• The Journal of Korean Physical Therapy
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• v.32 no.2
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• pp.88-93
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• 2020

Purpose: This study examined the inter-rater reliability of cervical proprioception, dynamic balance ability, and ankle dorsiflexion range of motion using STARmat^®, which is a practical clinical tool that can provide practitioners and patients with quantitative and qualitative results. Methods: Thirty healthy young subjects were enrolled in this study, and two well-trained physical therapists participated as a tester. Two testers measured the cervical joint position error at the starting position after neck flexion, extension, side bending, and rotation; three dynamic balance tests, including anterior excursion, anterior reaching with single leg balance, and posterior diagonal excursion; and ankle dorsiflexion range of motion using STARmat^®. The intra-class correlation coefficient (ICC) was used to determine the inter-rater reliability of the tests. Results: The inter-rater reliability for the cervical proprioception ranged from moderate to good (0.66 to 0.83), particularly for flexion (0.82), extension (0.70), right side bending (0.73), left side bending (0.71), right rotation (0.83), and left rotation (0.66). For the dynamic balance, the inter-rater reliability ranged from good to excellent (0.87 to 0.91), particularly for anterior excursion (0.86), posterior diagonal excursion (0.87 to 0.89), and anterior reaching with a single leg balance (0.90 to 0.91). In addition, for the ankle dorsiflexion range of motion, the ICC for the inter-rater reliability ranged from 0.95 to 0.96. Conclusion: STARmat^® is a reliable tool for measuring cervical proprioception, dynamic balance tests, and ankle dorsiflexion range of motion in healthy young adults.

• Physical Therapy Korea
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• v.29 no.3
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• pp.187-193
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• 2022

Background: Neuromuscular electrical stimulation (NMES) is a physical modality used to activate skeletal muscles for strengthening. While voluntary muscle contraction (VMC) follows the progressive recruitment of motor units in order of size from small to large, NMES-induced muscle contraction occurs in a nonselective and synchronous pattern. Therefore, the outcome of muscle strengthening training using NMES-induced versus voluntary contraction might be different, which might affect balance performance. Objects: We examined how the NMES training affected balance and proprioception. Methods: Forty-four young adults were randomly assigned to NMES and VMC group. All participants performed one-leg standing on a force plate and sat on the Biodex (Biodex R Corp.) to measure balance and ankle proprioception, respectively. All measures were conducted before and after a training session. In NMES group, electric pads were placed on the tibialis anterior, gastrocnemius, and soleus muscles for 20 minutes. In VMC group, co-contraction of the three muscles was conducted. Outcome variables included mean distance, root mean square distance, total excursion, mean velocity, 95% confidence circle area acquired from the center of pressure data, and absolute error of dorsi/plantarflexion. Results: None of outcome variables were associated with group (p > 0.35). However, all but plantarflexion error was associated with time (p < 0.02), and the area and mean velocity were 37.0% and 18.6% lower in post than pre in NMES group, respectively, and 48.9% and 16.7% lower in post than pre in VMC group, respectively. Conclusion: Despite different physiology underlying the NMES-induced versus VMC, both training methods improved balance and ankle joint proprioception.

• The Journal of Korean Physical Therapy
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• v.35 no.6
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• pp.206-212
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• 2023

Purpose: This study aimed to compare the lasting effects of the flossing band technique, dynamic and static stretching on hamstring on range of motion (ROM), muscle activity, and proprioception to identify the most effective pre-exercise method for preventing injuries. Methods: Thirty participants were randomly assigned to the flossing band (FB), dynamic stretching (DS), and static stretching (SS) groups, with 10 subjects in each. Measurements included muscle activity of the biceps femoris vis surface electromyography, knee ROM and proprioception during active knee extension and flexion using a smart joint goniometer. Assessments were conducted before, immediately after, 15, and 30 minutes after each intervention. Results: Proprioception showed no significant differences among groups at any time point. Significant differences in knee ROM were observed in the FB group (except between 15 and 30 minutes after), DS group (except between immediately after and 15 minutes after, and between 15 and 30 minutes after), and SS group (except between before and 15 minutes after, and between before and 30 minutes after). Muscle activity in the FB (except between before and 30 minutes after, and between 15 and 30 minutes after) and SS (between before and immediately after, between immediately after and 30 minutes after, and between 15 and 30 minutes after) groups showed significant differences, while the DS group exhibited no significant changes. Conclusion: Although direct comparisons did not establish superiority, within-group analyses indicated that the flossing band technique exhibited longer-lasting effects than dynamic and static stretching, providing valuable insights for injury prevention program design.

