Background:Acute ankle injury causes damage to joint mechanoreceptors and deafferentation and contributes to proprioception deficits in patients with chronic ankle instability(CAI).We aimed to explore whether deficits...Background:Acute ankle injury causes damage to joint mechanoreceptors and deafferentation and contributes to proprioception deficits in patients with chronic ankle instability(CAI).We aimed to explore whether deficits of proprioception,including kinesthesia and joint position sense(JPS),exist in patients with CAI when compared with the uninjured contralateral side and healthy people.We hypothesized that proprioception deficits did exist in patients with CAI and that the deficits varied by test methodologies.Methods:The study was a systematic review and meta-analysis.We identified studies that compared kinesthesia or JPS in patients with CAI with the uninjured contralateral side or with healthy controls.Meta-analyses were conducted for the studies with similar test procedures,and narrative syntheses were undertaken for the rest.Results:A total of 7731 studies were identified,of which 30 were included for review.A total of 21 studies were eligible for meta-analysis.Compared with the contralateral side,patients with CAI had ankle kinesthesia deficits in inversion and plantarflexion,with a standardized mean difference(SMD)of 0.41 and 0.92,respectively,and active and passive JPS deficits in inversion(SMD=0.92 and 0.72,respectively).Compared with healthy people,patients with CAI had ankle kinesthesia deficits in inversion and eversion(SMD=0.64 and 0.76,respectively),and active JPS deficits in inversion and eversion(SMD=1.00 and 4.82,respectively).Proprioception deficits in the knee and shoulder of patients with CAI were not statistically significant.Conclusion:Proprioception,including both kinesthesia and JPS,of the injured ankle of patients with CAI was impaired,compared with the uninjured contralateral limbs and healthy people.Proprioception varied depending on different movement directions and test methodologies.The use of more detailed measurements of proprioception and interventions for restoring the deficits are recommended in the clinical management of CAI.展开更多
目的:功能性踝关节不稳表现为本体感觉异常、神经肌肉控制能力下降以及反复性踝扭伤,严重影响其日常活动。本体感觉作为功能性踝关节不稳的重要方面,与对侧肢体和健康人群相比是否存在本体感觉的缺陷尚不明晰。因此,文章旨在分析功能性...目的:功能性踝关节不稳表现为本体感觉异常、神经肌肉控制能力下降以及反复性踝扭伤,严重影响其日常活动。本体感觉作为功能性踝关节不稳的重要方面,与对侧肢体和健康人群相比是否存在本体感觉的缺陷尚不明晰。因此,文章旨在分析功能性踝关节不稳的本体感觉特征。方法:计算机检索PubMed,Web of Science,EBSCO-host,Ovid,EMbase和中国知网数据库,搜索有关功能性踝关节不稳本体感觉特征的观察性研究,暴露因素为运动觉、关节位置觉、力觉中至少一项本体感觉缺陷,检索时限为各数据库建库至2022年2月。由2名研究者根据纳入与排除标准独立筛选文献并根据纽卡斯尔-渥太华量表与美国医疗保健研究和质量机构制定的横断面研究质量评价表评价纳入研究的质量,提取有关运动觉、关节位置觉、力觉与设定目标的绝对误差,使用RevMan 5.3软件进行Meta分析。结果:共纳入26项观察性研究,其中4项队列研究,6项病例-对照研究,16项横断面研究,均为中等以上质量文献。Meta分析结果显示:单侧功能性踝关节不稳患者相比于对侧肢体和健康人群存在内翻运动觉缺陷(SMD=0.53,95%CI:0.36-0.71,P<0.00001);单侧功能性踝关节不稳患者相比于对侧肢体存在内翻关节位置觉(主动与被动复制)的缺陷(SMD=1.60,95%CI:0.77-2.43,P=0.0002);单侧功能性踝关节不稳患者相比于健康人群存在内翻关节位置觉(主动与被动复制)的缺陷(SMD=0.66,95%CI:0.25-1.07,P=0.002);单侧功能性踝关节不稳患者相比于健康人群存在主动外翻关节位置觉缺陷(SMD=3.68,95%CI:1.85-5.52,P<0.0001);单侧功能性踝关节不稳患者相比于健康人群存在被动外翻关节位置觉缺陷(SMD=-0.61,95%CI:-1.19至-0.02,P=0.04);单侧功能性踝关节不稳患者与健康人群在跖屈关节位置觉(主动与被动复制)方面无显著性差异(SMD=0.80,95%CI:-0.19-1.79,P=0.11);单侧功能性踝关节不稳患者�展开更多
AIM To investigate proprioceptive discrepancies in the lower extremity in persons with type 2 diabetes mellitus(T2DM). METHODS In this cross-sectional study, a total of 46 older persons were divided into a T2DM group(...AIM To investigate proprioceptive discrepancies in the lower extremity in persons with type 2 diabetes mellitus(T2DM). METHODS In this cross-sectional study, a total of 46 older persons were divided into a T2DM group(n = 23) and a control group who did not have T2 DM(n = 23). Participants were given a brief warm up with stretching exercises. Diabetic neuropathy scores were collected prior to proprioceptive testing. For proprioceptive testing, participants performed leg extensions to randomized target positions of 15°, 30°, 45, 60° degrees of elevation in the sagittal plane, each target was repeated a total of four times. Subjects were guided to target positions in the absence of visual feedback via auditory cues from a custom JPS application. When the participant entered the target position, they memorized the location of their limb in space and subsequently attempted to relocate this position in space. Proprioceptive errors were measured from the target positioned, target remembered, target repositioned protocol. RESULTS Proprioceptive accuracy was lower in the diabetic groupat all levels of target angle than the control group(P < 0.05). The diabetic group had 46% greater inaccuracy than the control group at all levels of target position. Diabetics also reported greater neuropathy scores than controls in the past 12 mo P < 0.01. CONCLUSION Deficits in lower limb localization and greater diabetic neuropathy scores were identified in this study. Our findings may be associated with deafferentation as peripheral neuropathy is a common complication with the disease. These findings may help to explain the declining balance function in the older persons with T2DM which is also commonly reported.展开更多
