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Reproducibility of a knee and hip proprioception test in healthy older adults

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Abstract

Background

Proprioception can be assessed by measuring joint position sense (JPS). Most studies have focused on JPS of the knee joint while literature for other joints especially for hip JPS is scarce. Although some studies have evaluated proprioception of the knee joint, the reproducibility of methods has rarely been investigated.

Aims

To estimate intrasession reliability and agreement of an active–active JPS test for hip flexion/abduction and knee flexion in healthy older adults.

Methods

Nineteen healthy older adults participated in this study. The proprioception of the hip (flexion and abduction) and knee (flexion) were assessed in both legs using the “active–active” reproduction technique. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and limits of agreement (LOA) were estimated for relative angular error (RE), absolute angular error (AE), and variable angular error (VE).

Results

Reliability of our JPS test was substantial to almost perfect for the RE for both joints and legs (ICC values ranging from 0.75 to 0.93). We also found that the ICC values for AE were substantial for knee flexion and hip abduction of the left and right leg. The ICC results of VE showed poor reliability for hip and knee joints. SEM and LOA values for hip abduction were generally lower than for hip and knee flexion, indicating lower measurement error or more precise scores for the proprioception test of hip abduction.

Conclusion(s)

Proprioceptive acuity of the knee and hip joints in healthy older adults can be reliably assessed with an active–active procedure in a standing position with respect to relative and absolute error.

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References

  1. Sherrington CS (1906) The integrative action of the nervous system. Yale University, New Haven

    Google Scholar 

  2. Lord SR, Rogers MW, Howland A, Fitzpatrick R (1999) Lateral stability, sensorimotor function and falls in older people. J Am Geriatr Soc 47:1077–1081

    CAS  PubMed  Google Scholar 

  3. Rogers MW, Mille M-L (2003) Lateral stability and falls in older people. Exerc Sport Sci Rev 31(4):182–187

    Article  PubMed  Google Scholar 

  4. Lonn J, Crenshaw A, Djupsjobacka M, Johansson H (2000) Reliability of position sense testing assessed with a fully automated system. Clin Physiol 20(1):30–37

    Article  CAS  PubMed  Google Scholar 

  5. Bullock-Saxton J, Wong W, Hogan N (2001) The influence of age on weight-bearing joint reposition sense of the knee. Exp Brain Res 136(3):400–406

    Article  CAS  PubMed  Google Scholar 

  6. Pai YC, Rymer WZ, Chang RW, Sharma L (1997) Effect of age and osteoarthritis on knee proprioception. Arthritis Rheum 40(12):2260–2265

    Article  CAS  PubMed  Google Scholar 

  7. Manchester D, Woollacott M, Zederbauer-Hylton N, Marin O (1989) Visual, vestibular and somatosensory contributions to balance control in the older adult. J Gerontol 44(4):118–127

    Article  Google Scholar 

  8. Pickard CM, Sullivan PE, Allison GT, Singer KP (2003) Is there a difference in hip joint position sense between young and older groups? J Gerontol A Biol Sci Med Sci 58(7):631–635

    Article  PubMed  Google Scholar 

  9. Lord SR, Ward JA (1994) Age-associated differences in sensori-motor function and balance in community dwelling women. Age Age 23(6):452–460

    Article  CAS  Google Scholar 

  10. Benjaminse A, Sell TC, Abt JP, House AJ, Lephart SM (2009) Reliability and precision of hip proprioception methods in healthy individuals. Clin J Sport Med 19(6):457–463

    Article  PubMed  Google Scholar 

  11. Olsson L, Lund H, Henriksen M, Rogind H, Bliddal H, Danneskiold-Samsøe B (2004) Test-retest reliability of a knee joint position sense measurement method in sitting and prone position. Adv Physiother 6(1):37–47

    Article  Google Scholar 

  12. Kiefer G, Forwell L, Kramer J, Birmingham T (1998) Comparison of sitting and standing protocols for testing knee proprioception. Physiother Can 50(1):30–34

