Guest Lecture
What does proprioception testing tell us about patellofemoral pain?
Michael Callaghan, University of Manchester, UK
Proprioception has become an increasingly common measure of joint function. Various techniques have been used to detect differences between healthy knee joints and those with OA(8), ACL deficiency(3) and PF pain(1,4). Proprioception testing has also been used as an outcome measure after therapeutic interventions. This allows researchers to show an association between symptom changes and proprioception status after treatment with braces(7), taping(2) and rehabilitation programmes(5).
Methods to assess proprioception commonly involve perception of movement (TDPM) active and passive joint position sense (JPS).
A more recent technique of assessing proprioception using vibratory perception threshold (VPT) can distinguish between healthy and OA knees(6). This method may have advantages over the TDPM and JPS techniques in terms of reliability and reproducibility, but this has yet to be fully established.
Finally, fMRI techniques provide an exciting opportunity to examine neural activity the areas of the brain associated with proprioception and co-ordination during a simple knee joint JPS task. fMRI techniques can also note the activity changes that occur when patellar tape is applied.
References
- Baker V, Bennell K, Stillman B, Cowan SM, Crossley K: Abnormal knee joint position sense in individuals with patellofemoral pain syndrome. J Orthop Res 20:208-214, 2002
- Callaghan MJ, Selfe J, McHenry A, Oldham JA: Effects of patellar taping on knee joint proprioception in patients with patellofemoral pain syndrome. Man Ther 13:192-199, 2008
- Corrigan JP, Cashman WF, Brady MP: Proprioception in the cruciate deficient knee. J Bone Joint Surg (Br) 74(B):247-250, 1992
- Kramer J, Handfield T, Keifer G, Forwell L, Birmingham TB: Comparisons of weight bearing and non weight bearing tests of knee joint proprioception performed by patients with PFPS and asymptomatic. Clin J Sport Med 7:113-118, 1997
- Panics G, Tallay A, Pavlik A, Berkes I: Effect of proprioception training on knee joint position sense in female team handball players. Brit J Sports Med 42:472-476, 2008
- Shakoor N, Agrawal A, Block JA: Reduced lower extremity vibratory perception in osteoarthritis of the knee. Arthritis & Rheumatism (Arthritis Care & Research) 59:117-121, 2008
- Van Tiggelen D, Coorevits P, Witvrouw E: The Effects of a Neoprene Knee Sleeve on Subjects With a Poor Versus Good Joint Position Sense Subjected to an Isokinetic Fatigue Protocol. Clin J Sport Med 18:259-265, 2008
- Wegener L, Kisner C, Nichols D: Static and dynamic balance responses in persons with bilateral knee osteoarthritis. J Orthop Sports Phys Ther 25:13-18, 1997
Click to read Michael Callaghan's biography
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