To control movement,the brain has to integrate proprioceptive information from a variety of mechanoreceptors.The role of proprioception in daily activities,exercise,and sports has been extensively investigated,using d...To control movement,the brain has to integrate proprioceptive information from a variety of mechanoreceptors.The role of proprioception in daily activities,exercise,and sports has been extensively investigated,using different techniques,yet the proprioceptive mechanisms underlying human movement control are still unclear.In the current work we have reviewed understanding of proprioception and the three testing methods:threshold to detection of passive motion,joint position reproduction,and active movement extent discrimination,all of which have been used for assessing proprioception.The origin of the methods,the different testing apparatus,and the procedures and protocols used in each approach are compared and discussed.Recommendations are made for choosing an appropriate technique when assessing proprioceptive mechanisms in different contexts.展开更多
Objective:To evaluate the effects of Ving Tsun(VT)sticking-hand training on upper-limb joint position sense and muscular performance in community-dwelling middle-aged and older adults.Methods:Thirty-three adults were ...Objective:To evaluate the effects of Ving Tsun(VT)sticking-hand training on upper-limb joint position sense and muscular performance in community-dwelling middle-aged and older adults.Methods:Thirty-three adults were randomly allocated to either a VT group or a control group.The VT group received VT sticking-hand training twice per week for 3 months.Measurements were taken before and after the intervention period.The primary outcome was elbow-joint repositioning error,which was measured by an elbow-joint passive positioning and active repositioning test using a universal goniometer.Secondary outcomes were upper-limb muscles'peak force and time taken to reach peak force as measured by a hand-held dynamometer.Results:No significant time,group or time-by-group interaction effects were found for elbow-joint repositioning error or upper-limb muscle peak force outcomes.Shoulder flexor time to peak force decreased by 33.8%from pre-test to post-test in the VT group(P=0.007).Shoulder abductor,internal and external rotator,and elbow extensor times to peak force decreased by 30.0%-35.9%in the VT%roup(P<0.05)and by 30.4%-37.1%in the control group(P<0.05).Conclusions:VT sticking-hand training does not improve elbow-joint position sense or the maximum strength of upper-limb muscles in middle-aged and older adults.However,VT can improve shoulder flexor muscles'time to reach peak force in these populations.VT had no obvious effect on the time required to reach peak force in other shoulder muscles and elbow extensors.展开更多
Introduction: The instability of the joint is classified roughly into mechanical and functional. It is reported that the postoperative dislocation often occurs by the posterior approach of the THA and may be caused by...Introduction: The instability of the joint is classified roughly into mechanical and functional. It is reported that the postoperative dislocation often occurs by the posterior approach of the THA and may be caused by functionality instability due to the injury of the periarticular soft tissue. We analyzed the joint position sense of the hip according to an approach of the THA and examined effect to give postoperative dislocation. Materials & Methods: 92 patients (184 hip joints) who received THA in our hospital were selected in the study. Cases in which position sensation measurements were insufficient were excluded. As for the classification, the posterior approach (PL groups) was 39 hips, anterolateral approach (AL groups) was 30 hips, and control group was 37 hips. Results: There was no significant difference between the AL group and PL group in the absolute reproduction angle error score (ARAES). The relative reproduction angle error scores (RRAES) for passive internal and external rotations and active internal rotation were significantly lower in the AL and control groups than the PL group. Discussion: This study was suggested that the hip joint position sense in the AL group was better retained for the preservation of the soft tissue.展开更多
基金the National Natural Science Foundation of China(Grant No.81871823).
