Psychometric properties of knee proprioception tests targeting healthy individuals and those with anterior cruciate ligament injury managed with or without reconstruction: a systematic review protocol

Arumugam, Ashokan; Strong, Andrew; Tengman, Eva; Röijezon, Ulrik; Häger, Charlotte

doi:10.1136/bmjopen-2018-027241

Cited by 7 publications

(14 citation statements)

References 49 publications

(61 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To prepare the individual for complex athletic environments and reduce reinjury risk, rehabilitation might focus on NT with reduced demands on visual inputs and enhance automatic movement control with cognitive demands included. 18 Whether such NT training improves knee proprioception and, how this should be assessed in the best way, 13 are yet to be determined.…”

Section: Discussionmentioning

confidence: 99%

“…Outcome measures: Knee-specific proprioception tests targeting JPS, kinesthesia (threshold to detect passive motion (TTDPM)), force sense/perception, active movement extent discrimination, velocity sense or psychophysical threshold methods 13 ; they can be performed actively and/or passively with or without visual input in weight bearing or non-weight bearing positions. 10 …”

Section: Methodsmentioning

confidence: 99%

“…Therefore, psychometric properties of such tests must be established. 13 When designing rehabilitation programmes with longterm follow-up, aberrations in neuromotor control as well as neuroplastic changes should preferably be addressed. To reflect a wide spectrum of individual impairments, further research should investigate differences in individuals with ACL injuries managed with surgical (graft types) or conservative treatment, both sexes, athletes and non-athletes of different ages.…”

Section: Limitations and Future Recommendationsmentioning

confidence: 99%

“…Disturbed proprioception might also be caused by acute inflammation and pain, and the capsule and surrounding ligaments getting affected following instability. 10 11 Although there has been a debate regarding the effects of ACL injury on different knee proprioception tests, 2 12 our recent systematic review 13 suggests that knee joint position sense (JPS tests have sufficient validity in discriminating ACL-injured knees from asymptomatic knees (accepted). When compared with non-injured controls, individuals with ACL injury demonstrate altered movement strategies, 4 14 quadriceps muscle weakness 15 and onset and progression of osteoarthrosis.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury: a systematic review and GRADE evidence synthesis

et al. 2021

Self Cite

View full text Add to dashboard Cite

ObjectiveTo systematically review and summarise the evidence for the effects of neuromuscular training compared with any other therapy (conventional training/sham) on knee proprioception following anterior cruciate ligament (ACL) injury.DesignSystematic Review.Data sourcesPubMed, CINAHL, SPORTDiscus, AMED, Scopus and Physical Education Index were searched from inception to February 2020.Eligibility criteriaRandomised controlled trials (RCTs) and controlled clinical trials investigating the effects of neuromuscular training on knee-specific proprioception tests following a unilateral ACL injury were included.Data extraction and synthesisTwo reviewers independently screened and extracted data and assessed risk of bias of the eligible studies using the Cochrane risk of bias 2 tool. Overall certainty in evidence was determined using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool.ResultsOf 2706 articles retrieved, only 9 RCTs, comprising 327 individuals with an ACL reconstruction (ACLR), met the inclusion criteria. Neuromuscular training interventions varied across studies: whole body vibration therapy, Nintendo-Wii-Fit training, balance training, sport-specific exercises, backward walking, etc. Outcome measures included joint position sense (JPS; n=7), thresholds to detect passive motion (TTDPM; n=3) or quadriceps force control (QFC; n=1). Overall, between-group mean differences indicated inconsistent findings with an increase or decrease of errors associated with JPS by ≤2°, TTDPM by ≤1.5° and QFC by ≤6 Nm in the ACLR knee following neuromuscular training. Owing to serious concerns with three or more GRADE domains (risk of bias, inconsistency, indirectness or imprecision associated with the findings) for each outcome of interest across studies, the certainty of evidence was very low.ConclusionsThe heterogeneity of interventions, methodological limitations, inconsistency of effects (on JPS/TTDPM/QFC) preclude recommendation of one optimal neuromuscular training intervention for improving proprioception following ACL injury in clinical practice. There is a need for methodologically robust RCTs with homogenous populations with ACL injury (managed conservatively or with reconstruction), novel/well-designed neuromuscular training and valid proprioception assessments, which also seem to be lacking.PROSPERO registration numberCRD42018107349.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Limitations and Future Recommendationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury: a systematic review and GRADE evidence synthesis

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…The stability of the knee joint is destroyed with ACL injury, and the tibia will move forward, resulting in abnormalities in the shape and position of the meniscus and posterior cruciate ligament. These abnormalities can be used as indirect signs for the diagnosis of ACL injury (17,18).…”

Section: Discussionmentioning

confidence: 99%

The accuracy of MRI in the diagnosis of anterior cruciate ligament injury

Zhao¹,

Zhou²,

Chang³

et al. 2020

Ann Transl Med

View full text Add to dashboard Cite

Background: Anterior cruciate ligament (ACL) injury can cause damage to the meniscus and articular cartilage, and may even lead to osteoarthritis. This study aimed to analyze the accuracy and feasibility of magnetic resonance imaging (MRI) imaging signs in the diagnosis of knee joint ACL injury.Methods: A total of 78 patients admitted to our hospital from June 2018 to October 2019 with highly suspected ACL injury were selected for this prospective study. We used MRI and arthroscopy to diagnose the ACL injuries, and the results of MRI and arthroscopy, as well as the value of MRI in diagnosing ACL injury, were compared.Results: Among the 78 participants, 66 cases were diagnosed with ACL injury (28 with complete tear, 38 with partial tear), and 12 were normal according to arthroscopy. Among the 66 cases with ACL injury, 63 (95.45%) were confirmed by MRI detection. The sensitivity, specificity, and accuracy of MRI in the diagnosis of ACL injury were 95.45% (63/66), 91.67%, and 94.87%, respectively. The accuracy of MRI in the diagnosis of complete and partial tears were 92.86% and 94.74%, respectively. Among the four direct MRI signs of ACL injury, the differences in interruption of ACL continuity, thickening and edema, and abnormal walking were statistically significant (P<0.05). Among the 8 indirect MRI signs, all showed high specificity and low sensitivity, and which the specificity of posterior cruciate ligament index, Notch sign, meniscus exposure sign of posterior ankle, and lateral collateral ligament monolayer display showed higher specificity (P<0.05).Conclusions: Examination with MRI offers high accuracy in the diagnosis of ACL injury, and has good consistency with arthroscopic diagnosis, which can provide reliable guidance for the selection and formulation of clinical surgery plans, and might be used as the first choice for the non-traumatic diagnosis of ACL injury.

show abstract

Properties of Knee Joint Position Sense Tests for Anterior Cruciate Ligament Injury: A Systematic Review and Meta-analysis

Strong

Arumugam

Tengman

et al. 2021

Orthopaedic Journal of Sports Medicine

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Psychometric properties of knee proprioception tests targeting healthy individuals and those with anterior cruciate ligament injury managed with or without reconstruction: a systematic review protocol

Cited by 7 publications

References 49 publications

Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury: a systematic review and GRADE evidence synthesis

Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury: a systematic review and GRADE evidence synthesis

The accuracy of MRI in the diagnosis of anterior cruciate ligament injury

Properties of Knee Joint Position Sense Tests for Anterior Cruciate Ligament Injury: A Systematic Review and Meta-analysis

Contact Info

Product

Resources

About