    Google Scholar 

  13. Andersen SB, Terwilliger DM, Denegar CR (1995) Comparison of open versus closed kinetic chain test positions for measuring joint position sense. J Sport Rehabil 4(3):165–171

    Google Scholar 

  14. Adamovich SV, Berkinblit MB, Fookson O, Poizner H (1998) Pointing in 3D space to remembered targets. I. Kinesthetic versus visual target presentation. J Neurophysiol 79:2833–2846

    CAS  PubMed  Google Scholar 

  15. Felson DT, Gross KD, Nevitt MC, Yang M, Lane NE, Torner JC, Lewis CE, Hurley MV (2009) The effects of impaired joint position sense on the development and progression of pain and structural damage in knee osteoarthritis. Arthritis Care Res 61(8):1070–1076

    Article  Google Scholar 

  16. Good L, Roos H, Gottlieb DJ, Renström PA, Beynnon BD (1999) Joint position sense is not changed after acute disruption of the anterior cruciate ligament. Acta Orthop 70(2):194–198

    Article  CAS  Google Scholar 

  17. Kalaska JF (1994) Central neural mechanisms of touch and proprioception. Can J Physiol Pharmacol 72(5):542–545

    Article  CAS  PubMed  Google Scholar 

  18. Laufer Y, Hocherman S, Dickstein R (2001) Accuracy of reproducing hand position when using active compared with passive movement. Physiother Res Int 6(2):65–75

    Article  CAS  PubMed  Google Scholar 

  19. Boerboom A, Huizinga M, Kaan W, Stewart R, Hof A, Bulstra S, Diercks R (2008) Validation of a method to measure the proprioception of the knee. Gait Posture 28(4):610–614

    Article  CAS  PubMed  Google Scholar 

  20. Barrack RL, Skinner HB, Cook SD, Haddad RJ (1983) Effect of articular disease and total knee arthroplasty on knee joint-position sense. J Neurophysiol 50(3):684–687

    CAS  PubMed  Google Scholar 

  21. Baker V, Bennell K, Stillman B, Cowan S, Crossley K (2002) Abnormal knee joint position sense in individuals with patellofemoral pain syndrome. J Orthop Res 20(2):208–214

    Article  PubMed  Google Scholar 

  22. Fouladi R, Nasseri N, Rajabi R, Geranmayeh M (2010) Joint position sense of the knee in healthy female athletes across the menstrual cycle. Koomesh 12(1):31–38

    Google Scholar 

  23. Arockiaraj J, Korula R, Oommen A, Devasahayam S, Wankhar S, Velkumar S, Poonnoose P (2013) Proprioceptive changes in the contralateral knee joint following anterior cruciate injury. Bone Joint J 95(2):188–191

    Article  PubMed  Google Scholar 

  24. de Vet HC, Bouter LM, Bezemer PD, Beurskens AJ (2001) Reproducibility and responsiveness of evaluative outcome measures. Int J Technol Assess Health Care 17(04):479–487

    PubMed  Google Scholar 

  25. Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428

    Article  CAS  PubMed  Google Scholar 

  26. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  CAS  PubMed  Google Scholar 

  27. Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res 8(2):135–160

    Article  CAS  PubMed  Google Scholar 

  28. Pincivero DM, Bachmeier B, Coelho AJ (2001) The effects of joint angle and reliability on knee proprioception. Med Sci Sports Exerc 33(10):1708–1712

    Article  CAS  PubMed  Google Scholar 

  29. Hurkmans E, Van Der Esch M, Ostelo R, Knol D, Dekker J, Steultjens M (2007) Reproducibility of the measurement of knee joint proprioception in patients with osteoarthritis of the knee. Arthritis Care Res 57(8):1398–1403

    Article  CAS  Google Scholar 

  30. Piriyaprasarth P, Morris ME, Winter A, Bialocerkowski AE (2008) The reliability of knee joint position testing using electrogoniometry. BMC Musculoskelet Disord 9(1):6–16

    Article  PubMed Central  PubMed  Google Scholar 

  31. Mendelsohn ME, Overend TJ, Petrella RJ (2004) Effect of rehabilitation on hip and knee proprioception in older adults after hip fracture: a pilot study. Am J Phys Med Rehabil 83(8):624–632