文摘Background:Acute ankle injury causes damage to joint mechanoreceptors and deafferentation and contributes to proprioception deficits in patients with chronic ankle instability(CAI).We aimed to explore whether deficits of proprioception,including kinesthesia and joint position sense(JPS),exist in patients with CAI when compared with the uninjured contralateral side and healthy people.We hypothesized that proprioception deficits did exist in patients with CAI and that the deficits varied by test methodologies.Methods:The study was a systematic review and meta-analysis.We identified studies that compared kinesthesia or JPS in patients with CAI with the uninjured contralateral side or with healthy controls.Meta-analyses were conducted for the studies with similar test procedures,and narrative syntheses were undertaken for the rest.Results:A total of 7731 studies were identified,of which 30 were included for review.A total of 21 studies were eligible for meta-analysis.Compared with the contralateral side,patients with CAI had ankle kinesthesia deficits in inversion and plantarflexion,with a standardized mean difference(SMD)of 0.41 and 0.92,respectively,and active and passive JPS deficits in inversion(SMD=0.92 and 0.72,respectively).Compared with healthy people,patients with CAI had ankle kinesthesia deficits in inversion and eversion(SMD=0.64 and 0.76,respectively),and active JPS deficits in inversion and eversion(SMD=1.00 and 4.82,respectively).Proprioception deficits in the knee and shoulder of patients with CAI were not statistically significant.Conclusion:Proprioception,including both kinesthesia and JPS,of the injured ankle of patients with CAI was impaired,compared with the uninjured contralateral limbs and healthy people.Proprioception varied depending on different movement directions and test methodologies.The use of more detailed measurements of proprioception and interventions for restoring the deficits are recommended in the clinical management of CAI.
文摘目的:功能性踝关节不稳表现为本体感觉异常、神经肌肉控制能力下降以及反复性踝扭伤,严重影响其日常活动。本体感觉作为功能性踝关节不稳的重要方面,与对侧肢体和健康人群相比是否存在本体感觉的缺陷尚不明晰。因此,文章旨在分析功能性踝关节不稳的本体感觉特征。方法:计算机检索PubMed,Web of Science,EBSCO-host,Ovid,EMbase和中国知网数据库,搜索有关功能性踝关节不稳本体感觉特征的观察性研究,暴露因素为运动觉、关节位置觉、力觉中至少一项本体感觉缺陷,检索时限为各数据库建库至2022年2月。由2名研究者根据纳入与排除标准独立筛选文献并根据纽卡斯尔-渥太华量表与美国医疗保健研究和质量机构制定的横断面研究质量评价表评价纳入研究的质量,提取有关运动觉、关节位置觉、力觉与设定目标的绝对误差,使用RevMan 5.3软件进行Meta分析。结果:共纳入26项观察性研究,其中4项队列研究,6项病例-对照研究,16项横断面研究,均为中等以上质量文献。Meta分析结果显示:单侧功能性踝关节不稳患者相比于对侧肢体和健康人群存在内翻运动觉缺陷(SMD=0.53,95%CI:0.36-0.71,P<0.00001);单侧功能性踝关节不稳患者相比于对侧肢体存在内翻关节位置觉(主动与被动复制)的缺陷(SMD=1.60,95%CI:0.77-2.43,P=0.0002);单侧功能性踝关节不稳患者相比于健康人群存在内翻关节位置觉(主动与被动复制)的缺陷(SMD=0.66,95%CI:0.25-1.07,P=0.002);单侧功能性踝关节不稳患者相比于健康人群存在主动外翻关节位置觉缺陷(SMD=3.68,95%CI:1.85-5.52,P<0.0001);单侧功能性踝关节不稳患者相比于健康人群存在被动外翻关节位置觉缺陷(SMD=-0.61,95%CI:-1.19至-0.02,P=0.04);单侧功能性踝关节不稳患者与健康人群在跖屈关节位置觉(主动与被动复制)方面无显著性差异(SMD=0.80,95%CI:-0.19-1.79,P=0.11);单侧功能性踝关节不稳患者�
基金Supported by The Willamette University Mary Stuart Rogers Science Collaborative Research Program Endowment
文摘AIM To investigate proprioceptive discrepancies in the lower extremity in persons with type 2 diabetes mellitus(T2DM). METHODS In this cross-sectional study, a total of 46 older persons were divided into a T2DM group(n = 23) and a control group who did not have T2 DM(n = 23). Participants were given a brief warm up with stretching exercises. Diabetic neuropathy scores were collected prior to proprioceptive testing. For proprioceptive testing, participants performed leg extensions to randomized target positions of 15°, 30°, 45, 60° degrees of elevation in the sagittal plane, each target was repeated a total of four times. Subjects were guided to target positions in the absence of visual feedback via auditory cues from a custom JPS application. When the participant entered the target position, they memorized the location of their limb in space and subsequently attempted to relocate this position in space. Proprioceptive errors were measured from the target positioned, target remembered, target repositioned protocol. RESULTS Proprioceptive accuracy was lower in the diabetic groupat all levels of target angle than the control group(P < 0.05). The diabetic group had 46% greater inaccuracy than the control group at all levels of target position. Diabetics also reported greater neuropathy scores than controls in the past 12 mo P < 0.01. CONCLUSION Deficits in lower limb localization and greater diabetic neuropathy scores were identified in this study. Our findings may be associated with deafferentation as peripheral neuropathy is a common complication with the disease. These findings may help to explain the declining balance function in the older persons with T2DM which is also commonly reported.
