Lower Extremity Position Test: A Simple Quantitative Proprioception Assessment
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 12, Issue 5
Abstract
Objective: To develop a quantitative, easy to use and inexpensive tool, for assessing proprioception of the lower extremity of older population, to evaluate its test-retest reliability in young and older adult population and examine its known-groups validity. Design: Tool development and prospective test-retest assessment, one week apart, with a single assessor. Participants: Older adults (n=60) and young subjects (n=20). Main Outcome Measures: The Lower extremity position test (LEPT): seated subjects were asked to reproduce 12 cm or 22 cm distances, by verbally stopping passive movement of the foot produced by the tester on a plastic surface with distance markings. The deviation from the target point was measured as the mismatch score. T-test, ICC and Bland-Altman tests were used to determine group/leg differences and test-retest reliability. Results: There was no difference in performance between the right and left extremity performance for older subjects. Good to fair test-retest reliability was demonstrated in the older subjects’ group. The 95% repeatability ranges were group related. Conclusion: The Lower Extremity Position Test (LEPT) is a newly-developed testing tool with good clinical utility, reliable in older adults, and has known-group validity.Proprioception is the sense that enables to perceive the body’s movement and position, and permits smooth and coordinated motor performance. It includes sense of position and of movement, along with sense of weight and movement velocity and direction [1,2]. Balance and gait performance are correlated with lower extremity position sense acuity, and proprioceptive decline is correlated with mobility decline and with risk of falls [3,4]. Falls are the most frequent mechanism of injury in elderly population, with high economical cost [5]. Proprioception is deteriorating in average in older adults, as seen for other senses, but not necessarily in all [6,7]. Therefore, assessment of proprioception performance is of interest in order to plan appropriate prevention and treatment. Proprioception assessment has been widely addressed in the last years, and is agreed to be of importance for diagnosis, for impairment degree assessment, for change over time and for the evaluation of treatment effect [1,2,8,9]. However, to date quantitative methods are expensive and clinically unavailable, and therefore not in routine use [1]. Clinically, lower extremity proprioception is measured predominantly by assessing detection of movement and/or discrimination of movement direction, following passive movement of the joint; presenting categorical ratings (intact, impaired, absent; 0-1-2) [2,10].Thus, there is a need for a quantitative proprioception assessment tool that will meet requirements of psychometric properties and of clinical utility (in terms of cost, time to administer, limited need for special equipment and training, and portability) [1,10]. The brief kinesthesia test is such a quantitative tool for assessing upper extremity proprioception. It is brief, easy to administer, inexpensive, and able to evaluate performance in population of different ages, while offering a ratio scale [11].
Authors and Affiliations
Hadas Ofek, Mordechai Alperin, Yocheved Laufer
Keywords
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- EP ID EP593833
- DOI 10.26717/BJSTR.2019.12.002306
- Views 163
- Downloads 0
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