    Article  PubMed  Google Scholar 

  32. Rankin G, Stokes M (1998) Reliability of assessment tools in rehabilitation: an illustration of appropriate statistical analyses. Clin Rehabil 12(3):187–199

    Article  CAS  PubMed  Google Scholar 

  33. Lin C-H, Lien Y-H, Wang S-F, Tsauo J-Y (2006) Hip and knee proprioception in elite, amateur, and novice tennis players. Am J Phys Med Rehabil 85(3):216–221

    Article  PubMed  Google Scholar 

  34. Bennell K, Wee E, Crossley K, Stillman B, Hodges P (2005) Effects of experimentally-induced anterior knee pain on knee joint position sense in healthy individuals. J Orthop Res 23(1):46–53

    Article  PubMed  Google Scholar 

  35. Ishii Y, Terajima K, Terashima S, Bechtold JE, Laskin RS (1997) Comparison of joint position sense after total knee arthroplasty. J Arthroplast 12(5):541–545

    Article  CAS  Google Scholar 

  36. Weir JP (2005) Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res 19(1):231–240

    PubMed  Google Scholar 

  37. Atkinson G, Nevill AM (1998) Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports Med 26(4):217–238

    Article  CAS  PubMed  Google Scholar 

  38. Duman I, Taskaynatan MA, Mohur H, Tan AK (2012) Assessment of the impact of proprioceptive exercises on balance and proprioception in patients with advanced knee osteoarthritis. Rheumatol Int 32(12):3793–3798

    Article  PubMed  Google Scholar 

  39. Song CH, Petrofsky JS, Lee SW, Lee KJ, Yim JE (2011) Effects of an exercise program on balance and trunk proprioception in older adults with diabetic neuropathies. Diabetes Technol Ther 13(8):803–811

    Article  PubMed  Google Scholar 

  40. Nallegowda M, Singh U, Handa G, Khanna M, Wadhwa S, Yadav SL, Kumar G, Behari M (2004) Role of sensory input and muscle strength in maintenance of balance, gait, and posture in Parkinson’s disease: a pilot study. Am J Phys Med Rehabil 83(12):898–908

    Article  PubMed  Google Scholar 

  41. Dover G, Powers ME (2003) Reliability of joint position sense and force-reproduction measures during internal and external rotation of the shoulder. J Athl Train 38(4):304–310

    PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This research was funded by the European Commission through MOVE-AGE, an Erasmus Mundus Joint Doctorate programme (2011-0015). Mirjam Pijnappels was financially supported by a TOP-NIG Grant (No. 91209021) from the Dutch Organization for Scientific Research (NWO). The authors would like to thank Arjan de Zwart for his valuable assistance on data collection.

Conflict of interest

The authors declare that there are no conflicts of interest.

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Authors and Affiliations

  1. Faculty of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam, Van der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands

    Mina Arvin, Marco J. M. Hoozemans, Jaap H. van Dieën & Mirjam Pijnappels

  2. Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium

    Sabine M. P. Verschueren

  3. Orthopaedic Outpatient Department, Centre for Orthopaedic Research Alkmaar (CORAL), Medical Centre Alkmaar, Alkmaar, The Netherlands

    Marco J. M. Hoozemans & Bart J. Burger

  4. King Abdulaziz University, Jeddha, Saudi Arabia

    Jaap H. van Dieën

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  1. Mina Arvin
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  2. Marco J. M. Hoozemans
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  3. Bart J. Burger
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  4. Sabine M. P. Verschueren
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  6. Mirjam Pijnappels
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Correspondence to Marco J. M. Hoozemans.

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Arvin, M., Hoozemans, M.J.M., Burger, B.J. et al. Reproducibility of a knee and hip proprioception test in healthy older adults. Aging Clin Exp Res 27, 171–177 (2015). https://doi.org/10.1007/s40520-014-0255-6

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  • DOI: https://doi.org/10.1007/s40520-014-0255-6

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