基金the University of Canberra,Key Laboratory of Exercise and Health Sciences of Ministry of Education,Shanghai University of Sport and Shanghai Municipal Science and Technology Commission (No.13490503800)supported by Shanghai Pujiang Program (No.15PJ1407600)
文摘To control movement,the brain has to integrate proprioceptive information from a variety of mechanoreceptors.The role of proprioception in daily activities,exercise,and sports has been extensively investigated,using different techniques,yet the proprioceptive mechanisms underlying human movement control are still unclear.In the current work we have reviewed understanding of proprioception and the three testing methods:threshold to detection of passive motion,joint position reproduction,and active movement extent discrimination,all of which have been used for assessing proprioception.The origin of the methods,the different testing apparatus,and the procedures and protocols used in each approach are compared and discussed.Recommendations are made for choosing an appropriate technique when assessing proprioceptive mechanisms in different contexts.
基金This work was partially supported by the Hong Kong College of Community Medicine(TY Chau Training and Research Scholarship 2017).
文摘Objective:To evaluate the effects of Ving Tsun(VT)sticking-hand training on upper-limb joint position sense and muscular performance in community-dwelling middle-aged and older adults.Methods:Thirty-three adults were randomly allocated to either a VT group or a control group.The VT group received VT sticking-hand training twice per week for 3 months.Measurements were taken before and after the intervention period.The primary outcome was elbow-joint repositioning error,which was measured by an elbow-joint passive positioning and active repositioning test using a universal goniometer.Secondary outcomes were upper-limb muscles'peak force and time taken to reach peak force as measured by a hand-held dynamometer.Results:No significant time,group or time-by-group interaction effects were found for elbow-joint repositioning error or upper-limb muscle peak force outcomes.Shoulder flexor time to peak force decreased by 33.8%from pre-test to post-test in the VT group(P=0.007).Shoulder abductor,internal and external rotator,and elbow extensor times to peak force decreased by 30.0%-35.9%in the VT%roup(P<0.05)and by 30.4%-37.1%in the control group(P<0.05).Conclusions:VT sticking-hand training does not improve elbow-joint position sense or the maximum strength of upper-limb muscles in middle-aged and older adults.However,VT can improve shoulder flexor muscles'time to reach peak force in these populations.VT had no obvious effect on the time required to reach peak force in other shoulder muscles and elbow extensors.
文摘Introduction: The instability of the joint is classified roughly into mechanical and functional. It is reported that the postoperative dislocation often occurs by the posterior approach of the THA and may be caused by functionality instability due to the injury of the periarticular soft tissue. We analyzed the joint position sense of the hip according to an approach of the THA and examined effect to give postoperative dislocation. Materials & Methods: 92 patients (184 hip joints) who received THA in our hospital were selected in the study. Cases in which position sensation measurements were insufficient were excluded. As for the classification, the posterior approach (PL groups) was 39 hips, anterolateral approach (AL groups) was 30 hips, and control group was 37 hips. Results: There was no significant difference between the AL group and PL group in the absolute reproduction angle error score (ARAES). The relative reproduction angle error scores (RRAES) for passive internal and external rotations and active internal rotation were significantly lower in the AL and control groups than the PL group. Discussion: This study was suggested that the hip joint position sense in the AL group was better retained for the preservation of the soft tissue.