Ann Rehabil Med.  2017 Apr;41(2):218-224. 10.5535/arm.2017.41.2.218.

Quantitative Assessment of Proprioception Using Dynamometer in Incomplete Spinal Cord Injury Patients: A Preliminary Study

• Chang WK
• Jung YS
• Oh MK
• Kim K

• KMID: 2389479
• DOI: http://doi.org/10.5535/arm.2017.41.2.218

Abstract

OBJECTIVE
To investigate the feasibility of a knee proprioception evaluation using a dynamometer as a tool for evaluating proprioception of the lower extremities in patients with incomplete spinal cord injury (SCI), and to explore its usefulness in predicting the ambulatory outcome.
METHODS
A total of 14 SCI patients (10 tetraplegic, 4 paraplegic; all AIS D) were included in this study. The passive repositioning error (PRE) and active repositioning error (ARE) were measured with a dynamometer, along with tibial somatosensory evoked potential (SSEP) and abductor hallucis motor-evoked potential (MEP). Ambulatory capacity was assessed with the Walking Index for Spinal Cord Injury II (WISCI-II), both at the time of the proprioception test (WISCI_i) and at least 6 months after the test (WISCI_6mo).
RESULTS
The PRE showed a negative correlation with WISCI_i (r=-0.440, p=0.034) and WISCI_6mo (r=-0.568, p=0.010). Linear multiple regression showed the type of injury, lower extremities motor score, MEP, and PRE accounted for 75.4% of the WISCI_6mo variance (p=0.080).
CONCLUSION
Proprioception of the knee can be measured quantitatively with a dynamometer in patients with incomplete SCI, and PRE was related to the outcome of the ambulatory capacity. Along with the neurological and electrophysiological examinations, a proprioception test using a dynamometer may have supplementary value in predicting the ambulatory capacity in patients with incomplete SCI.

Keyword

Spinal cord injuries; Proprioception; Walking

MeSH Terms

Evoked Potentials, Somatosensory
Humans
Knee
Lower Extremity
Proprioception*
Spinal Cord Injuries*
Spinal Cord*
Walking

Figure

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  Fig. 1 Patient positioned in dynamometer for left knee proprioception test (System 4 Pro; Biodex Medical Inc., Shirley, NY, USA).

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  Fig. 2 Correlation between the repositioning error and lower extremities motor power. (A) Active repositioning error and (B) passive repositioning error. LEMS, lower extremities motor score.

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