Proprioception of the shoulder joint in healthy, unstable, and surgically repaired shoulders

Lephart, Scott M.; Warner, Jon J.P.; Borsa, Paul A.; Fu, Freddie H.

doi:10.1016/s1058-2746(09)80022-0

Cited by 285 publications

(195 citation statements)

References 38 publications

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“…In studies exploring JPS at the shoulder in uniplane movements, the repositioning errors ranged from 28 to 58. 24,26,27 Suprak and colleagues 25 examined JPS on unconstrained shoulder movements and reported 48 to 98. We demonstrated the errors ranged from 38 to 108.…”

Section: Discussionmentioning

confidence: 99%

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

Yang

Chen

Jan

et al. 2008

Journal Orthopaedic Research

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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...

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Section: Discussionmentioning

confidence: 99%

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

Yang

Chen

Jan

et al. 2008

Journal Orthopaedic Research

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“…The incidence of recurrent dislocation ranges from 17-96% with a mean of 67% in patient populations between the ages of 21-30 years old. 1,[5][6][7][8][9][10][11][12][13][14][15] Therefore, the rehabilitation program should progress cautiously in young athletic individuals. It should be noted that Hovelius et al 8,16,17 has demonstrated that the rate of recurrent dislocations is based on the patient's age and not affected by the length of post-injury immobilization.…”

Section: Frequency Of Dislocationmentioning

confidence: 99%

“…Neuromuscular control may be defined as the efferent, or motor, output in reaction to an afferent, or sensory input. 2,10 The afferent input is the ability to detect the glenohumeral joint position and motion in space with resultant efferent response by the dynamic stabilizers as they blend with the joint capsule to assist in stabilization of the humeral head. Injury with resultant insufficient neuromuscular control could result in deleterious effects to the patient.…”

Section: Neuromuscular Controlmentioning

confidence: 99%

“…Rhythmic stabilization drills may also be performed to facilitate a muscular co-contraction/co-activation to improve neuromuscular control and enhance the sensitivity of the afferent mechanoreceptors. 10 ( Figure 11) The goal is to create a more efficient agonist/antagonist co-contraction to improve force coupling and joint stability during active movements.…”

Section: Figurementioning

confidence: 99%

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Nonoperative rehabilitation for traumatic and atraumatic glenohumeral instability

Wilk

Macrina²,

Reinold³

2012

Shoulder Instability: A Comprehensive Approach

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“…24 Previous studies of shoulder kinesthesia have focused on the recognition of a specific joint position or onset of motion, which is performed passively, and have neglected efferent connections to muscles and the contribution of kinesthesia to movement control. 1,3,20,29,36 Latent electromyographic reaction times following sudden changes in upper extremity position demonstrate a relationship between kinesthetic feedback and an associated efferent muscle response. 2,35 However, this connection does not fully explain the role of kinesthesia in CNS control mechanisms for upper extremity movements.…”

mentioning

confidence: 99%

Measures of Accuracy for Active Shoulder Movements at 3 Different Speeds With Kinesthetic and Visual Feedback

Brindle

Nitz²,

Uhl³

et al. 2004

J Orthop Sports Phys Ther

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Study Design: Repeated-measures experiment. Objective: To compare measures of end point accuracy (EPA) for 2 feedback conditions: (1) visual and kinesthetic feedback and (2) kinesthetic feedback alone, during shoulder movements, at 3 different speeds. Background: Shoulder joint kinesthesia is typically reported with EPA measures, such as constant error. Reporting multiple measures of EPA, such as variable error and absolute error, could provide a more detailed description of performance. Methods and Measures: Subjects were seated with the shoulder abducted 90°in the scapular plane and externally rotated 75°, with the forearm placed in a custom shoulder wheel. Subjects internally rotated the shoulder 27°to a target position at 48°of shoulder external rotation for both conditions. Motion analysis was used to determine peak angular velocity and 3 EPA measures for shoulder movements. Each EPA measure was compared between the 2 feedback conditions and among the 3 speeds with a separate 2-way analysis of variance. Results: Movements performed with kinesthetic feedback alone, measured by constant error (PϽ.01), variable error (PϽ.01), and absolute error (PϽ.01), were less accurate than movements performed with visual and kinesthetic feedback. Faster movements were less accurate when measured by constant error (P = .01) and absolute error (PϽ.01) than slower movements. Subjects tended to overshoot the target in the absence of visual feedback; however, movement speed played minimal role in the overshooting. Conclusions: Multiple measures of EPA, such as constant, variable, and absolute error during simple restricted shoulder movements may provide additional information regarding the evaluation of a motor performance or identify different central nervous system control mechanisms for joint kinesthesia.

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Proprioception of the shoulder joint in healthy, unstable, and surgically repaired shoulders

Cited by 285 publications

References 38 publications

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

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

Nonoperative rehabilitation for traumatic and atraumatic glenohumeral instability

Measures of Accuracy for Active Shoulder Movements at 3 Different Speeds With Kinesthetic and Visual Feedback

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