Background: Older adults use different ankle muscle activation patterns during difficult static balance conditions. It has been suggested that this is related to a decline in proprioception with age, resulting in reduced postural balance. However, the association between proprioception and ankle muscle activity during quiet standing has not been directly assessed. Objects: This study aimed to investigate the effects of age and sensory condition on ankle muscle activity and the association between ankle proprioception and ankle muscle activity. Methods: We recruited 10 young women and 9 older women. Ankle proprioception was evaluated using joint position sense (JPS) and force sense (FS) divided by dorsiflexion and plantarflexion. The electromyographic activity of the tibialis anterior (TA) and gastrocnemius (GCM) muscles was collected during quiet standing. Results: Older women activated GCM muscle more than young during quiet standing and when performing difficult tasks. Older women had more errors in JPS dorsiflexion and FS plantarflexion than did young. The GCM muscle activity is related to JPS dorsiflexion and FS plantarflexion. Conclusion: Lower proprioception of the GCM with age leads to increased muscle activity, resulting in reduced postural balance. There was no difference in TA proprioception or muscle activity among older women with frequent physical activity.

Background: Neuromuscular electrical stimulation (NMES) is a physical modality used to activate skeletal muscles for strengthening. While voluntary muscle contraction (VMC) follows the progressive recruitment of motor units in order of size from small to large, NMES-induced muscle contraction occurs in a nonselective and synchronous pattern. Therefore, the outcome of muscle strengthening training using NMES-induced versus voluntary contraction might be different, which might affect balance performance. Objects: We examined how the NMES training affected balance and proprioception. Methods: Forty-four young adults were randomly assigned to NMES and VMC group. All participants performed one-leg standing on a force plate and sat on the Biodex (Biodex R Corp.) to measure balance and ankle proprioception, respectively. All measures were conducted before and after a training session. In NMES group, electric pads were placed on the tibialis anterior, gastrocnemius, and soleus muscles for 20 minutes. In VMC group, co-contraction of the three muscles was conducted. Outcome variables included mean distance, root mean square distance, total excursion, mean velocity, 95% confidence circle area acquired from the center of pressure data, and absolute error of dorsi/plantarflexion. Results: None of outcome variables were associated with group (p > 0.35). However, all but plantarflexion error was associated with time (p < 0.02), and the area and mean velocity were 37.0% and 18.6% lower in post than pre in NMES group, respectively, and 48.9% and 16.7% lower in post than pre in VMC group, respectively. Conclusion: Despite different physiology underlying the NMES-induced versus VMC, both training methods improved balance and ankle joint proprioception.

Background: Previous studies have reported that improving the spinal stability could be more effective in the prevention and treatment of recurrence. Lumbar stabilization exercise is known to strengthen the lumbar extension muscles and enhance physical, psychological and social functions. Objectives: To investigated the effect of lumbar spiral stenosis on the kinetic link training and lumbar stabilization exercise. Design: A randomized controlled trial. Methods: Study was preformed by randomly allocated 28 LSS participants into a kinetic link training group (KLT, n=14) and a lumbar stabilization exercise group (LSE, n=14). Kinetic link training and lumbar stabilization exercise were performed to subjects in both groups 5 times a week for 6 weeks. To verify the effect of LSS, changes in VAS, ODI, and proprioception before and after intervention were observed. Results: In KLT, statistically significant changes were found in VAS, ODI, and Proprioception before and after intervention. In LSE, there were significant changes in VAS and ODI before and after intervention. KLT and LSE before and after intervention indicated significant differences in proprioception. Conclusion: KLT and LSE are applied to LSS, there are effects of pain decrease, lumbar recovery and proprioception improvement.

Background: During postural control, older adults are more dependent on proprioception than are young adults. Ankle proprioception, which plays an important role in maintaining postural balance, decreases with age. Published studies are insufficient to establish a significant age difference in postural sway resulting from the known age-related decrease in ankle proprioception and do not examine various detailed test conditions. Objects: The present study aimed to compare ankle proprioception between older and younger groups along dimensions of position vs. force proprioception and dorsiflexion vs. plantarflexion. The present study also aimed to compare postural sway between young and older women during quiet standing under two sensory conditions. Methods: We recruited seven young women aged 21–24 and seven older women aged 60–63. Ankle proprioception was assessed as the accuracy of the joint position sense (JPS) and the force sense (FS). Postural sway was assessed using center-of-pressure measurements recorded during quiet standing under two sensory positions: eyes open and eyes closed with head tilted back. Results: Older women had lower JPS in dorsiflexion and lower FS in plantarflexion than did younger women. We found no significant age differences in JPS in plantarflexion or in FS in dorsiflexion. We observed a main effect of group on postural sway in two sway parameters out of three. We observed significant differences in JPS with dorsiflexion, and in FS with plantarflexion. Conclusion: Proprioception for ankle plantar flexor decreased more significantly with aging than did that for ankle dorsiflexor, accounting for the impaired postural balance observed in older women.

