathways, motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation of the contralateral motor cortex were recorded from the right FCR and biceps brachii (BB). ULV significantly reduced H-reflex amplitude by 15.7% for both conditioned and unconditioned reflexes (24.0 ± 15.7 vs. 18.4 ± 11.2% M max ; p < 0.05). Middle latency cutaneous reflexes were also significantly reduced by 20.0% from CONTROL (-1.50 ± 2.1% Mmax) to ULV (-1.73 ± 2.2% Mmax; p < 0.05). There was no significant effect of ULV on MEP amplitude (p > 0.05). Therefore, ULV inhibits cutaneous and H-reflex transmission without influencing corticospinal excitability of the forearm flexors suggesting increased presynaptic inhibition of afferent transmission as a likely mechanism. A general increase in inhibition of spinal pathways with ULV may have important implications for improving rehabilitation for individuals with spasticity (SCI, stroke, MS, etc.).

Neoprene Knee Sleeves of Varying Tightness Augment Barbell Squat One Repetition Maximum Performance Without Improving Other Indices of Muscular Strength, Power, or Endurance

ABSTRACT

Machek, SB, Cardaci, TD, Wilburn, DT, Cholewinski, MC, Latt, SL, Harris, DR, and Willoughby, DS. Neoprene knee sleeves of varying tightness augment barbell squat one repetition maximum performance without improving other indices of muscular strength, power, or endurance. J Strength Cond Res 35(2S): S6-S15, 2021-Neoprene knee sleeves are commonly used by powerlifters and recreational users but are heavily under-researched. Furthermore, no data exist on whether knee sleeves of varying compressive tightness impact muscular performance similar to commonly used knee wraps, which are both generally effective and more so when increasingly constrictive. Fifteen resistance trained, knee sleeve naive, recreational weight lifting men (22.1 ± 4.1 years; 177.5 ± 5.9 cm; 87.8 ± 7.8 kg) visited the laboratory on 3 separate occasions one week apart, assigned in a randomized, crossover, and counterbalanced fashion to either a minimally supportive control sleeve (CS) condition, a manufacturer-recommended sizing neoprene knee sleeve ("normal" sleeve; NS), or a one size smaller (than NS) neoprene knee sleeve (tighter sleeve [TS]). On each visit, subjects sequentially completed vertical jump (countermovement and squat jumps for both peak and mean power), one repetition maximum (1RM) barbell squat, and GymAware assessments (peak power, peak velocity, and dip) at 90% (reported) and 100% (tested) 1RM as well as one-leg extension (1RM, repetitions to failure, and total volume load at 75% 1RM) tests. All data were analyzed using one-way repeated measures analysis of variance at p < 0.05. Analysis revealed a significant condition effect on barbell squat 1RM (p = 0.003; η2 = 0.339), whereby both NS (p = 0.044; 166 ± 24 kg) and TS (p = 0.019; 166 ± 21 kg) outperformed CS (161 ± 22 kg), with no difference between neoprene sleeves. Conversely, no other tested parameters differed between knee sleeve conditions (p ≥ 0.05). The present results demonstrate that neoprene knee sleeves may function independent of tightness, relative to recommended sizing and ultimately unlike knee wraps. Furthermore, the singular benefits observed on barbell squat maximal strength potentially suggests an exercise-specific benefit yet to be fully elucidated.

Compressive Garments in Individuals with Autism and Severe Proprioceptive Dysfunction: A Retrospective Exploratory Case Series

(1) Background: Compression garments (CGs) are an adjuvant treatment for generalized joint hypermobility (GJH), including the Ehlers-Danlos syndrome/hypermobility types. The effects of CGs are likely to be related to better proprioceptive control. We aimed to explore the use of CGs in individuals with autism and severe proprioceptive dysfunction (SPD), including individuals with GJH, to control posture and challenging behaviors. (2) Methods: We retrospectively described 14 patients with autism and SPD, including seven with comorbid GJH, who were hospitalized for major challenging behaviors with remaining behavioral symptomatology after the implementation of multidisciplinary approaches, including medication, treatment of organic comorbidities, and behavioral restructuring. Each patient received a CG to wear for at least 1 h (but most often longer) per day for six weeks. We assessed challenging behaviors in these participants with the Aberrant Behavior Checklist (ABC), sensory integration with the Dunn questionnaire, and postural sway and motor performance using a self-designed motricity path at baseline, two weeks, and six weeks. (3) Results: We observed a significant effect on most ABC rating scores at two weeks, which persisted at six weeks (total score, p = 0.004; irritability, p = 0.007; hyperactivity, p = 0.001; lethargy, p = 0.001). Postural control in dorsal and profile positions was significantly improved between before and after wearing the CGs (p = 0.006 and 0.007, respectively). Motor performance was also significantly improved. However, we did not observe a significant change in Dunn sensory scores. During the six-week duration, the treatment was generally well-tolerated. A comorbid GJH diagnosis was not associated with a better outcome. (4) Conclusions: CGs appear to be a promising adjuvant treatment for both behavioral and postural impairments in individuals with autism and SPD.

Position of compression garment around the knee affects healthy adults' knee joint position sense acuity

Athletes use compression garments (CGs) to improve sport performance, accelerate rehabilitation from knee injuries or to enhance joint position sense (JPS). The position of CGs around the knee may affect knee JPS but the data is inconsistent. The purpose of the present study was to determine the effects of CG position on healthy adults' knee joint position sense acuity. In a counterbalanced, single-blinded study, 16 healthy young adults (8 female, age: 25.5 y) performed an active knee joint position-matching task with and without (CON) a below-knee (BK), above-knee (AK), or whole-knee (WK) CG in a randomized order on the dominant (CompDom) or the non-dominant leg (CompNon-Dom). We also determined the magnitude of tissue compression by measuring anatomical thigh and calf cross sectional area (CSA) in standing using magnetic resonance imaging (MRI). Subjects had less absolute repositioning error (magnitude of error) in BK compared with CON condition. On the other hand, the analysis of the direction of error (constant error) revealed that in each condition subjects tended to underestimate the target position (AK, BK and CON: 75%; WK: 94%). In WK condition there was a significantly larger negative error (-2.7 ± 3.4) as compared with CON (-1.6 ± 3.7) condition. There also was less variable error, in WK compared to BK and CON conditions, indicating less variability in their position sense using a WK CG, regardless of the underestimation. CG reduced thigh CSA by 4.5 cm² or 3% and calf CSA by Δ1.3 cm² or 1%. The position of CG relative to the knee modifies knee JPS. The findings helps us better understand how the application of a WK CG may support athletic activities.

