| Summary: | 碩士 === 國立臺灣大學 === 物理治療學研究所 === 92 === Background: “Proprioception” is generally referred as the perception of limb position in space. Poor proprioception may result in the inability of maintaining static and dynamic posture. Active-active knee reposition test under resistance condition simulates muscle activities in daily life and is suggested by researchers to be the most proper way to assess knee proprioception. Previous studies differed in their resistance conditions under which the active-active knee reposition tests were performed. However, no study has ever compared the influence of different resistance conditions and knee joint angles in assessing knee reposition. Thus, no consistent standardized protocol has yet been established for the assessment of knee proprioception. Purposes: The purpose of this study was to compare the difference of knee joint reposition test performed during closed kinetic chain in four resistance conditions and two target angles in healthy subjects. Methods: Forty-three healthy young adults participated in the study. Four resistances conditions (25%, 50%, 75%, and 100% of body weight) and two knee joint angles (0°-30°, 30°-60°flexion) were randomly assigned to the subjects. The absolute angle error (AAE) was calculated as the difference between each target and reposition angle measured by an electrogoniometer. Repeated two-way analysis of variance (two repeated factors, 4-resistance condition and 2-target knee angle) was performed to exam the main effect and interaction. A P value of 0.05 was considered significant. Results: Forty subjects, 20 men (24.8±4.6 years old) and 20 women (24.8±3.5 years old) completed this study. There was a significant difference of the AAE in 4-resistance conditions and 2-target knee angles with no interaction between these two factors. AAE was significantly smaller under the 75% of body weight resistance condition (p=0.001) compared with 25% and 100% of body weight conditions. There was a tendency toward AAE to be smaller at greater resistance, except during 100% of body weight. These data also indicated that the target angle of 0°-30° had more precise AAE than those of 30°-60°(p<0.001). Discussions: There was a tendency toward smaller AAE at greater resistance conditions; the minimal AAE appeared at 75% but not 100% of body weight. This might due to the increased sensory input led by more muscle activities at greater resistance conditions, but when the resistance reached the body weight, the results of the test would be hampered. On the other hand, a smaller AAE appeared at the target angle of 0°-30°. This might result from the “screw home mechanism”, that is the increase tension in the knee joint capsule and more sensory inputs are provided by non-contractile tissues. Conclusions: The range in which the subject could bear performing closed chain resisted knee extension, the larger resistance resulted in a smaller AAE and a target angle of 0°-30°had a smaller AAE than those of 30°-60°. Further studies of a more precise standardized protocol to assess knee joint reposition sense in different age groups or diseases are needed, and the parameters measured in our study could be taken into account.
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