Proprioception assessment in subjects with idiopathic loss of shoulder range of motion: joint position sense and a novel proprioceptive feedback index.

Abstract

We examined the effects of elevation range and plane on shoulder joint proprioception in subjects with idiopathic loss of shoulder range of motion (ROM). Joint position sense (JPS) and a novel proprioceptive feedback index (PFI), including difference magnitude and the similarity index, were used to assess proprioception. Twelve subjects (eight male, four female) with involved stiff shoulders and normal opposite shoulders were recruited from a university hospital. Subjects attempted to repeat six target positions. Target positions consisted of arm elevation in three planes (frontal, scapular, and sagittal planes) and two ranges (end/mid range). Six trials of each target position were used to determine acceptable trials for stabilization of the data, less than 5% of the cumulative mean values for at least three successive trials. The data stabilized at the sixth repetition. Compared to control shoulders, involved shoulders had enhanced proprioception during end range movements (p < 0.05). The magnitude of the repositioning error and difference magnitude decreased (1.6 degrees -3.5 degrees for repositioning error and 22.2 degrees -62.1 degrees for difference magnitude), whereas similarity index improved at end range movements compared to mid range movements (p < 0.05) in involved stiff shoulders. Results of JPS and PFI suggest that both capsuloligamentous and musculotendinous mechanoreceptors play an important role in proprioception feedback during active movements in subjects with idiopathic loss of shoulder ROM.