Effects of knee orthoses on kinesthetic awareness and balance in healthy individuals

Introduction

Conflicting evidence exists regarding the effects of knee orthoses on proprioception. One belief is that pressure applied by orthoses heightens kinesthetic awareness and that this affects balance. This study aimed to investigate the effects of two different orthosis designs on kinesthetic awareness and balance in healthy individuals.

Methods

Twenty individuals (13 women) participated in this case series study. Each was tested wearing 1/no orthosis, 2/soft elastic orthosis and 3/non-elastic jointed orthosis. Pressure under orthoses was recorded. Kinesthetic awareness was investigated by testing joint position sense and threshold to detection of passive motion. Balance was tested using a modified sensory organization test.

Results

Non-elastic jointed orthoses applied the greatest pressure to the knee. With non-elastic jointed orthoses, threshold to detection of passive motion was significantly poorer for pooled results (p = 0.02) and when the start position of the knee was 70° (mean threshold = 0.6°, 0.6°, 0.7° for no-orthosis, elastic and jointed-orthoses; p = 0.03). No major differences were observed in JPS or balance and correlation between proprioception and balance was poor.

Conclusions

There may be a limit to the amount of pressure that should be applied to the knee joint by an orthosis. Exceeding this limit may compromise kinesthetic awareness.

Heritability of proprioceptive senses

Heritability studies using the twin model have provided the basis to disentangle genetic and environmental factors that contribute to several complex human traits. However, the relative importance of these factors to individual differences in proprioception is largely unknown despite the fact that proprioceptive senses are of great importance, allowing us to respond to stimuli stemming from the space around us and react to altering circumstances. Hence, a total of 44 healthy male twins (11 MZ and 11 DZ pairs), 19-28 yr old, were examined for movement, position, and force sense at the elbow joint, and their heritability estimates were computed. Results showed that genetic factors explained 1) 72 and 76% of the total variance of movement sense at the start and the end of the movement, respectively, 2) 60 to 77% of the total variance of position sense, depending on the angle of elbow flexion and whether forearm positioning was active or passive, and 3) 73 and 70% of the total variance of the force sense at 90 and 60° of elbow flexion, respectively. It is concluded that proprioception assessed by these conscious sensations is to a substantial degree genetically dependent, with heritability indexes ranging from 0.60 to 0.77, depending on the task. NEW & NOTEWORTHY Proprioceptive acuity varies among people, but it is not known how much of this variability is due to differences in their genes. This study is the first to report that proprioception, expressed as movement sense, position sense, and force sense, is substantially heritable, and it is conceivable that this may have implications for motor learning and control, neural development, and neurorehabilitation.

An above-knee compression garment does not improve passive knee joint position sense in healthy adults

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.

A patellar bandage improves mobility but not static balance in elderly female fallers

BACKGROUND

The deterioration in the somatosensory and motor systems observed with increasing age can cause balance problems. Studies have shown that the use of infrapatellar bandages can enhance proprioception and improve postural balance.

AIMS

To evaluate the effect of an infrapatellar bandage on static balance and mobility in elderly female fallers and non-fallers.

METHODS

Forty older women (20 fallers and 20 non-fallers) were evaluated. Mobility (Timed Up and Go test) and balance (force platform) were measured in the presence and absence of additional sensory information (elastic infrapatellar bandage).

RESULTS

Mobility differed in fallers (p = 0.0001), but not in non-fallers (p = 0.27), when the patellar bandage was applied. Additional sensory information did not improve static balance in either group (p > 0.05), but a trend towards improvement was observed in fallers.

CONCLUSION

Additional sensory input from an infrapatellar bandage improves mobility but not bipedal stance in elderly fallers.

Is There Evidence that Runners can Benefit from Wearing Compression Clothing?

BACKGROUND

Runners at various levels of performance and specializing in different events (from 800 m to marathons) wear compression socks, sleeves, shorts, and/or tights in attempt to improve their performance and facilitate recovery. Recently, a number of publications reporting contradictory results with regard to the influence of compression garments in this context have appeared.

OBJECTIVES

To assess original research on the effects of compression clothing (socks, calf sleeves, shorts, and tights) on running performance and recovery.

METHOD

A computerized research of the electronic databases PubMed, MEDLINE, SPORTDiscus, and Web of Science was performed in September of 2015, and the relevant articles published in peer-reviewed journals were thus identified rated using the Physiotherapy Evidence Database (PEDro) Scale. Studies examining effects on physiological, psychological, and/or biomechanical parameters during or after running were included, and means and measures of variability for the outcome employed to calculate Hedges'g effect size and associated 95 % confidence intervals for comparison of experimental (compression) and control (non-compression) trials.

RESULTS

Compression garments exerted no statistically significant mean effects on running performance (times for a (half) marathon, 15-km trail running, 5- and 10-km runs, and 400-m sprint), maximal and submaximal oxygen uptake, blood lactate concentrations, blood gas kinetics, cardiac parameters (including heart rate, cardiac output, cardiac index, and stroke volume), body and perceived temperature, or the performance of strength-related tasks after running. Small positive effect sizes were calculated for the time to exhaustion (in incremental or step tests), running economy (including biomechanical variables), clearance of blood lactate, perceived exertion, maximal voluntary isometric contraction and peak leg muscle power immediately after running, and markers of muscle damage and inflammation. The body core temperature was moderately affected by compression, while the effect size values for post-exercise leg soreness and the delay in onset of muscle fatigue indicated large positive effects.

CONCLUSION

Our present findings suggest that by wearing compression clothing, runners may improve variables related to endurance performance (i.e., time to exhaustion) slightly, due to improvements in running economy, biomechanical variables, perception, and muscle temperature. They should also benefit from reduced muscle pain, damage, and inflammation.

