Abstract:Control and ACLR subjects demonstrated similar dynamic, passive, and active joint-position-sense error and CNS processing speed even though ACLR subjects reported greater impairment of function. The impairment of proprioception is independent of post-ACLR perception of function.
“…Subgroups were created in the meta-analysis based on the type of JPS test: passive-active (29 comparisons across 11 studies §§ ), passive-passive (10 comparisons across 5 studies 7 , 34 , 65 , 79 , 111 ), active-active (14 comparisons across 4 studies 19 , 67 , 71 , 92 ), and passive–visual estimation (6 comparisons across 2 studies 89 , 90 ). Because of an insufficient number of studies, 1 meta-analysis subgroup (passive–visual estimation) was precluded, and only the other 3 subgroup meta-analyses were considered relevant ( Figure 2 ).…”
Background: Knee proprioception is believed to be deficient after anterior cruciate ligament (ACL) injury. Tests of joint position sense (JPS) are commonly used to assess knee proprioception, but their psychometric properties (PMPs) are largely unknown. Purpose: To evaluate the PMPs (reliability, validity, and responsiveness) of existing knee JPS tests targeting individuals with ACL injury. Study Design: Systematic review; Level of evidence, 4. Methods: PubMed, Allied and Complementary Medicine, CINAHL, SPORTDiscus, Web of Science, Scopus, CENTRAL, and ProQuest databases were searched to identify studies that assessed PMPs of knee JPS tests in individuals with ACL injury. The risk of bias for each included study was assessed and rated at the outcome level for each knee JPS test. Overall quality and levels of evidence for each PMP were rated according to established criteria. Meta-analyses with mean differences were conducted using random effects models when adequate data were available. Results: Included were 80 studies covering 119 versions of knee JPS tests. Meta-analyses indicated sufficient quality for known-groups and discriminative validity (ACL-injured knees vs knees of asymptomatic controls and contralateral noninjured knees, respectively), owing to significantly greater absolute errors for ACL-injured knees based on a strong level of evidence. A meta-analysis showed insufficient quality for responsiveness, which was attributed to a lack of significant change over time after diverse interventions with a moderate level of evidence. Statistical heterogeneity ( I 2 > 40%) was evident in the majority of meta-analyses. All remaining PMPs (reliability, measurement error, criterion validity, convergent validity, and other PMPs related to responsiveness) were assessed qualitatively, and they failed to achieve a sufficient quality rating. This was a result of either the study outcomes not agreeing with the statistical cutoff values/hypotheses or the level of evidence being rated as conflicting/unknown or based on only a single study. Conclusion: Knee JPS tests appear to have sufficient validity in differentiating ACL-injured knees from asymptomatic knees. Further evidence of high methodologic quality is required to ascertain the reliability, responsiveness, and other types of validity assessed here. We recommend investigations that compare the modifiable methodologic components of knee JPS tests on their PMPs to develop standardized evidence-based tests.
“…Subgroups were created in the meta-analysis based on the type of JPS test: passive-active (29 comparisons across 11 studies §§ ), passive-passive (10 comparisons across 5 studies 7 , 34 , 65 , 79 , 111 ), active-active (14 comparisons across 4 studies 19 , 67 , 71 , 92 ), and passive–visual estimation (6 comparisons across 2 studies 89 , 90 ). Because of an insufficient number of studies, 1 meta-analysis subgroup (passive–visual estimation) was precluded, and only the other 3 subgroup meta-analyses were considered relevant ( Figure 2 ).…”
Background: Knee proprioception is believed to be deficient after anterior cruciate ligament (ACL) injury. Tests of joint position sense (JPS) are commonly used to assess knee proprioception, but their psychometric properties (PMPs) are largely unknown. Purpose: To evaluate the PMPs (reliability, validity, and responsiveness) of existing knee JPS tests targeting individuals with ACL injury. Study Design: Systematic review; Level of evidence, 4. Methods: PubMed, Allied and Complementary Medicine, CINAHL, SPORTDiscus, Web of Science, Scopus, CENTRAL, and ProQuest databases were searched to identify studies that assessed PMPs of knee JPS tests in individuals with ACL injury. The risk of bias for each included study was assessed and rated at the outcome level for each knee JPS test. Overall quality and levels of evidence for each PMP were rated according to established criteria. Meta-analyses with mean differences were conducted using random effects models when adequate data were available. Results: Included were 80 studies covering 119 versions of knee JPS tests. Meta-analyses indicated sufficient quality for known-groups and discriminative validity (ACL-injured knees vs knees of asymptomatic controls and contralateral noninjured knees, respectively), owing to significantly greater absolute errors for ACL-injured knees based on a strong level of evidence. A meta-analysis showed insufficient quality for responsiveness, which was attributed to a lack of significant change over time after diverse interventions with a moderate level of evidence. Statistical heterogeneity ( I 2 > 40%) was evident in the majority of meta-analyses. All remaining PMPs (reliability, measurement error, criterion validity, convergent validity, and other PMPs related to responsiveness) were assessed qualitatively, and they failed to achieve a sufficient quality rating. This was a result of either the study outcomes not agreeing with the statistical cutoff values/hypotheses or the level of evidence being rated as conflicting/unknown or based on only a single study. Conclusion: Knee JPS tests appear to have sufficient validity in differentiating ACL-injured knees from asymptomatic knees. Further evidence of high methodologic quality is required to ascertain the reliability, responsiveness, and other types of validity assessed here. We recommend investigations that compare the modifiable methodologic components of knee JPS tests on their PMPs to develop standardized evidence-based tests.
“…As informações sensoriais do sistema musculoesquelético incluem a propriocepção e a dor 1 35,36 , em especial nas lesões do LCA 23,31,35,[37][38][39][40][41][42]…”
A propriocepção é a capacidade de percepção da posição estática e dinâmica do corpo e seus segmentos. Objetivo: Analisar o foco das publicações atuais e rever o conteúdo sobre avaliação, tratamento e prevenção da propriocepção na recuperação cinética funcional esportiva. Materiais e Métodos: Revisão de periódicos científicos dos últimos 12 anos, através dos descritores: propriocepção, traumatismos em atletas e fisioterapia; no portal CAPES, além de busca específica em PEDro e COCHRANE. Incluiu estudos que se propunham a avaliar, prevenir ou tratar a propriocepção em lesões possíveis nos esportes, foram excluídos estudos com população menor que 15. Resultados: Foram encontrados no total de 1412 artigos. Os 43 artigos que atendiam os critérios foram tabulados e organizados por articulação abordada. Equipamentos tecnológicos e instrumentos de baixa complexidade e custo podem ser úteis para avaliar variáveis relativas à propriocepção. Técnicas que objetivam aumento de força muscular associada ao equilíbrio estático e dinâmico parecem contribuir com desempenho do sistema proprioceptivo, melhorando a estabilidade e defesa articular. Conclusão: A avaliação, tratamento e prevenção da propriocepção demonstrou alta relevância na manutenção do equilíbrio, da estabilidade articular e do controle da força muscular excêntrica sendo de grande valia na recuperação cinética funcional das lesões e desempenho do atleta. As articulações do quadril e punho/mão carecem de estudos a respeito. Prevenção de lesões, comparações entre intervenções, em especial estudos em longo prazo, além de estudos sobre a fisioterapia proprioceptiva na hidroterapia, ou específica a um esporte enriqueceriam o conteúdo científico atual.
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