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Bryan L. Riemann, Nancy Caggiano Tray and Scott M. Lephart

Objectives:

To determine the physiological adaptations that might occur with a 4-week unilateral multiaxial training program in lower leg kinesthesia, peak torque, and postural control.

Study Design:

True experimental pretest-posttest control-group design.

Setting:

Research laboratory.

Subjects:

26 healthy, active subjects (14 men, 12 women).

Interventions:

Subjects were assigned to an experimental or control group. The experimental group performed multiaxial coordination training 3 days/wk for 4 weeks.

Main Outcome Measures:

Both groups were tested 3 times, pretest and 2 and 4 weeks after training was initiated. Outcome measures included conscious appreciation of ankle kinesthesia, eversion and dorsiflexion isokinetic peak torque, and static and functional postural control.

Results:

Results revealed a significant Group × Test interaction only for inversion kinesthesia.

Conclusions:

Four weeks of multiaxial coordination training did not significantly improve any of the dependent variables in healthy individuals. Further research should consider the effects of such a program on injured subjects.

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Joseph S. Soltys and Sara E. Wilson

Regulating spinal motion requires proprioceptive feedback. While studies have investigated the sensing of static lumbar postures, few have investigated sensing lumbar movement speed. In this study, proprioceptive contributions to lateral trunk motion were examined during paraspinal muscle vibration. Seventeen healthy subjects performed lateral trunk flexion movements while lying prone with pelvis fixed. A 44.5-Hz vibratory stimulus was applied to the paraspinal muscles at the L3 level. Subjects attempted to match target paces of 9.5, 13.5, and 17.5 deg/s with and without paraspinal muscle vibration. Vibration of the paraspinal musculature was found to result in slower overall lateral flexion. This effect was found to have a greater influence in the difference of directional velocities with vibration applied to the left musculature. These changes reflect the sensitivity of lumbar velocity sense to applied vibration leading to the perception of faster muscle lengthening and ultimately resulting in slower movement velocities. This suggests that muscle spindle organs modulate the ability to sense velocity of motion and are important in the control of dynamic motion of the spine.

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Page Wornom Zanella, S Matthew Willey, Sonia L Seibel and Christopher J Hughes

Context:

There is a lack of research on the effects of scapular tape on shoulder joint repositioning.

Objective:

To quantify the effects of scapular taping on shoulder joint repositioning during flexion and abduction.

Design:

Repeated measures before and after trial.

Setting:

Academic institution.

Participants:

36 subjects without shoulder pathology.

Intervention:

Scapular taping with flexion and abduction.

Main Outcome Measures:

Lateral scapular slide test, plumb-line assessment, and a depth measurement. Absolute error in joint repositioning in flexion and abduction at 3 angles with and without scapular taping was measured.

Results:

No differences were found for tape vs no tape in flexion (P = .92) or abduction (P = .40) or between winging and nonwinging subjects in flexion (P = .62) or abduction (P = .91).

Conclusions:

Scapular taping has no effect on joint repositioning during active shoulder flexion or abduction. Scapular winging does not affect active joint repositioning after scapular taping.

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Cynthia J. Wright and Brent L. Arnold

Context:

Force sense (FS), the proprioceptive ability to detect muscle-force generation, has been shown to be impaired in individuals with functional ankle instability (FAI). Fatigue can also impair FS in healthy individuals, but it is unknown how fatigue affects FS in individuals with FAI.

Objective:

To assess the effect of fatigue on ankle-eversion force-sense error in individuals with and without FAI. Design: Case control with repeated measures.

Setting:

Sports medicine research laboratory.

Participants:

32 individuals with FAI and 32 individuals with no ankle sprains or instability in their lifetime. FAI subjects had a history of ≥1 lateral ankle sprain and giving-way ≥1 episode per month.

Interventions:

Three eversion FS trials were captured per load (10% and 30% of maximal voluntary isometric contraction) using a load cell before and after a concentric eversion fatigue protocol.

Main Outcome Measures:

Trial error was the difference between the target and reproduction forces. Constant error (CE), absolute error (AE), and variable error (VE) were calculated from 3 trial errors. A Group × Fatigue × Load repeated-measures ANOVA was performed for each error.

Results:

There were no significant 3-way interactions or 2-way interactions involving group (all P > .05). CE and AE had a significant 2-way interaction between load and fatigue (CE: F 1,62 = 8.704, P = .004; AE: F 1,62 = 4.024, P = .049), and VE had a significant main effect for fatigue (F 1,62 = 5.130, P = .027), all of which indicated increased FS error with fatigue at 10% load. However, at 30% load only VE increased with fatigue. The FAI group had greater error as measured by AE (F 1,62 = 4.571, P = .036) but not CE or VE (P > .05).