Effects of a compression garment on sensory feedback transmission in the human upper limb

Compression apparel is popular in both medical and sport performance settings. Perceived benefits are suggested to include changes in sensory feedback transmission caused by activation of mechanoreceptors. However, little is known about effects of compression apparel on sensorimotor control. Our purpose was to mechanistically examine whether compression apparel modulates sensory feedback transmission and reaching accuracy in the upper limb. Two experiments were completed under CONTROL and COMPRESSION (sleeve applied across the elbow joint) conditions. M-waves and H-reflexes were elicited by stimulating the median nerve and were recorded via surface electromyography (EMG). In experiment 1, H-reflexes and M-H recruitment curves were assessed at REST, during wrist flexion (10% EMG_max), and during a cutaneous conditioning of the superficial radial (SR) or distal median (MED) nerve. Cutaneous reflexes were elicited during 10% wrist flexion via stimulation of SR or MED. In experiment 2, unconditioned H-reflex measures were assessed at rest, during arm cycling, and during a discrete reaching task. Results indicate that compression apparel modulates spinal cord excitability across multiple sensory pathways and movement tasks. Interestingly, there was a significant improvement in reaching accuracy while wearing the compression sleeve. Taken together, the compression sleeve appears to increase precision and sensitivity around the joint where the sleeve is applied. Compression apparel may function as a "filter" of irrelevant mechanoreceptor information allowing for optimal task-related sensory information to enhance proprioception. NEW & NOTEWORTHY Wearing a customized compression sleeve was shown to alter the excitability of multiple pathways within the central nervous system regardless of conditioning input or movement task and was accompanied by improved accuracy of reaching movements and determination of movement end point. Compression apparel may assist as a type of "filter function" of tonic and nonspecific mechanoreceptor information leading to increased precision and movement sensitivity around the joint where compression is applied.

The influence of below-knee compression garments on knee-joint proprioception

OBJECTIVE

The purpose of the study was to assess the influence of below-knee compression garments on proprioception accuracy under, information processing constraints designed to cause high or low conscious attention to the task.

METHODS

In a counterbalanced, single-blinded, crossover trial, 44 healthy participants (26 male/18 female) with a mean age of 22.7±6.9 years performed an active joint repositioning task using their nondominant and their dominant leg, with and without below-knee compression and with and without conducting a secondary task.

RESULTS

Analysis of variance revealed no main effect of leg dominance and no interactions (p's>0.05). However, a main effect was evident for both compression (F_{1, 43}=84.23, p<0.001, ηp²=0.665) and secondary task (F_{1, 43}=4.391, p=0.04, ηp²=0.093).

CONCLUSIONS

The study is the first to evaluate the effects of a belowknee compression garment on knee proprioception under differential information processing constraints. We conclude that proprioception accuracy of the knee joint is significantly enhanced post application of below-knee compression garments and when a secondary task is conducted concurrently with active joint repositioning. The findings suggest that below-knee compression garments may improve proprioception of the knee, regardless of leg dominance, and that secondary tasks that direct attention away from proprioceptive judgments may also improve proprioception, regardless of the presence of compression. Clinical implications are discussed with respect to proprioception in modern.sports and rehabilitation settings.

Effect of a patellar strap on the joint position sense of the symptomatic knee in athletes with patellar tendinopathy

OBJECTIVES

The primary aim of this study was to investigate the effect of a patellar strap on the proprioception of the symptomatic leg in PT. Secondary aims were to investigate a possible difference in effectiveness between athletes with high and low proprioceptive acuity, and whether predictors of effectiveness could be found.

DESIGN

Randomised cross-over pilot study.

METHODS

24 athletes with PT (age 27.3±9.0, VISA-P 50.6±11.2) performed a joint position sense test with and without a patellar strap. The difference between both conditions was analysed using linear mixed-model analysis.

RESULTS

No improvement in the joint position sense using the strap for the whole group was found, while those classified as having low proprioceptive acuity did improve using the strap (p=0.015, 17.2%). A larger knee girth, longer duration of symptoms and more tendon abnormalities were negatively associated with the strap's effectiveness.

CONCLUSIONS

The use of a patellar strap improves the knee joint proprioception - measured with joint position sense - of the symptomatic leg in athletes with poor proprioceptive acuity. Especially athletes with relatively small knee girth, short duration of symptoms and small tendon abnormalities might benefit from the strap. As proprioception plays an important role in motor control, and deficits in proprioception may put an athlete at risk for (re-)injury, these findings may be relevant for prevention as well as rehabilitation purposes in those PT athletes with low proprioceptive acuity.

Eccentric Exercise, Kinesiology Tape, and Balance in Healthy Men

CONTEXT

  Deficits in balance have been identified as a possible risk factor for knee injuries in athletes. Despite a lack of evidence for its effectiveness, kinesiology tape (KT) is widely used to prevent knee injuries.

OBJECTIVE

  To investigate the influence of KT at the knee joint on balance ability in healthy men after eccentric exercise.

DESIGN

  Crossover study.

SETTING

  University laboratory.

PATIENTS OR OTHER PARTICIPANTS

  Twelve young men with no history of lower limb injury volunteered for the study (age = 23.3 ± 2.6 years). All participants were students enrolled in a sports science program.

INTERVENTION(S)

  Participants performed the balance test with and without KT at the knee joint on 2 separate days.

MAIN OUTCOME MEASURE(S)

  The ability to maintain balance was assessed during a single-legged-stance test using a computerized balance-stability test system. The test was performed before and after 30 minutes of downhill walking on a treadmill.

RESULTS

  Eccentric exercise resulted in a deterioration of balance ability, which was attenuated by the use of KT. Further analyses revealed that the effectiveness of KT depended on the participant's balance status, with the preventive effect being greater in participants presenting with poorer baseline balance ability.

CONCLUSIONS

  Applied to the knee joint, KT counteracted the exercise-related deterioration of balance ability observed when no tape was used. Participants presenting with below-average balance ability received more benefit from KT. By preventing exercise-related impairment of balance ability, KT might help to reduce the risk of sport-associated knee injuries.

Wearing a Wetsuit Alters Upper Extremity Motion during Simulated Surfboard Paddling

Surfers often wear wetsuits while paddling in the ocean. This neoprene covering may be beneficial to upper extremity movement by helping to improve proprioceptive acuity, or it may be detrimental by providing increased resistance. The purpose of this study was to evaluate the effects of wearing a wetsuit on muscle activation, upper extremity motion, heart rate, and oxygen consumption during simulated surfboard paddling in the laboratory. Twelve male, recreational surfers performed two paddling trials at a constant workload on a swim bench ergometer both with and without a wetsuit. Kinematic data and EMG were acquired from the right arm via motion capture, and oxygen consumption and heart rate were recorded with a metabolic cart and heart rate monitor. Wearing a wetsuit had no significant effect on oxygen consumption or heart rate. A significant increase in EMG activation was observed for the middle deltoid but not for any of the other shoulder muscle evaluated. Finally, approximate entropy and estimates of the maximum Lyapunov exponent increased significantly for vertical trajectory of the right wrist (i.e. stroke height) when a wetsuit was worn. These results suggest that a 2mm wetsuit has little effect on the energy cost of paddling at lower workloads but does affect arm motion. These changes may be the result of enhanced proprioceptive acuity due to mechanical compression from the wetsuit.

