Proprioceptive Assessment Of Knee Joint In Stroke Patients

Objective: To explore the reliability of using Biodex system 4 multi-joint isokinetic dynamometer(Biodex corporation,Newyork,USA)to evaluate the proprioception of knee joint.To evaluate the proprioceptive function of knee joint in stroke patients by using appropriate test model,and to observe its changes,so as to provide theoretical basis for the formulation of rehabilitation treatment plan for stroke patients.Part 1The reliability of evaluating knee joint proprioception by different test modes of isokinetic dynamometerMethods: Biodex System 4 multi-joint isokinetic dynamometer was used to evaluate the proprioception of bilateral knee joints in 32 healthy volunteers.Four test modes,open chain active,open chain passive,closed chain active and closed chain passive,are used respectively.Target angle selection: open chain mode is 30 °,45 °,60 °,closed chain mode is-30 °,-45 °,-60 °,and angular velocity selection: active mode 300 °/ s,passive mode 2 °/ s.The proprioception of knee joint was evaluated by absolute error angle(the difference between target angle and actual angle).Tester A and tester B were responsible for the test,a total of 4tests(tester A test 2 times,tester B test 2 times),each test interval of one week.The reliability of the results was analyzed by using the intraclass correlation coefficient(ICC).Results: 1.Open-chain active test mode: The intraclass correlation coefficient(ICC)of different tester were 0.678-0.758(target angle 30 °),0.691-0.766(target angle 45 °)and0.649-0.773(target angle 60 °).The intraclass correlation coefficient(ICC)of test-retest reliability were 0.765-0.773(target angle 30 °),0.776-0.791(target angle 45 °)and 0.757-0.767(target angle 60 °).2.Open-chain passive test mode: The intraclass correlation coefficient(ICC)of different tester were 0.630-0.775(target angle 30 °),0.626-0.785(target angle 45 °)and 0.681-0.758(target angle 60 °).The intraclass correlation coefficient(ICC)of test-retest reliability were 0.696-0.776(target angle 30 °),0.714-0.752(target angle 45 °),and 0.725-0.726(target angle 60 °).3.Closed-chain active test mode: The intraclass correlation coefficient(ICC)of different tester were 0.089-0.295(target angle-30 °),0.154-0.357(target angle-45 °)and 0.087-0.292(target angle-60 °).The intraclass correlation coefficient(ICC)of test-retest reliability were 0.278-0.301(target angle-30 °),0.208-0.242(target angle-45 °)and 0.252-0.260(target angle-60 °).4.Closed-chain passive test mode:The intraclass correlation coefficient(ICC)of different tester were 0.142-0.416(target angle-30 °),0.259-0.459(target angle-45 °),and 0.084-0.450(target angle-60 °);The intraclass correlation coefficient(ICC)of test-retest reliability were 0.219-0.319(target angle-30 °),0.239-0.316(target angle-45 °),and 0.224-0.439(target angle-60 °).Conclusion: The reliability of open chain active test mode and open chain passive test mode is good.Biodex System 4 multi-joint isokinetic dynamometer has good evaluation value.The reliability of closed-chain active test mode and closed-chain passive test mode is low,so care should be taken in the application of closed-chain active test mode and closed-chain passive test mode.Part 2Evaluation of knee joint proprioceptive function in stroke patients by open chain passive mode of isokinetic dynamometer.Methods: the open chain passive test mode of Biodex System 4 multi joint isokinetic dynamometer was used to evaluate the proprioception of bilateral knee joint in 33 patients with stroke.The target angle was 30 °,45 °and 60 °,respectively,and the angular velocity was 2 °/ s.the proprioceptive function of knee joint was evaluated by absolute error angle.Results: 1.When the target angle was 30 °,45 °and 60 °,the hemiplegic knee joint ofthe stroke patients and normal knee joint of healthy group were significant different(P <0.01).2.When the target angle was 30 °,45 °and 60 °,the non-hemiplegic knee joint of the stroke patients and normal knee joint of healthy group were significant different(P < 0.05).Conclusion: 1.The open chain passive test mode of Biodex System 4 multi-joint isokinetic dynamometer has good reliability and can objectively evaluate the proprioceptive function of knee joint of stroke patients.2.There are different degrees of dysfunction in the proprioceptive function of bilateral knee joint in stroke patients.