Dynamic-Position-Sense Impairment’s Independence of Perceived Knee Function in Women With ACL Reconstruction

in Journal of Sport Rehabilitation
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Context:

There is conflicting evidence in the literature regarding whether women with anterior cruciate ligament reconstruction (ACLR) demonstrate impaired proprioception. This study examined dynamic-position-sense accuracy and central-nervous-system (CNS) processing time between those with and without long-term ACLR.

Objective:

To compare proprioception of knee movement in women with ACLR and healthy controls.

Design:

Cross-sectional.

Setting:

Human neuromuscular performance laboratory.

Participants:

11 women (age 22.64 ± 2.4 y) with ACLR (1.6–5.8 y postsurgery) and 20 women without (age 24.05 ± 1.4 y).

Interventions:

The authors evaluated subjects using 3 methods to assess position sense. During knee flexion at pseudorandomly selected speeds (40°, 60°, 80°, 90°, and 100°/s), subjects indicated with their index finger when their knee reached a predetermined target angle (50°). Accuracy was calculated as an error score. CNS processing time was computed using the time to detect movement and the minimum time of angle indication. Passive and active joint-position sense were also determined at a slow velocity (3°/s) from various knee-joint starting angles.

Main Outcome Measurements:

Absolute and constant error of target angle, indication accuracy, CNS processing time, and perceived function.

Results:

Both subject groups showed similar levels of error during dynamic-position-sense testing, despite continued differences in perceived knee function. Estimated CNS processing time was 260 ms for both groups. Joint-position sense during slow active or passive movement did not differ between cohorts.

Conclusions:

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.

Littmann, Iguchi, and Shields are with the Dept of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA. Madhavan is with the Neural Plasticity Laboratory, Rehabilitation Institute of Chicago, Chicago, IL. Kolarik is with Mercy Hospital, Council Bluffs, IA.