Reliability and measurement precision of concentric-to-isometric and eccentric-to-isometric knee active joint position sense tests in uninjured physically active adults

OBJECTIVES

Proprioception is important because it is used by the central nervous system to mediate muscle control of joint stability, posture, and movement. Knee active joint position sense (AJPS) is one representation of knee proprioception. The purpose of this study was to establish the intra-tester, inter-session, test-retest reliability of concentric-to-isometric (seated knee extension; prone knee flexion) and eccentric-to-isometric (seated knee flexion; prone knee extension) knee AJPS tests in uninjured adults.

DESIGN

Descriptive.

SETTING

University laboratory.

PARTICIPANTS

Six males, six females (age 26.2 ± 5.7 years; height 171.1 ± 9.6 cm; mass 71.1 ± 16.6 kg).

MAIN OUTCOME MEASURES

Mean absolute error (AE; °); intraclass correlation coefficient (ICC) (2,1); standard error of measurement (SEM; °).

RESULTS

Mean AE ranged from 3.18° to 5.97° across tests. The ICCs and SEMs were: seated knee extension 0.13, 1.3°; prone knee flexion 0.51, 1.2°; seated knee flexion 0.31, 1.7°; prone knee extension 0.87, 1.4°.

CONCLUSIONS

The prone knee flexion and prone knee extension tests demonstrated moderate to good reliability. Prone knee flexion and prone knee extension AJPS tests may be useful in cross-sectional studies estimating how proprioception contributes to knee functional joint stability or prospective studies estimating the role of proprioception in the onset of knee injury.

A pilot study of the effect of Kinesiology tape on knee proprioception after physical activity in healthy women

OBJECTIVES

Kinesiology tape has gained significant popularity in recent years and is widely used as an adjunct for treatment and prevention of musculoskeletal injuries. However, evidence regarding its influence on knee proprioception is scarce. The purpose of this study was to evaluate the effect of Kinesiology tape on knee proprioception after physical activity in healthy women. It was hypothesized that Kinesiology tape enhances knee proprioception.

DESIGN

Longitudinal analysis, pretest-posttest design.

METHODS

Twelve young women with healthy knees were tested for knee proprioception without the use of Kinesiology tape and wearing Kinesiology tape at the knee. The joint position sense was measured at the start and after a 30-min uphill walking protocol on a treadmill. Outcome was the knee angle deviation.

RESULTS

No significant difference of proprioceptive performance between the application with Kinesiology tape and without Kinesiology tape was found after uphill walking (p > 0.05). However, when the participants' results for knee angle deviation were graded into good (< 6.1°) and poor ( > 6.1°), Kinesiology tape significantly enhanced those with poor proprioceptive ability after uphill walking, compared to the untaped knee (p = 0.002).

CONCLUSIONS

This study has shown that the application of Kinesiology tape did not improve knee proprioception in a group of healthy young women. However, it also has demonstrated that Kinesiology tape provided significant proprioceptive enhancement at the knee joint after uphill walking in healthy women with poor proprioceptive ability. This may support its use in sports medicine for preventing knee injuries.

A novel compression garment with adhesive silicone stripes improves repeated sprint performance - a multi-experimental approach on the underlying mechanisms

Background

Repeated sprint performance is determined by explosive production of power, as well as rapid recovery between successive sprints, and there is evidence that compression garments and sports taping can improve both of these factors.

Methods

In each of two sub-studies, female athletes performed two sets of 30 30-m sprints (one sprint per minute), one set wearing compression garment with adhesive silicone stripes (CGSS) intended to mimic taping and the other with normal clothing, in randomized order. Sub-study 1 (n = 12) focused on cardio-respiratory, metabolic, hemodynamic and perceptual responses, while neuronal and biomechanical parameters were examined in sub-study 2 (n = 12).

Results

In both sub-studies the CGSS improved repeated sprint performance during the final 10 sprints (best P < 0.01, d = 0.61). None of the cardio-respiratory or metabolic variables monitored were altered by wearing this garment (best P = 0.06, d = 0.71). Also during the final 10 sprints, rating of perceived exertion by the upper leg muscles was reduced (P = 0.01, d = 1.1), step length increased (P = 0.01, d = 0.91) and activation of the m. rectus femoris elevated (P = 0.01, d = 1.24), while the hip flexion angle was lowered throughout the protocol (best P < 0.01, d = 2.28) and step frequency (best P = 0.34, d = 0.2) remained unaltered.

Conclusion

Although the physiological parameters monitored were unchanged, the CGSS appears to improve performance during 30 30-m repeated sprints by reducing perceived exertion and altering running technique.

The effect of knee brace and knee sleeve on the proprioception of the knee in young non-professional healthy sportsmen

BACKGROUND

Proprioception has been defined as the capacity to feel the position of a joint in space as sensed by the central nervous system. Prophylactic knee braces are supposed to help in knee injury prevention not just with a mechanical support of the joint but also improving proprioception. The main aim of this study was to determine the effects of a knee brace and a knee sleeve on knee proprioception. The secondary aim was to determine if different starting angles of the knee and different movement directions influence knee proprioception.

METHODS

We tested a group of twenty healthy male sport students without knee injuries. They were tested with the brace, with the sleeve and without support. The threshold of detection of passive knee movement with a starting knee angle of 30° and 60°, both in flexion and extension was determined.

RESULTS

We did not find any statistically significant change in the threshold of detection of passive knee movement wearing the brace or the sleeve compared to the unsupported condition (p=0.462, α=0.05). We found a significantly lower proprioceptive sensitivity starting at the more flexed knee angle (p=0.005, α=0.05) and moving in extension than in the other test situations (p=0.001, α=0.05).

CONCLUSION

Movement direction and starting position appear to influence the threshold of detection of passive knee movement. The results of this study also suggest that knee supports do not influence either positively or negatively knee proprioception of uninjured active subjects.

