Proprioception assessment in subjects with idiopathic loss of shoulder range of motion: Joint position sense and a novel proprioceptive feedback index

Abstract

ABSTRACT:We examined the effects of elevation range and plane on shoulder joint proprioception in subjects with idiopathic loss of shoulder range of motion (ROM). Joint position sense (JPS) and a novel proprioceptive feedback index (PFI), including difference magnitude and the similarity index, were used to assess proprioception. Twelve subjects (eight male, four female) with involved stiff shoulders and normal opposite shoulders were recruited from a university hospital. Subjects attempted to repeat six target positions. Target positions consisted of arm elevation in three planes (frontal, scapular, and sagittal planes) and two ranges (end/mid range). Six trials of each target position were used to determine acceptable trials for stabilization of the data, less than 5% of the cumulative mean values for at least three successive trials. The data stabilized at the sixth repetition. Compared to control shoulders, involved shoulders had enhanced proprioception during end range movements (p < 0.05). The magnitude of the repositioning error and difference magnitude decreased (1.68-3.58 for repositioning error and 22.28-62.18 for difference magnitude), whereas similarity index improved at end range movements compared to mid range movements (p < 0.05) in involved stiff shoulders. Results of JPS and PFI suggest that both capsuloligamentous and musculotendinous mechanoreceptors play an important role in proprioception feedback during active movements in subjects with idiopathic loss of shoulder ROM. Proprioception is a type of feedback from the limbs to the central nervous system 1 that has been described as a sensory modality with combination of joint position sense (JPS), the ability of a person to identify and reproduce limb position in space, and kinesthesia, the perception of limb motion. 2 Stimuli from peripheral mechanoreceptors in joints, muscles, and skin provide the central nervous system with information regarding JPS and kinesthesia to modify motor control. 3,4 Proprioceptive mechanisms are essential in maintaining joint stability, especially for the shoulder, where stability is sacrificed for a large range of motion. 5,6 JPS is commonly tested using either active or passive reproduction of joint positioning, whereas kinesthesia studies have been limited to identifying the threshold to detect limb motion using a passive motion. For detecting JPS, the shoulder joint of a blindfolded subject is moved through an active or passive range of motion to a predetermined position and held for 5 to 10 s. Upon return to the starting position, subjects attempt to replicate the target position when they feel the presented position has been matched. The difference between the presented and reproduced position is the repositioning error. For kinesthesia proprioception, movement detection is identified using passive movement. 7,8 This method cannot measure proprioceptive feedback during active motion. In our study, we assessed proprioception during active limb motion with a novel method, the proprioceptive feedback index (PFI...

Efficacy of Proprioceptive Exercises in Patients with Subacromial Impingement Syndrome

“…19Y24 Although they are suggested in the rehabilitation of upper extremity problems in everyday practice, research about this subject is limited. 13,25,26 This study is the first randomized controlled research in patients with SIS investigating the effectiveness of proprioceptive exercises on proprioception, clinical, and functional assessments. The authors found a significant improvement in terms of pain, ROM, function, muscle strength, and proprioceptive assessment in both groups.…”

The effects of scapular taping on electromyographic muscle activity and proprioception feedback in healthy shoulders

“…The sensors for the system were attached to bony landmarks with adhesive tape and Velcro straps. These surface sensor placements were the sternum, the flat superior bony surface of the scapular acromial process, and the distal humerus between the lateral and medial epicondyles 13. A fourth sensor, attached to a stylus, was used to digitize palpated anatomical coordinates (bony landmarks: sternal notch, xiphoid process, 7th cervical vertebra, eighth thoracic vertebra, acromioclavicular joint, root of the spine of the scapula, inferior angle of the scapula, and lateral and medial epicondyles; the glenohumeral joint rotation center was operationalized by the anterior humeral joint and posterior humeral joint) 19, 20.…”

“…For the analysis, proprioceptive feedback index (PFI)13 was calculated from the mean of the 4th, 5th, and 6th trials. The PFI comprised two values: one derived from the total absolute angle difference between targeted movement and reproduced trials of movements (the sum of 10% movement difference, square root of ((target − reproduced plane) 2 + (target − reproduced elevation) 2 + (target − reproduced axial rotation) 2 recorded for movement (proprioceptive feedback magnitude, PFM); the other is derived from the correlation between instant movement and prototype instant movement on arm elevation (similarity index, SI) 13. An instant movement was generated from every 10% of the movement based on time by averaging across each trial of each test.…”

“…Tape may adjust muscle activity via proprioceptive feedback, a sensory modality allowing a person to identify the position of a limb in space and perceive limb motion 12. Subjects with stiff shoulder have reduced proprioceptive feedback during arm elevation,13 but others reported that scapular taping did not affect joint repositioning during active shoulder movements 9. Just how electromyography (EMG) and proprioception are changed by taping and whether the altered EMG amplitude is associated with proprioception should be determined.…”

A New Neurocognitive Interpretation of Shoulder Position Sense during Reaching: Unexpected Competence in the Measurement of Extracorporeal Space

“…Other results suggest that capsule ligamentous and musculotendinous mechanoreceptors in the shoulder joint have significant function in proprioception feedback during active movements in subjects with idiopathic loss of range of motion in the shoulder [31]. …”