Can F.1, Chan D.1
1Hacettepe University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Samanpazari- Ankara, Turkey
Background: Many authors agree that proprioception can be affected by exercises. However, there is still a debate on effect of active or passive range of motion exercises for shoulder proprioception. Furthermore, there is not enough study which assess both active and passive joint position sense using objective measurement for shoulder joint.
Purpose: This study aimed to investigate acute effects of one time intervention using active and passive exercises on shoulder proprioception tested both active and passive joint position sense in healthy subjects.
Methods: 22 male and 23 female, a total of 45 sedentary healthy subjects aged between 19 and 37 years old, were randomly divided into 2 exercises group and a control group (n=15). After completion of initial testing, the subjects were assigned to Active Movement Group, Passive Movement Group and control group. Shoulder proprioception was assessed as joint position sense, and kinesthesia tested as Threshold to Detection of Passive Movement (TDPM) using original proprioception testing device (PTD) version 2.0. Dominant shoulder at 70% internal rotation (IR), 90% external rotation and 50% of ROM were measured in the sitting position. Each group received single intervention. Active Movement Group was performing active internal and external rotation of shoulder at a fixed speed. The protocol for Passive Movement Group was to replicate the active movement protocol with a single essential difference that the movement was passive. Same speed of 90°/sec and range of motion was set for passive intervention. The Control Group did not receive any intervention. On the second day, the proprioception tests have been performed before and immediately after the exercises, then 30 minutes, 1 hour and 1 day after the exercises.
Results: In the Active movement group, there was no difference in joint position sense (JPS 90% ER:0.776; JPS 50% ROM: 0.975; JPS 70% IR: 0.107 ) while some decrease in kinesthetic sense compared to baseline values (TDPM 90% ER: 0.543;TDPM 50% ROM: 0.001; TDPM 70% IR:0.540). The Passive Movement Group showed improvements in proprioception mainly at the extremes of ROM (JPS 90% ER: 0.568; JPS 50% ROM:0.320; JPS 70% IR:0.161; TDPM 90% ER: 0.210;TDPM 50% ROM:0.541;TDPM 70% IR: 0.141) after the exercises and compared to baseline (p 0.05). Active movement just recovered kinesthetic sense to equal to initial assessment and to baseline values. Passive movement through ROM at 90°/sec speed has improved JPS at 70% internal rotation and at all angles for kinesthesia. Best effect was seen in 30 minutes after the intervention ( z=2.68, p=0.007). No significant and consisted difference between the exercise groups was seen at any point.
Conclusion(s): There was differences in shoulder proprioception within the exercise groups between initial assessment and at a specific time interval after interventions.This was confirmed for passive movement whereas it was partially confirmed for the active movement.
Implications: This study will be beneficial to show the acute effects of different type of exercises on joint proprioception. Passive exercises may improve shoulder proprioception. However, clinicians should be aware of possible fatigue even with a single intervention of active movement and the subsequent negative effects on proprioception.
Funding acknowledgements: This study has been performed self-funded
Topic: Musculoskeletal: upper limb
Ethics approval: Ethical Commitee of Hacettepe University has approved this study. The Ethical Commitee report number was GO 14/96-19.
All authors, affiliations and abstracts have been published as submitted.