Scapular bracing and alteration of posture and muscle activity in overhead athletes with poor posture

CONTEXT

Overhead athletes commonly have poor posture. Commercial braces are used to improve posture and function, but few researchers have examined the effects of shoulder or scapular bracing on posture and scapular muscle activity.

OBJECTIVE

To examine whether a scapular stabilization brace acutely alters posture and scapular muscle activity in healthy overhead athletes with forward-head, rounded-shoulder posture (FHRSP).

DESIGN

Randomized controlled clinical trial.

SETTING

Applied biomechanics laboratory.

PATIENTS OR OTHER PARTICIPANTS

Thirty-eight healthy overhead athletes with FHRSP.

INTERVENTION(S)

Participants were assigned randomly to 2 groups: compression shirt with no strap tension (S) and compression shirt with the straps fully tensioned (S + T). Posture was measured using lateral-view photography with retroreflective markers. Electromyography (EMG) of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) in the dominant upper extremity was measured during 4 exercises (scapular punches, W's, Y's, T's) and 2 glenohumeral motions (forward flexion, shoulder extension). Posture and exercise EMG measurements were taken with and without the brace applied.

MAIN OUTCOME MEASURE(S)

Head and shoulder angles were measured from lateral-view digital photographs. Normalized surface EMG was used to assess mean muscle activation of the UT, MT, LT, and SA.

RESULTS

Application of the brace decreased forward shoulder angle in the S + T condition. Brace application also caused a small increase in LT EMG during forward flexion and Y's and a small decrease in UT and MT EMG during shoulder extension. Brace application in the S + T group decreased UT EMG during W's, whereas UT EMG increased during W's in the S group.

CONCLUSIONS

Application of the scapular brace improved shoulder posture and scapular muscle activity, but EMG changes were highly variable. Use of a scapular brace might improve shoulder posture and muscle activity in overhead athletes with poor posture.

A kinetic and kinematic analysis of the effect of stochastic resonance electrical stimulation and knee sleeve during gait in osteoarthritis of the knee

Extended use of knee sleeves in populations at risk for knee osteoarthritis progression has shown functional and quality of life benefits; however, additional comprehensive kinematic and kinetic analyses are needed to determine possible physical mechanisms of these benefits which may be due to the sleeve's ability to enhance knee proprioception. A novel means of extending these enhancements may be through stochastic resonance stimulation. Our goal was to determine whether the use of a knee sleeve alone or combined with stochastic resonance electrical stimulation improves knee mechanics in knee osteoarthritis. Gait kinetics and kinematics were assessed in subjects with medial knee osteoarthritis when presented with four conditions: control1, no electrical stimulation/sleeve, 75% threshold stimulation/sleeve, and control2. An increase in knee flexion angle throughout stance and a decrease in flexion moment occurring immediately after initial contact were seen in the stimulation/sleeve and sleeve alone conditions; however, these treatment conditions did not affect the knee adduction angle and internal knee abduction moment during weight acceptance. No differences were found between the sleeve alone and the stochastic resonance with sleeve conditions. A knee sleeve can improve sagittal-plane knee kinematics and kinetics, although adding the current configuration of stochastic resonance did not enhance these effects.

Exploring the effect of pelvic belt configurations upon athletic lumbopelvic pain

BACKGROUND

Lumbopelvic injuries are often refractory to treatment and can limit return to sport. Research shows that 50 Newtons (N) of force applied transversely to the pelvis improves lumbopelvic stability and pain. This study applies transverse and diagonal forces to the pelvis in athletes with lumbopelvic pain, and investigates effects on pain and function.

OBJECTIVE

To investigate the effects of transverse and diagonal compressive forces applied to the pelvis of athletes with lumbopelvic pain

STUDY DESIGN

A randomized, repeated measures design using 20 athletes with lumbopelvic pain.

METHODS

No belt and four pelvic belt configurations (50 N force) were tested. Outcome measures were: resting pain, pain on active straight leg raise (ASLR), resisted hip adduction force and pain on 1-metre broad jump. Force on the adduction test was determined via load cell.

RESULTS

Data were analyzed using repeated measures ANOVA. Squeeze test showed significant effect of condition F (4, 76) = 2.7, P < 0.05. On ASLR ipsilateral to the side of pain, pain decreased across conditions (F (4, 76) = 2.5 P = 0.05).

CONCLUSION

Results suggest application of diagonal forces towards the site of pain may have additional benefits in improving pain and function. Such information may inform the development of an orthosis. Clinical relevance The results may be used clinically to determine the effectiveness of different belt placements (with belts or straps) in managing athletic lumbopelvic pain. The results offer an alternative to the application of transverse belts, and may inform new approaches in the development of orthotics.

Bringing light into the dark: effects of compression clothing on performance and recovery

To assess original research addressing the effect of the application of compression clothing on sport performance and recovery after exercise, a computer-based literature research was performed in July 2011 using the electronic databases PubMed, MEDLINE, SPORTDiscus, and Web of Science. Studies examining the effect of compression clothing on endurance, strength and power, motor control, and physiological, psychological, and biomechanical parameters during or after exercise were included, and means and measures of variability of the outcome measures were recorded to estimate the effect size (Hedges g) and associated 95% confidence intervals for comparisons of experimental (compression) and control trials (noncompression). The characteristics of the compression clothing, participants, and study design were also extracted. The original research from peer-reviewed journals was examined using the Physiotherapy Evidence Database (PEDro) Scale. Results indicated small effect sizes for the application of compression clothing during exercise for short-duration sprints (10-60 m), vertical-jump height, extending time to exhaustion (such as running at VO2max or during incremental tests), and time-trial performance (3-60 min). When compression clothing was applied for recovery purposes after exercise, small to moderate effect sizes were observed in recovery of maximal strength and power, especially vertical-jump exercise; reductions in muscle swelling and perceived muscle pain; blood lactate removal; and increases in body temperature. These results suggest that the application of compression clothing may assist athletic performance and recovery in given situations with consideration of the effects magnitude and practical relevance.

Static and dynamic postural control in competitive athletes after anterior cruciate ligament reconstruction and controls

PURPOSE

To evaluate the test-retest reliability and compare the static and dynamic postural control values in competitive athletes following anterior cruciate ligament (ACL) reconstruction and controls.

