Reliability of the active knee joint position sense test and influence of limb dominance and sex

Abstract

The output of a sensorimotor performance can be measured with the joint position sense (JPS) test. However, investigations of leg dominance, sex and quality measures on this test are limited. Therefore, these potential influencing factors as well as reliability and consistency measures were evaluated for angular reproduction performance and neuromuscular activity during the active knee JPS test in healthy participants. Twenty healthy participants (10 males; 10 females; age 29 ± 8 years; height 165 ± 39 cm; body mass 69 ± 13 kg) performed a seated knee JPS test with a target angle of 50°. Measurements were conducted in two sessions separated by two weeks and consisted of two blocks of continuous angular reproduction (three minutes each block). The difference between reproduced and target angle was identified as angular error measured by an electrogoniometer. During reproduction, the neuromuscular activity of the quadriceps muscle was assessed by surface electromyography. Neuromuscular activity was normalized to submaximal voluntary contraction (subMVC) and displayed per muscle and movement phase. Differences between leg dominance and sex were calculated using Friedman-test (α = 0.05). Reliability measures including intraclass correlation coefficient (ICC), Bland–Altman analysis (bias ± limits of agreement (LoA)) and minimal detectable change (MDC) were analysed. No significant differences between leg dominance and sex were found in angular error and neuromuscular activity. Angular error demonstrated inter-session ICC scores of 0.424 with a bias of 2.4° (± 2.4° LoA) as well as MDC of 6.8° and moderate intra-session ICC (0.723) with a bias of 1.4° (± 1.65° LoA) as well as MDC of 4.7°. Neuromuscular activity for all muscles and movement phases illustrated inter-session ICC ranging from 0.432 to 0.809 with biases between − 2.5 and 13.6% subMVC and MDC from 13.4 to 63.9% subMVC. Intra-session ICC ranged from 0.705 to 0.987 with biases of − 7.7 to 2.4% subMVC and MDC of 2.7 to 46.5% subMVC. Leg dominance and sex seem not to influence angular reproduction performance and neuromuscular activity. Poor to excellent relative reliability paired with an acceptable consistency confirm findings of previous studies. Comparisons to pathological populations should be conducted with caution.

Does footedness affect bilateral plantar flexor responses to sudden stance perturbations under unilateral lower leg muscular fatigue?

“…They found that center of pressure variability under the feet soles was equivalent between the right and left legs. Further investigation corroborated equivalent balance stability between the legs in quiet standing 7 , in addition to interlateral symmetric Special issue: "Fatigue issue in the performance of motor skills" coordinative structure 8 and muscular activation 9 . Similar findings of symmetric balance control between the legs has been observed also in more challenging conditions of unstable support base 10 , dynamic balance 11 , and in response to balance perturbations 12 .…”

“…Closely related to the muscular responses required in our experiment, Vieira et al 12 showed that reactive responses in unipedal stance were symmetric between the legs in onset delay for muscular activation following a sudden stance perturbation 33 . Previous comparisons between the legs in the performance of tasks with different levels of difficulty failed to show asymmetries in balance stability 10 and in lower leg muscular responses 9,34 . Results of symmetric muscular responses between the legs are congruent with findings of bilateral activation of the primary sensory and motor areas 35,36 and dorsolateral prefrontal cortices 37 during feet-in-place reactive responses to balance perturbations.…”

The effects of exercise training on knee repositioning sense in people with knee osteoarthritis: a systematic review and meta-analysis of clinical trials

“…So standard differences in means were used to pool data. But the accuracy and reliability of various tools are different in examining the knee repositioning sense [ 38 – 40 ]. On the other hand, various exercise protocols were prescribed in eligible studies.…”