Conclusions:

Greater AE indicates that FAI individuals are less accurate in their force production. Fatigue impaired force sense in all subjects equally. These deficits provide evidence of impaired proprioception with fatigue and in individuals with FAI.

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Katya Trousset, David Phillips and Andrew Karduna

, 2002 ). Accurate information regarding position of limbs is necessary to successfully perform movements of daily living and athletic performance ( Riemann & Lephart, 2002 ). Conscious interpretation of afferent proprioceptive information can be divided into three subdivisions: kinesthesia, joint

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Marc R. Safran, Christopher D. Harner, Jorge L. Giraldo, Scott M. Lephart, Paul A. Borsa and Freddie H. Fu

Proprioceptive deficits have been demonstrated following anterior cruciate ligament (ACL) disruption, but little research exists evaluating proprioception in the posterior cruciate ligament (PCL)-deficient and/or -reconstructed knee. We have studied proprioception in PCL-deficient and PCL-reconstructed knees. The following summarizes our protocol and results of proprioceptive testing of kinesthesia and joint position sense in participants with isolated PCL injuries and those who underwent PCL reconstruction. We studied 18 participants with isolated raptures of the PCL and 10 participants who underwent PCL reconstruction. Proprioception was evaluated by two tests: the threshold to detect passive motion (TTDPM) and the ability to passively reproduce passive positioning (RPP). These assess kinesthesia and joint position sense, respectively. We have shown that isolated PCL deficiency in the human knee does result in reduced kinesthesia and enhanced joint position sense. Thus, the proprioceptive mechanoreceptors in the PCL do appear to have some function. We further found that PCL reconstruction significantly improved kinesthesia at 45° of knee flexion, while 110° was not significantly different between the involved and uninvolved knee in both studies.

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Scott M. Lephart, Mininder S. Kocher, Freddie H. Fu, Paul A. Borsa and Christopher D. Harner

Injury to the anterior cruciate ligament (ACL) is thought to disrupt joint afferent sensation and result in proprioceptive deficits. This investigation examined proprioception following ACL reconstruction. Using a proprioceptive testing device designed for this study, kinesthetic awareness was assessed by measuring the threshold to detect passive motion in 12 active patients, who were 11 to 26 months post-ACL reconstruction, using arthroscopic patellar tendon autograft (n=6) or allograft (n=6) techniques. Results revealed significantly decreased kinesthetic awareness in the ACL reconstructed knee versus the uninvolved knee at the near-terminal range of motion and enhanced kinesthetic awareness in the ACL reconstructed knee with the use of a neoprene orthotic. Kinesthesia was enhanced in the near-terminal range of motion for both the ACL reconstructed knee and the contralateral uninvolved knee. No significant between-group differences were observed with autograft and allograft techniques.

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C. Buz Swanik, Scott M. Lephart, Frank P. Giannantonio and Freddie H. Fu

Anterior cruciate ligament (ACL) injury disrupts static and dynamic knee restraints, compromising functional stability. Deafferentation of ACL mechan-oreceptors alters the spinal reflex pathways to motor nerves and muscle spindles in addition to the cortical pathways for conscious and unconscious appreciation of proprioception and kinesthesia. These pathways are required by the feed-forward and feedback neuromuscular control systems to dynamically stabilize joints. Feed-forward motor control is responsible for preparatory muscle activity, while feedback motor control regulates reactive muscle activity. The level of muscle activation, preparatory or reactive, influences muscular stiffness, thereby providing dynamic restraint for the ACL-deficient athlete. Rehabilitation protocols should incorporate activities that enhance muscle stiffness while encouraging adaptations to peripheral afferents, spinal reflexes, and cortical motor patterns. Four elements crucial for reestablishing neuromuscular control and functional stability are proprioceptive and kinesthetic awareness, dynamic stability, preparatory and reactive muscle characteristics, and conscious and unconscious functional motor patterns.

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Amanda L. Ager, Dorien Borms, Magali Bernaert, Vicky Brusselle, Mazarine Claessens, Jean-Sébastien Roy and Ann Cools

visual feedback. 2 The nomenclature of proprioception has evolved to reflect an overarching theme, which includes kinesthesia (the awareness of passive or active joint movement), joint position sense (the reproduction of joint angles actively or passively), as well as our sense of force production

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Original Research Reports Sleep Efficiency and Overreaching in Swimmers Sean P. Wall * Carl G. Mattacola * C. Buz Swanik * Susan Levenstein * 4 2003 12 1 1 12 10.1123/jsr.12.1.1 Research Unilateral Multiaxial Coordination Training and Ankle Kinesthesia, Muscle Strength, and Postural Control