METHODS

Thirty athletes, 8.4 ± 1.8 months after ACL reconstruction, and thirty healthy matched controls were asked to execute single-leg stance and single-legged drop jump tests onto a force plate. Amplitude and velocity in anteroposterior and mediolateral directions, and mean total velocity were measured for static evaluation. Peak vertical ground reaction force (PVGRF) during landing and takeoff and loading rate were measured for dynamic evaluation. To evaluate test-retest reliability, 15 participants of each group repeated the tests 6-8 days after the first session. Mixed model of analysis of variance was used to determine differences between the involved, uninvolved, and control limbs. The test-retest reliability was measured using intraclass correlation coefficient and standard error of measurement.

RESULTS

Greater postural sway has been observed in the operated leg of ACL-reconstructed athletes compared with the non-operated side (P < 0.01) and the matched limb of the control group (P < 0.01). During landing, PVGRF and loading rate on the uninvolved limb of the athletes who had undergone ACL reconstruction were greater in comparison with those of the control group (P < 0.001). Both static and dynamic postural measures have high test-retest reliability, ranging from 0.73 to 0.88.

CONCLUSIONS

Static and dynamic postural measures are reliable tests to evaluate functional performance of athletes following ACL reconstruction. Eight months postsurgery, competitive athletes still demonstrated postural asymmetries, compared to matched controls, which might result in their susceptibility to future ACL injury.

LEVEL OF EVIDENCE

Prognostic study, case-control, Level III.

Stochastic resonance electrical stimulation to improve proprioception in knee osteoarthritis

Proprioceptive deficits occur with knee osteoarthritis (OA) and improving proprioception may slow joint degeneration by allowing more appropriate joint loading. Stochastic resonance (SR) stimulation improves balance and the sensitivity of specific mechanoreceptors. Our purpose was to evaluate the effects of SR electrical stimulation combined with a knee sleeve on proprioception in subjects with knee OA. Joint position sense (JPS) was measured in 38 subjects with knee OA during four conditions in both a partial weight-bearing (PWB) and non weight-bearing (NWB) task: no electrical stimulation/no sleeve, no electrical stimulation/sleeve, 50 μA-RMS stimulation/sleeve, and 75 μA-RMS stimulation/sleeve. Subjects also reported their knee pain, stiffness, functionality (WOMAC), and instability. Repeated measures ANOVA and Spearman correlations were performed to investigate differences between the conditions and relationships among the outcome measures. JPS during the 75 μA-RMS stimulation/sleeve and sleeve alone conditions was significantly improved compared to the control condition in the PWB task. However, the 75 μA-RMS stimulation/sleeve and the sleeve alone conditions did not differ from each other. A moderate correlation was found between the improvements with the 75 μA-RMS stimulation/sleeve condition compared to the JPS of the control condition in the PWB task. No differences in JPS were found between the four conditions in the NWB task. Significant correlations were found between the control JPS and WOMAC indices (p<0.005). Improved proprioception during the PWB task was achieved with a sleeve alone and in combination with SR stimulation. The observed correlations suggest that subjects with larger proprioceptive deficits may benefit most from these therapies.

The impact of stochastic resonance electrical stimulation and knee sleeve on impulsive loading and muscle co-contraction during gait in knee osteoarthritis

BACKGROUND

Increased impulsive loading and muscle co-contraction during gait have been observed in individuals with knee osteoarthritis. Proprioceptive deficits in this population may contribute to these effects. Proprioception has been shown to improve with the combination of stochastic resonance electrical stimulation and a knee sleeve in knee osteoarthritis. Our goal was to determine whether stochastic resonance stimulation combined with a knee sleeve would decrease impulsive loading rates and muscle co-contraction during gait in knee osteoarthritis.

METHODS

Gait kinetics, kinematics and muscle activity were assessed during walking in subjects with knee osteoarthritis during three different conditions: no stochastic resonance/no sleeve (control), stochastic resonance at 75% threshold/sleeve, and no stochastic resonance/sleeve. Loading rates were calculated from the ground reaction force. Muscle co-contraction was calculated from the ratio of vastus lateralis to lateral hamstring activity. Differences between conditions were assessed using a repeated measures analysis of variance (P<0.05).

FINDINGS

The 75% threshold/sleeve and sleeve only conditions resulted in increased knee flexion at contact and reduced loading rates compared to the control condition (P<0.05). However, these measures did not significantly differ between the 75% threshold/sleeve and sleeve only conditions. Muscle co-contraction was found to decrease with the 75% threshold/sleeve condition compared to the other conditions.

INTERPRETATION

Increased knee flexion and decreased loading rates may be a result of proprioceptive improvements resulting from the sleeve or sleeve/stimulation combination. The stochastic resonance stimulation did not demonstrate an ability to enhance the effects of the sleeve with the exception of reductions in muscle co-contraction.

Does bracing influence brain activity during knee movement: an fMRI study

Studies have shown that proprioceptive inputs during active and passive arm movements are processed in the primary and secondary somatosensory cortex and supplementary motor area of the brain. At which level of the central nervous system proprioceptive signals coming from the knee are regulated remains to be elucidated. In order to investigate whether there is a detectable difference in brain activity when various proprioceptive inputs are exerted at the knee, functional magnetic resonance imaging (fMRI) was used. fMRI in 13 healthy, right leg-dominant female volunteers compared brain activation during flexion-extension movements of the right knee under three different conditions: with application of a tight knee brace, with application of a moderate tight knee sleeve, and without application of a brace or sleeve. Brain activation was detected in the primary sensorimotor cortex (left and right paracentral lobule) and in the left superior parietal lobule of the brain. There was a significantly higher level of brain activation with the application of the brace and sleeve, respectively, compared to the condition without a brace or sleeve. A significantly higher cortical activation was also seen when comparing the braced condition with the condition when a sleeve was applied. The results suggest that peripheral proprioceptive input to the knee joint by means of a brace or sleeve seems to influence brain activity during knee movement. The results of this study also show that the intensity of brain activation during knee movement can be influenced by the intensity of proprioceptive stimulation at the joint.

Effects of vision and tactile stimulation of the neck on postural control during unperturbed stance and cervical joint position sense in young asymptomatic adults

STUDY DESIGN

Before and after intervention trials.

OBJECTIVE

To evaluate the effects of visual input and tactile stimulation of the neck on postural control during unperturbed stance and cervical joint position sense.

SUMMARY OF BACKGROUND DATA

Although beneficial effects on lower-limb joints proprioception have been reported when vision was available and when tactile stimulation was applied around lower-limb joints, there has hitherto been no study investigating whether and how vision and tactile stimulation applied to the neck could modify postural control during unperturbed stance and joint position sense.