Background: Whole-body vibration (WBV) has been used to alleviate proprioceptive damage by musculoskeletal and neurological conditions. However, no study has determined whether wearing shoes while applying WBV can affect proprioception precision of the knee joint. Objects: This study aimed to determine the differences in the proprioceptive precision of the knee joint before and after WBV and to compare the proprioceptive precision of the knee joint between barefoot and shoe-wearing conditions. Methods: This study recruited 33 healthy participants. A passive-to-active angle reproduction test was used to measure the proprioception precision of the knee joint using an electrogoniometer, and the target angle was set to a knee flexion of 30°. Proprioception precision was calculated using the error angle (angular difference from 30°). Proprioceptive precision was measured in weight-bearing and non-weight-bearing positions before and after applying WBV for 20 minutes at 12 Hz in barefoot and shoe-wearing conditions. Mixed repeated analysis of variance was used to determine the differences in changes in the proprioceptive precision of the knee joint according to foot conditions. Results: There were significant improvements in the weight-bearing (p = 0.002) and nonweight- bearing (p < 0.001) proprioceptive precision of the knee joint after applying WBV. However, there was no significant difference in the change in proprioceptive precision of the knee joint after applying WBV between the barefoot and shoe-wearing conditions. Conclusion: WBV stimulation had an immediate effect on improving the proprioceptive precision of the knee joint. However, foot conditions (barefoot or shoe-wearing) during WBV application did not influence the proprioceptive precision of the knee joint.

Background: The spinal nerves, which start at the lumbar level, are connected to the nerve innervation in the knees. Currently, there is a lack of research on the treatment of knee pain through lumbar mobilization. Objectives: To investigate the effects of lumbar joint mobilization (LJM) and transcutaneous electronic nerve stimulation (TENS) on proprioception and muscular strength in volleyball players with chronic knee pain. Design: Two group pre-posttest. Methods: A total of 26 professional volleyball players with chronic knee pain were allocated to the LJM (n=13) and TENS (n=13) groups. In the LJM group, grade III - IV amplitude was applied 3 times for 1 minute (80 times per minute) at the affected lumbar (L2-3) facet joint in the prone position. In the TENS group, the TENS treatment device was used to directly apply or 15 minutes to the area of chronic knee pain (100 Hz, 150 ㎲). Proprioception was measured by knee flexion and extension angles, and muscle strength was evaluated using an isokinetic test. Measurements were taken before and after interventions. Results: In the eye opened conditiond, proprioception significantly increased during both knee extension and flexion after LJM, while only knee extension was significantly increased in the TENS group. There was also a significant difference in knee extension between the two groups. In the eye close conditiond, proprioception was significantly improved only during knee extension in the LJM group, and the difference in knee extension between the groups was also significant (P<.05). The maximum torque of the affected knee joint was significantly improved at 60°/sec in both groups (P<.05); however, there was no difference between the two groups. There was no significant difference in the maximum flexion torque within or between the groups. Conclusion: This study suggests that LJM improved proprioception and muscular strength in volleyball players with chronic knee pain.

Background: The importance of postural stabilization and cervical mobilization in subjects with pain from the anterior head posture is drawing more attention. However, studies on head and neck stabilizing intervention after mobilization are lacking. Objective: To examine the effects of Kinesiotaping and posture setting exercise on forward head posture (FHP). Design: Crossover Study Design Methods: The subjects were 17 male and female college students in their 20s with FHP. They were randomized into the Kinesiology taping group (KTG) with 9 subjects and posture stabilizing exercise group (PSEG) with 8 subjects. The intervention was conducted for 4 weeks, and changes in pain, craniovertebral angle (CVA), and proprioception were observed before and after intervention. Results: Pain was significantly reduced in the KTG and PSEG both before and after intervention. CVA and proprioception were significantly increased only in the PSEG. The differences in CVA and proprioception between the two groups were significant. Conclusions: These findings suggest that the application of posture setting exercise could decrease pain, proprioceptive error and increase CVA on FHP