• The Journal of Korean Physical Therapy
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• v.15 no.2
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• pp.12-18
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• 2003

Proprioception can be defined as a specialized variation of touch that encompasses the sensation of joint movement(kinesthesia) and joint position(static joint position sense). Several types of joint and muscular mechanoreceptors provide proprioceptive information for joint stability. Joint mechanoreceptors have been classified into four types based of activation characteristics : Ruffini endings, Pacinian corpuscles, Golgi tendon organlike endings, free nerve endings. The paper review the morphology, distrubution, function of mechanoreceptors in shoulder joint.

• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.854-862
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• 2018

Objective To investigate the effect of treadmill training with eyes open (TEO) and closed (TEC) on the knee joint position sense (JPS), functional balance and mobility in children with spastic diplegia. Methods Forty-five children with spastic diplegia aged 11-13 years participated in this study. They were randomly assigned to three groups of equal number. The control group (CON) underwent designed physical therapy program whereas, the study groups (TEO and TEC) underwent the same program, in addition to treadmill gait training with eyes open and closed, respectively. Outcome measures were the degree of knee joint position error, functional balance and mobility. Measurements were taken before and after 12 weeks of intervention. Results After training, the three groups showed statistically significant improvement in all measured outcomes, compared to the baseline with non-significant change in the knee JPS in the CON group. When comparing posttreatment results, the TEC group showed greater significant improvement in all measured outcomes, than the TEO and CON groups. Conclusion Treadmill training with eyes open and closed is effective in rehabilitation of children with diplegia, but blocked vision treadmill training has more beneficial effect.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.619-625
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• 2013

PURPOSE: The purpose of this study was to determine the effects of muscle fatigue on knee joint position sense in the young, elderly adults, and stroke patients. METHODS: The subjects were recruited into three groups; young group(YG)(N=15), elderly group(EG)(N=15), and stroke group(SG)(N=15). Exercise-induced fatigue was achieved by repeated active exercise 60 times on an angle at 10 to 100 degrees of the knee joint with an angle speed of $120^{\circ}/s$, with three sets for 15 minutes. Evaluation was performed for determination of repositioning error using passive angle repositioning (PAR) and active angle repositioning (AAR). RESULT: Regarding the error score for the knee joint position sense in both the baseline and muscle fatigue, significant increases were observed between the YG and EG (p<.05), and between the EG and SG (p<.01), and between YG and SG (p<.05) in the PAR, YG and SG (p<.05) in the AAR. CONCLUSION: In particular, the results of this study indicate that management and intervention for elderly adults and stroke patients can result in improvement of proprioception.

• Physical Therapy Korea
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• v.6 no.3
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• pp.22-37
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• 1999

It was recently reported that exercise-induced fatigue is related to joint position sense although some controversy remains. The purposes of this study were to examine the effect on the accuracy of reproducing the knee angles after a fatiguing isokinetic quadriceps exercise at four different levels (10%, 30%, 50%, and 70% of maximal force) and to find the optimal exercise level without causing knee joint proprioception impairment. Forty healthy women, ages 19 to 27, were randomly assigned to four experimental groups. Before and after the exercise, accuracy of positioning with respect to auditory feedback for specific angles was estimated by calculating the mean errors between specific angles and reproduction angles. Fatigue was measured by EMG signals displayed by a frequency spectrum analysis during the quadriceps exercise. Results showed that there was no significant difference in accuracy of the knee joint positioning sense following the exercises in group 1, group 2, and group 3 (10%, 30%, and 50% of maximal force, respectively); the exception being group 4 (70%). Fatigue level was significantly increased in group 4 but there were no significant increases of fatigue level in group 1, group 2, or group 3. The results concluded that the optimal exercise level to acquire the therapeutic exercise effectiveness without position sense impairment was at 50% of maximal force. Further studies using large sample size and patient groups with poor knee joint proprioception would be needed to confirm this conclusion and to clarify the possibility of clinical applications.