METHODS

The effects of visual input and tactile stimulation of the neck on postural control during unperturbed stance (Experiments 1 and 2) and cervical joint position sense (Experiments 3 and 4) were assessed in four separate experiments. During these experiments, two experimental tasks (a postural task during unperturbed stance and the CRT to NHP) were executed without (No vision) and with the availability of the vision (Vision) and without (No tactile stimulation condition) and with the application of strips of adhesive bandage to the skin over and around the neck (Tactile stimulation condition). Twelve different subjects participated in the four experiments.

RESULTS

For experiments 1 and 2, decreased centre of foot pressure displacements were observed in the Vision relative to the No vision and in the Tactile stimulation relative to the No tactile stimulation condition. For experiments 3 and 4, more accurate and more consistent repositioning performances were observed in the Vision relative to the No vision and in the Tactile stimulation relative to the No tactile stimulation condition, as indicated by decreased absolute and variable errors, respectively.

CONCLUSION

Altogether, our results suggest that subjects were able to take advantage of vision and increased neck cutaneous information provided by the by strips of adhesive bandage applied to the neck to improve postural control during unperturbed stance and cervical joint position sense.

Reliability and precision of hip proprioception methods in healthy individuals

OBJECTIVE

The goal of this study was to establish the intrasession and intersession reliability and precision of threshold to detect passive motion (TTDPM), force sense (FS), and active joint position sense (JPS) tests for the hip in healthy individuals.

DESIGN

Descriptive laboratory study.

SETTING

Research laboratory.

PARTICIPANTS

Data were collected on 20 subjects between the ages of 18 and 30 years. They were physically active and had no history of major lower extremity injury or surgery or hip injuries.

INTERVENTIONS

Threshold to detect passive motion, FS, and active JPS were measured using a Biodex System 3 and a Vicon Motion Analysis System.

MAIN OUTCOME MEASURES

Error scores were calculated as the absolute difference between the reference and reproduction values. Intraclass correlation (ICC) and standard error of measurement (SEM) were used to assess intrasession and intersession reliability and precision.

RESULTS

Adduction showed good reliability for JPS, with an intersession ICC (SEM) of 0.753 (0.248 degrees). For TTDPM, abduction showed an intrasession ICC (SEM) of 0.825 (0.256 degrees) and adduction had an intrasession ICC (SEM) of 0.765 (0.266 degrees). The intersession ICCs (SEM) were as follows: flexion 0.810 (0.143 degrees), extension 0.777 (0.195 degrees), abduction 0.906 (0.176 degrees), and adduction 0.893 (0.144 degrees). Flexion showed a good intersession ICC for FS: 0.764 (0.932 Nm).

CONCLUSIONS

Results indicate that a reliable and precise method of measuring hip TTDPM has been established. Further investigation is necessary to develop reliable and precise measurement methods for FS and active JPS of the hip and to identify if TTDPM is related to hip kinematics, hip kinetics, and muscle activation about the hip during functional tasks.

The effects of stochastic resonance electrical stimulation and neoprene sleeve on knee proprioception

Background

A variety of knee injuries and pathologies may cause a deficit in knee proprioception which may increase the risk of reinjury or the progression of disease. Stochastic resonance stimulation is a new therapy which has potential benefits for improving proprioceptive function. The objective of this study was to determine if stochastic resonance (SR) stimulation applied with a neoprene sleeve could improve knee proprioception relative to a no-stimulation/no-sleeve condition (control) or a sleeve alone condition in the normal, healthy knee. We hypothesized that SR stimulation when applied with a sleeve would enhance proprioception relative to the control and sleeve alone conditions.

Methods

Using a cross-over within subject design, twenty-four healthy subjects were tested under four combinations of conditions: electrical stimulation/sleeve, no stimulation/sleeve, no stimulation/no sleeve, and stimulation/no sleeve. Joint position sense (proprioception) was measured as the absolute mean difference between a target knee joint angle and the knee angle reproduced by the subject. Testing was conducted during both partial-weight bearing (PWB) and non-weight bearing (NWB) tasks. Differences in joint position sense between the conditions were evaluated by repeated-measures analysis of variance testing.

Results

Joint position sense error during the stimulation/sleeve condition (2.48° ± 1.32°) was found to be more accurate (P < 0.05) relative to the control condition (3.35° ± 1.63°) in the PWB task. No difference in joint position sense error was found between stimulation/sleeve and sleeve alone conditions for the PWB task. Joint position sense error was not found to differ between any of the conditions for the NWB task.

Conclusion

These results suggest that SR electrical stimulation when combined with a neoprene sleeve is an effective modality for enhancement of joint proprioception in the PWB knee. We believe these results suggest the need for further study of the potential of SR stimulation to correct proprioceptive deficits in a clinical population with knee injury/pathology or in subjects at risk of injury because of a proprioceptive deficit.

Efeito de informação sensorial adicional na propriocepção e equilíbrio de indivíduos com lesão do LCA

OBJETIVO: Investigar o efeito da utilização de informação sensorial adicional na propriocepção e no equilíbrio de indivíduos com lesão do Ligamento Cruzado Anterior (LCA). MÉTODOS: Participaram deste estudo 28 indivíduos com lesão unilateral do LCA e 28 indivíduos com joelhos sadios. A propriocepção foi avaliada por meio do limiar para detecção de movimento passivo da articulação do joelho nas posições de 15 e 45 graus, para as direções de flexão e de extensão. O equilíbrio foi avaliado em posição unipodal sem visão, sobre uma plataforma de força e investigado por meio da amplitude e da velocidade média de oscilação do centro de pressão. As condições de informação sensorial utilizadas foram: informação normal, bandagem infra-patelar e faixa infra-patelar. RESULTADOS: Indivíduos com lesão do LCA apresentam um prejuízo na propriocepção e no equilíbrio quando comparados a indivíduos com joelhos sadios (p<0,05). Entretanto, com adição de informação sensorial, tanto a capacidade proprioceptiva quanto o equilíbrio de indivíduos com lesão do LCA é melhorado (p<0,05). Indivíduos com joelhos sadios não apresentam benefício na utilização de informação sensorial adicional (p>0,05). CONCLUSÃO: A lesão do LCA acarreta um prejuízo da propriocepção e do equilíbrio, porém estes efeitos são minimizados com utilização de informação sensorial adicional.