Background: Functional ankle instability (FAI) indicating a decrease in muscle strength, proprioception, neuromuscular control, balance and postural control function. Objective: To investigate the effect of jumping exercise on the supporting surface on the ankle muscle thickness, proprioceptive sensation, and balance in adults with FAI. Design: Randomized Controlled Trial. Methods: Twenty young people with FAI were randomly assigned to the unstable supporting surface jump group (N=10) and the stable supporting surface jump group (N=10). The intervention was conducted three times a week for eight weeks, and for 30 minutes per session. Trampoline was used as an unstable support surface and the stable support surface was carried out on a regular floor. The thickness of the tibialis anterior muscle and medial gastrocnemius muscle was measured by ultrasonography, and the proprioception of dorsiflexion and plantarflexion was measured using an electrogoniometer. The dynamic balance was also measured with a balance meter. Results: The the muscle thickness of the medial gastrocnemius muscle was significantly higher in the stable supporting surface jump group than in the unstable supporting surface jump group (p<.05). Furthermore, the plantar flexion proprioception and dynamic balance were significantly improved in the unstable supporting surface jump group than in the stable supporting surface jump group in the intergroup comparison (p<.05). Conclusions: The conclusion has been reached in this study that the jumping exercise on the unstable supporting surface could be a more effective in improving FAI than the regular surface.

The purpose of this study was to assess the changes in balance and proprioception of adults with limited ankle joint dorsiflexion, after the application of talocrural joint mobilization. The subjects of this study included 23 college students in their twenties with limited ankle joint dorsiflexion. The students were randomly assigned to the ankle joint mobilization group (AJMG, n=12) and the control group (CG, n=11). After 2 weeks of intervention using grade III talocrural joint mobilization in the anterior-posterior movement, the balance and proprioception of the subjects were assessed. Static/dynamic balance capabilities and ankle proprioception were analyzed using paired t-test and independent t-test. The dynamic balance and proprioception of AJMG were significantly improved after intervention (p<.05), In the comparison between the groups after the intervention, the dynamic balance and proprioceptive sense of AJMG were significantly improved compared to the control group (p<.05). This study suggests that AJMG can help improve the dynamic balance and proprioception.

To examine the changes in pain, the severity of the neck disorder, craniovertebral angle, and muscle activity in young adults with forward head posture. 37 “N” University students in their 20s with forward head posture, including both male and female participants. Measurement of pain, NDI (neck disorder index) craniovertebral angle, and muscle activity were taken before and after the 6 week intervention period. The pain was measured using the visual analog scale. The severity of the neck disorder was measured using the NDI The craniovertebral angle was measured by taking a photo. The muscle activity was measured using surface electromyography. Neck posture correction exercises paired with proprioceptive training is the most effective intervention for reducing pain. Both neck posture correction exercises paired with Kinesio taping or proprioceptive training are effective interventions for addressing neck disability, craniocervical angle, and muscle activity. Neck posture correction exercises paired with Kinesio taping or proprioceptive training are more effective at addressing pain, neck disorder, craniocervical angle, and muscle activity than performing the neck posture correction exercises alone.

The purpose of this study was to investigate the effects of sling exercise on muscle activity and balance on football players with chronic ankle instability. Eight subjects performed Biodex and sling exercises for four weeks and compared the muscle activity and balance ability of the uninjured and injured feet. Stable and unstable foot % MVIC did not change significantly after treatment in all muscles. The total balance ability was not significantly different between the two groups, however, increased only in the unstable side. The anterior/posterior balance ability also represented no significant difference between the groups and was significantly improved only in the unstable side. The medial/lateral balance ability was not significantly different between the groups and was significantly improved only in the unstable side. This study suggests that sling exercise contributes to improving % MVIC, total balance ability, anterior/ posterior balance ability, and medial/lateral balance ability of the unstable side.

The purpose of this study was to verify prprioception perception and compare between collegiate golfers and non-golfers using tilting platform. Thirty golfers and twenty-eight non-golfers were participated. All participants were performed perception test on the tilting platform. Frequency analysis was performed using SPSS(ver. 24.0) to determine the perception response according to the grade, and performed using independent t-test. Most participants were perceived from 1° to 2° of slopes and perceived left-right slope than forward-backward slope. Repeated practice such as walking on the uneven ground or standing on sloped ground might help to improve proprioception perception. Future research using a tilting platform will be to develop the training program.

The purpose of this study was to compare the effects of Kinesio taping in each area of the ankle versus the knee to improve balance abilities and proprioception sense. The healthy twenty eight students were divided into two groups, Group A and B. Ankle taping was applied to Group A, and knee taping was applied to Group B. In the ankle taping group, significant increase of dynamic balance abilities was appeared in the forward, left ward and right ward (p<.05). In the knee taping group, there was significant increase of dynamic balance abilities in the forward and left ward (p<.05). There was no significant increase of static balance abilities in both groups. In both groups of ankle and knee taping, there was significant increase of proprioception sense. These findings suggest that ankle and knee taping was helpful for improving dynamic balance abilities and proprioception sense.

