The effects of joint angle and reliability on knee proprioception

Purpose: The purpose of this study was to examine the reliability and effects of knee angle on the detection and subsequent response to passive knee movement. Methods: Twenty college-aged male and 20 female volunteers were evaluated for proprioception by a newly developed perturbation test. Subjects were in a prone position on an isokinetic chair with their right lower leg attached to a freely moving resistance adapter. The knee was placed in a starting position of 15, 30, or 60 degrees of flexion. While relaxed, the knee was dropped into extension, and the subjects were instructed to "catch their leg" when movement was perceived. Five trials were completed at each angle, in a random order. An electrogoniometer was secured to the lateral portion of the knee in order to measure angular displacement after perturbation in two specific phases: detection (displacement from leg release to movement cessation) and response (displacement from movement cessation to peak knee flexion). A three-factor ANOVA (two repeated factors (knee angle and proprioception phase) and one between factor (gender)) was performed on the average and standard deviation of the five trials for significant main effects and interactions. Results: The results demonstrated a significant phase by angle interaction, and no gender effect. It was shown that at a more extended knee joint position (15 degrees), significantly less knee movement occurred before perception, followed by a greater response, than in a more flexed position (30 and 60 degrees). Conclusion: The major findings of this study suggest that the detection of passive knee movement, and the subsequent voluntary response, may be dependent on joint angle. Considerations of the present method for proprioception assessment are warranted to enhance test-retest reliability.