Posture and equilibrium in orthopedic and rheumatologic diseases

Posture and balance may be affected in many spine or lower-limb disorders. An extensive evaluation including clinical tests and movement analysis techniques may be necessary to characterize how rheumatologic or orthopedic diseases are related to static or dynamic changes in postural control. In lower limbs, unbalance may be related to a decreased stability following arthrosis or ligament injuries at knee or ankle levels, while hip lesions appear less associated with such troubles. Spinal diseases at cervical level are frequently associated with postural changes and impaired balance control, related to the major role of sensory inputs during stance and gait. At lower levels, changes are noticed in major scoliosis and may be related to pain intensity in patients with chronic low-back pain. Whatever the initial lesion and the affected level, improvement in clinical or instrumental tests following rehabilitation or brace wearing provides argument for a close relationship between rheumatologic or orthopedic diseases and related impairments in posture and balance control.

The effects of sensorimotor training on knee proprioception and function for patients with knee osteoarthritis: a preliminary report

Objective: To investigate the effects of a sensorimotor training programme in osteoarthritic patients.

Design: Randomized, single-blind, controlled trial.

Setting: Kinesiology laboratory at School of Physical Therapy.

Participants: A total of 60 patients were randomly assigned to the training group and the control group. Only 29 patients (training group, 15; control group, 14) completed the study.

Intervention: The training group underwent a sensorimotor training programme using a sling suspension system complemented by a routine physical therapy. The control group underwent a routine physical therapy.

Main measures: Active joint repositioning, functional testings, and self-reported function with the Western Ontario & McMaster Universities Arthritis Index before and after the eight-week intervention.

Results: There were significant differences between the two groups with respect to the improvement in proprioception as measured by active joint repositioning (the changes in the absolute error were 1.9± 1.7°, training group versus 0.1 ± 2.8°, control group (P<0.05), and in self-reported functional difficulty (33.2 ±35.1, training group versus 8.0± 10.2, control group; P<0.05)). There was no significant difference between the two groups in other outcomes.

Conclusion: A sensorimotor training using a sling suspension system improved the patients' proprioception in the knee joints and their self-reported function. Thus, these exercises may serve as an exercise programme for patients with knee osteoarthritis.

The effects of a neoprene knee sleeve on subjects with a poor versus good joint position sense subjected to an isokinetic fatigue protocol

OBJECTIVES

It has been shown that muscle fatigue has a negative influence on proprioception. Several studies already have demonstrated improvement of proprioception by using knee sleeves.

HYPOTHESIS

Neoprene knee sleeves have different effects on the joint position sense in locally fatigued subjects with good or poor proprioceptive acuity.

DESIGN

A true experimental design with random assignment to intervention and control limbs.

SETTING

Military hospital, department of physical medicine and rehabilitation.

PARTICIPANTS

Sixty-four healthy subjects.

INTERVENTIONS

All subjects underwent four consecutive assessments of the same active joint-repositioning test under different conditions (braced, nonbraced, fatigued, and nonfatigued).

MAIN OUTCOME MEASUREMENTS

A three-way analysis of variance with repeated-measures design was conducted to investigate the effects of side (braced versus control side), assessment sequence (one to four), and proprioceptive acuity ("good" versus "poor"), and their interactive effect on the joint position sense.

RESULTS

Post hoc analysis revealed that only subjects with "poor" proprioceptive acuity benefit from the braced condition before the isokinetic fatigue protocol (P < 0.001). In contrast, all subjects benefit from the braced condition after the fatigue test.

CONCLUSIONS

Bracing is helpful in individuals with a poor baseline proprioceptive acuity in both fatigued and nonfatigued states. Subjects with a good joint position sense benefit from bracing only when in a fatigued state. The present findings suggest a rationale for using neoprene knee sleeves as a preventative measure or treatment in subjects and patients to enhance proprioceptive acuity in a fatigued state. Classification into "poor" and "good" proprioceptive acuity is only relevant in the nonfatigued condition.

A randomized controlled trial comparing the effectiveness of functional knee brace and neoprene sleeve use after anterior cruciate ligament reconstruction

BACKGROUND

Despite a lack of evidence for their effectiveness, functional knee braces are commonly prescribed to patients after anterior cruciate ligament (ACL) reconstruction.

PURPOSE

This trial was conducted to compare postoperative outcomes in patients using an ACL functional knee brace and patients using a neoprene knee sleeve.

HYPOTHESIS

Patients using a brace will have superior outcomes than those using a sleeve.

STUDY DESIGN

Randomized controlled clinical trial; Level of evidence, 1.

METHODS

One hundred fifty patients were randomized to receive a brace (n = 76) or neoprene sleeve (n = 74) at their 6-week postoperative visit after primary ACL reconstruction with hamstring autograft. Patients were assessed preoperatively, then 6 weeks and 6, 12, and 24 months postoperatively. Outcome measures included disease-specific quality of life (Anterior Cruciate Ligament-Quality of Life [ACL-QOL] Questionnaire), anterior tibial translation (KT-1000 arthrometer side-to-side difference), the single-limb forward hop test (limb symmetry index), and Tegner Activity Scale. Outcomes at 1 and 2 years were compared after adjusting for baseline scores. Subjective ratings of how patients felt while using the brace/sleeve were also collected for descriptive purposes using a questionnaire. Four a priori directional subgroup hypotheses were evaluated using tests for interactions.

RESULTS

There were no significant differences between brace (n = 62) and sleeve (n = 65) groups for any of the outcomes at 1- and 2-year follow-ups. Adjusted mean differences at 2 years were as follows: -0.94 (95% confidence interval [CI], -7.52 to 5.64) for the ACL-QOL Questionnaire, -0.10 mm (95% CI, -0.99 to 0.81) for KT-1000 arthrometer side-to-side difference, -0.87% (95% CI, -8.89 to 7.12) for hop limb symmetry index, and -0.05 (95% CI, -0.72 to 0.62) for the Tegner Activity Scale. Subjective ratings of confidence in the knee provided by the brace/sleeve were higher for the brace group than the sleeve group. Subgroup findings were minimal. Adverse events were few and similar between groups.

CONCLUSIONS

A functional knee brace does not result in superior outcomes compared with a neoprene sleeve after ACL reconstruction. Current evidence does not support the recommendation of using an ACL functional knee brace after ACL reconstruction.