Background: Many studies have reported positive results of the various mirror training and virtual reality games in improving dynamic standing balance and posture adjustment in chronic stroke patients. However, no systematic study has been conducted to compare the effects of virtual reality games and the mirror balance training. Objects: The purpose of this study was to compare the effectiveness of Wii balance games and Mirror Self- Balancing Exercises in improving proprioception of knee joint and standing balance of people with chronic stroke. Methods: Twenty patients with chronic stroke volunteered for this study. The subjects were randomly divided into a Wii balance games group and a Mirror Self-Balancing Exercises group with 10 patients in each group. Each training was performed for 30 mins a day for 4 days. In addition to the balance training, 30 mins neuro-developmental-treatment based routine physical therapy was given to both groups. Proprioception was measured using two continuous passive motion devices, and static balance was measured using a Wii balance board. Dynamic balance assessment tools included the Berg Balance Scale, Dynamic Gait Index, and Timed Up-and-Go test. Results: All measured variables before and after the experimental results showed a significant improvement in both groups (p<.05). Only the improvement of the affected knee proprioception appeared to be significantly greater in the Wii balance game group (p<.05). However, other variables did not differ between the groups (p>.05). Conclusion: The findings suggest that both Wii balance games and Mirror Self-Balancing Exercises may be helpful for improving the proprioception of knee joint and the balance of patients with chronic stroke.

We investigated the effects of a Virtual reality(VR) program on the proprioception and instability of functional ankle instability(FAI) patients. Among the 20s old individuals who lived in Republic of Korea; 20 people were selected through a public participation process. The 20 participants were then randomly divided into two groups, one of strength exercise(n=10) and one of balance exercise(n=10). Of the patients who had experienced an ankle sprain in the past and currently felt ankle instability, those who recorded 24 points or less on the Cumberland ankle instability tool(CAIT) were determined to have FAI. We selected the strength exercise and balance exercise in the Nintendo Wii Fit Plus as a VR program. The subjects used the program on the Wii Balance Board three times per week for 20 minutes and total 10-minute warm-up and down for four weeks. Proprioception and CAIT of the balance exercise group were improved significantly after the exercise compared to before the exercise(p<.05). Authors recommend that the balance exercise in the VR program be used as an aid for physical therapeutic intervention.

The purpose of this study was to investigate the effect of lumbar stabilization training and additional thoracic mobilization on pain, proprioception and static balance in patients with chronic low back pain. The subjects of this study were 48 chronic low back pain patients who were randomly allocated to an experimental group 1 (n1=16, lumbar stabilization and thoracic mobilization, thoracic hypomobility), experimental group 2 (n2=16, lumbar stabilization and thoracic mobilization, thoracic normal mobility), and a control group (n3=16, lumbar stabilization, thoracic hypomobility) after a thoracic mobility test. Both experimental groups underwent lumbar stabilization training and additional thoracic mobilization. The control group underwent only lumbar stabilization training. The intervention was performed 3 times per week, 30 minutes each time, for a total of 6 weeks. Thoraco-lumbar joint reposition error was measured using an electrogoniometer and static balance ability was measured using the Tetrax posture analysis system. Subjects’ pain level was measured using a 100 ㎜ visual analogue scale. Statistical analyses were performed using a one-way analysis of variance and a paired t-test. Post-hoc testing was carried out with a Bonferroni test. The pain level was significantly lower in both experimental groups compared to the control group. Both experimental groups showed significant reductions in joint reposition error angle (flexion, extension, and side bending) compared to the control group. The static balance level was significantly lower in both experimental groups than in the control group. In summary, lumbar stabilization exercises and additional thoracic mobilization significantly improved the pain level, proprioception, and static balance in patients with chronic low back pain.

The purpose of this study was to examine the differentiation of proprioception, invertor and evertor muscle strength, and time to peak torque at a velocity of 300 °/sec of the ankle joint in people with or without functional ankle instability (FAI). Nineteen subjects with a history of ankle sprain participated. All subjects were divided into FAI group (n1=9, Cumberland ankle instability tool (CAIT)≤24) and a control group (n2=10) based on their CAIT scores. Isokinetic dynamometer was used to measure the sense of active joint position of the ankle at mid-range and end-range of an inversion motion and invertor as well as the evertor muscle strength and time to peak torque at 300 °/s. The FAI group showed a statistically reduction in invertor and evertor muscle strength and time to peak torque when compared to the control group (p<.05). Muscle strength and time to peak torque of the invertor and evertor, as well as the sense of active joint position at end-range were also lower in the FAI group than in the control (p<.05). Correlations between CAIT score and position sense at end-range (r=-.577) and invertor muscle strength (r=.554) were statistically significant (p<.05). Individuals with FAI showed reduction in invertor and evertor muscle strength and recruitment time as well as in proprioception of the ankle joint. Thus, proprioception and invertor and evertor muscle strength of the ankle joint at fast angular velocity may be investigated when examining and planning care for individuals with FAI.