• Journal of Korean Physical Therapy Science
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• v.31 no.1
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• pp.33-45
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• 2024

Background: This study aimed to investigate the effect of elastic band-resistive exercise using audio-visual medium on pain, proprioception, and motor function in adults with chronic neck and shoulder pain. Design: One group pretest-posttest follow-up experimental design. Method: Twenty adult women with neck and shoulder pain voluntarily participated in this study. Elastic band-resistive exercise using audio-visual medium including cervical flexion and extension, shoulder external rotation, and scapular retraction-protraction motions was conducted 5 times a week for 3 weeks. The Numerical Rating Scale, pressure threshold tool, CROM goniometer, and Image J software were used to assess subjective pain level, tenderness threshold (pain), joint position sense error (proprioception), joint range of motion, and postural alignment (motor function), respectively. Result:: The pain intensity and threshold and joint position sense error showed significant decreases after the intervention, whereas the joint range of motion angle revealed significant increases. The postural alignment including forward head posture and rounded shoulder revealed significant improvements after the intervention. Conclusions: Therefore, we suggest that elastic band-resistive exercise through audio-visual medium would be helpful in preventing and managing pain and physical dysfunction in individuals with chronic neck and shoulder pain, and then it would support the development of health management-related online education content.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.191-200
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• 2021

Purpose : Chronic ankle instability can lead to problems in balance and gait due to weakness of the ankle muscles and decreased proprioceptive sensation. Balance training that stimulates proprioceptors is necessary to improve ankle stability. We aimed to compare the effects of unstable support balance exercises using whole body sonic vibration and an aero-step (TOGU) on proprioception and balance in individuals with unilateral functional ankle instability. Methods : Thirty-six participants with unilateral functional ankle instability were randomly recruited and divided into two groups (group 1 = sonic whole body vibration, group 2= TOGU). Individuals in each group participated in training for 5 weeks, 40 minutes per session, 5 times per week, and performed weight-bearing exercises in five postures on different unstable support surfaces. Proprioception was measured by digital inclinometer (Dualer IQ), and balance was measured by force platform (Biodex balance system). Results : Significant differences were observed in proprioception before and after intervention within both group (p<.05). Significant differences were also observed in the balance index before and after intervention within both groups (p<.05). Conclusion : As a result of this study, it is suggested that for individuals with ankle instability, unstable support surface training using a whole body sonic vibrator and TOGU can have a positive effects on proprioception and balance ability.

• Physical Therapy Korea
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• v.12 no.1
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• pp.22-27
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• 2005

The purpose of this study was to investigate the effects of visual information and different elevations of medially wedged insoles on the proprioceptive sense of the knee joint. The subjects of this study were 16 able-bodied men who were not athletic. An electrogoniometer was used to determine the error value between calculated 50% of full flexion (target position) and performed 50% of full flexion in a standing position with the upper extremities crossed. Tests were randomly performed in $2{\times}4$ conditions. Visual variations included open eyes vs. closed eyes, while the elevation was adjusted through the use (or lack thereof) of medially wedged insoles of 10 mm, 14 mm, and 18 mm. The average error value in each condition was statistically analyzed. The findings of this study revealed as follows: 1) The average error value was significantly higher with the subjects' eyes open than with their eyes closed (p<.05). 2) The averaged error value was also significantly higher when the subjects were elevated 18 mm than with no elevation at all (p<.05). The findings of this study should be considered in lower extremity rehabilitation programs when medially wedged insoles used.