Zanesljivost meritev občutka za položaj kolenskega sklepa v zaprti in odprti kinetični verigi : pregled literature

Marinčič, Andreja (author), Puh, Urška (mentor), Palma, Polona (co-mentor)

Uvod: Propriocepcija omogoča učinkovito in koordinirano izvajanje nalog, saj nam zagotavlja informacijo o položaju in gibanju sklepov in telesa. Zavedni del propriocepcije najpogosteje ocenjujemo s kliničnim ocenjevanjem ali merjenjem občutka za položaj sklepa. Namen: Namen diplomskega dela je bil, da bi s pregledom literature ugotovili zanesljivost meritev občutka za položaj kolenskega sklepa v odprti in zaprti kinetični verigi. Metode dela: Iskanje literature smo opravili s pomočjo brskalnikov in podatkovnih zbirk PubMed in CINAHL. Vključili smo raziskave v angleškem jeziku, z opisanim protokolom meritev občutka za položaj kolenskega sklepa v zaprti ali odprti kinetični verigi. Rezultati: Vključenih je bilo deset raziskav. Za meritve zanesljivosti posameznega preiskovalca so uporabili elektrogoniometer (intraklasni koeficient korelacije v zaprti kinetični verigi znaša 0,57–0,97 in v odprti 0,17–0,79), video kamero (v zaprti kinetični verigi je intraklasni koeficient korelacije 0,90) in motorizirano napravo za merjenje propriocepcije (v odprti kinetični verigi je intraklasni koeficient korelacije 0,18–0,56). Odlično zanesljivost med preiskovalci so z uporabo elektrogoniometra ugotovili v zaprti kinetični verigi, saj je vrednost intraklasnega koeficienta korelacije 0,81-0,88 in v odprti 0,75–0,87. Avtorji so ugotovili odlično povezavo med elektrogoniometrom in video analizo v zaprti kinetični verigi (intraklasni koeficient korelacije znaša 0,94–0,98), ter med izokinetičnim dinamometrom in elektrogoniometrom (intraklasni koeficient korelacije znaša 0,63–0,92) v odprti kinetični verigi. Ugotovili so, da je propriocepcija slabša (intraklasni koeficient znaša 0,74) v tveganem položaju sklepa za poškodbo sprednje križne vezi (stopala širše od ramen, zunanja rotacija). Pri zdravih osebah so meritve v zaprti kinetični verigi zanesljivejše (absolutna napaka znaša 4,1°) v primerjavi z odprto (absolutna napaka znaša 5,5°). Občutek za položaj sklepa je po vbrizganju fiziološke raztopine v kolenski sklep slabši v odprti kinetični verigi (absolutna napaka znaša 1,41°), v primerjavi z zaprto, saj je absolutna napaka manjša (0,47°). Pri osebah po možganski kapi je bil občutek za položaj sklepa boljši v zaprti (absolutna napaka je 7,0°) v primerjavi z odprto kinetično verigo, kjer je absolutna napaka večja (12,7°). Razprava in sklep: Glede na rezultate lahko sklepamo, da so meritve občutka za položaj kolenskega sklepa bolj zanesljive v zaprti kinetični verigi, saj vključimo vse proprioceptorje, ki so pomembni pri posredovanju informacij o položaju sklepa pri vsakodnevnih aktivnostih.

• Language: Slovenian
• Keywords: propriocepcija, občutek za položaj kolenskega sklepa, odprta kinetična veriga, zaprta kinetična veriga
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-99007
• COBISS.SI-ID: 5379179
• Publication date in RUL: 20.12.2017

Secondary language

• Language: English
• Title: Reliability of the knee joint position sense measurement in open and closed kinetic chain : literature review

Abstract

Background: Proprioception enables effective and coordinated performance of tasks, as it provides us with information of the joint and body position and movement. A conscious part of proprioception is most often assessed by clinical evaluation or by measuring joint position sense. Purpose: Our goal was to determine reliability of joint position sense measurements in open and closed kinetic chain by examining the literature. Methods: We searched for literature using browsers and databases: PubMed, CINAHL. We included researches in English language, fully accessible, research in which measurement protocol is described, research that included measurements in open and closed kinetic chain. Results: We included ten researches. For intrarater reliability of knee joint position sense measurements they used electrogoniometer (intraclass correlation coefficient for closed kinetic chain = 0,57–0,97; intraclass correlation coefficient for open kinetic chain = 0,17–0,79), video camera (intraclass correlation coefficient for closed kinetic chain = 0,90), and purpose-built motorized proprioception measuring device (intraclass correlation coefficient for open kinetic chain = 0,18–0,56). Excellent interrater reliability in closed (intraclass correlation coefficient = 0,81–0,88) and in open kinetic chain (intraclass correlation coefficient = 0,75–0,87) using electrogoniometer. Excellent correlation between electrogoniometer and video analysis in closed kinetic chain (intraclass correlation coefficient = 0,94–0,98) and between isokinetic dynamometer and electrogoniometer in open kinetic chain (intraclass correlation coefficient = 0,63–0,92). Joint position sense is worse (intraclass correlation coefficient = 0,74) in risked position of the knee (feet wider than shoulders, external rotation). Among healthy adults measurements are more reliable in closed kinetic chain (absolute error = 4,1°) compared with open kinetic chain (absolute error = 5,5°). Knee joint position sense is worse in open kinetic chain after joint infusion (absolute error = 1,41°) compared with closed kinetic chain (absolute error = 0,47°). After stroke joint position sense is better in closed kinetic chain (absolute error = 7,0°) compared with open kinetic chain (absolute error = 12,7°). Discussion and conclusion: According to the results, we can conclude that the measurements of knee joint position sense are more reliable in closed kinetic chain, because we include all proprioceptors that are important in providing information of joint position sense in everyday activities.

• Keywords: proprioception, knee joint position sense, open kinetic chain, closed kinetic chain