The purpose of this study is to examine the influence of a horse riding simulator and galvanic vestibular stimulation on improving the ability to balance posture and proprioception. Thirty healthy adults participated and were randomly assigned to a horse riding simulator group (=10), galvanic vestibular stimulation (GVS) group (=10), control group (=10). Experiment groups were trained 3 times per week over 6 weeks. The ability to balance posture was measured by force plate and proprioception was measured by Joint position sense. The following results were obtained. the changes of balance index were significant interaction in each group in accordance with the experiment time in 0, 3 and 6 weeks (p<.05). All groups showed the most decreasing pattern compared with the control group. But was not statistically significant. Proprioception was significant interaction in each group in accordance with the experiment time (p<.05). All groups showed the most decreasing pattern compared with the control group. The above results indicated that the 6 weeks horse riding simulator and galvanic vestibular stimulation training demonstrated positive effects in the ability to balance posture and proprioception. These results suggest that the horse riding simulator and galvanic vestibular stimulation training could be therapeutic intervention that can improve balance and postural control.

목적 : 본 연구의 목적은 첫째, 체성감각 수용기의 활성화인 마찰에 의한 통증 입력이 고유수용성 감각에 미치는 영 향을 알아보고 둘째, 작업수행 기술 수준에 따른 작업수행 요인 중 하나인 고유수용성 감각의 변화를 규명하는 것 이다. 연구방법 : 실험군으로 1년 간 작업 실습에 참가한 제철 산업 전공 남자 대학생 22명과 대조군으로 일반 남자 대학 생 22명을 선정하였고. 3차원 동작분석 장비 Winarm을 이용하여 주관절 굴곡 신전, 수근관절 굴곡 신전 시 관절 위치 오차를 측정하여 고유수용성 감각 정도를 구하였다. 이 후 빗질을 이용하여 마찰 통증을 발현하였고 고유수 용성 감각을 재측정하였다. 수집된 자료는 계산식을 이용하여 오차의 평균을 산출한 뒤 통계분석 하였다. 결과 : 주관절 굴곡, 신전과 수근관절 굴곡, 신전 시 실험군과 대조군 모두 마찰에 의한 통증 입력 이후 자세 위치 오 차가 증가하였다(p<.05). 실험군과 대조군의 자세 위치 오차의 전후 차이를 비교한 결과 주관절의 y축 오차에서만 통계적으로 유의한 차이가 나타났고 (p<.05) 다른 변인들은 모두 통계적으로 유의한 차이가 나타나지 않았다. 결론 : 체성 감각인 통증의 증가는 위치조절에 필요한 고유수용성 감각 활성을 감소시키고 통증 발현 시 작업수행 기술 수준과는 상관없이 고유수용성감각 감소는 일정한 것으로 나타났다. 따라서 산업재해 예방을 위해서는 통증 을 감소시키고 고유수용성 감각을 증가시키는 프로그램이 필요할 것으로 사료된다.

The purpose of this study was to analyze and compare the effect of resistance exercise and balance exercise on proprioception and WOMAC index of patients with degenerative knee osteoarthritis. A total of 40 subjects participated in this study. The subjects were diagnosed with degenerative knee osteoarthritis and all were more than 60 years old. They were divided into three groups. Group Ⅰ(n=8) was trained with resistance exercise, Group Ⅱ(n=6) was trained with balance exercise and GroupⅢ(n=6) was trained with range of motion as a control. The results of this study were as follows. It was significantly indicated that the resistance exercise group and balance exercise group elicited error-reduction on proprioception goal-angle (p<.05). There was a statistically significant difference on proprioception between resistance exercise group and control(range of motion) group. There was a statistically significant reduction on WOMAC index between resistance exercise group and balance exercise group (p<.05) and on the WOMAC index between resistance exercise group and range of motion group(p<.05). In conclusion, resistance exercise and balance exercise are effective on degenerative knee osteoarthritis and resistance exercise is the most effective for improving proprioception and WOMAC index. More research on the intervention according to the degree of degenerative knee osteoarthritis is needed.