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The Effects of Joint Position and Direction of Joint Motion on Proprioceptive Sensibility in Anterior Cruciate Ligament-Deficient Athletes

Neuromuscular Research Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania

Scott M. Lephart, PhD, ATC

Neuromuscular Research Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania

James J. Irrgang, MS, ATC, PT

Neuromuscular Research Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania

Marc R. Safran, MD

Neuromuscular Research Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania

Freddie H. Fu, MD

Neuromuscular Research Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania

We studied a group of anterior cruciate ligament-defi cient athletes to identify whether joint position and direction of joint motion have a significant effect on proprioception. Twenty-nine anterior cruciate ligament- deficient athletes were tested for their threshold to detect passive motion at both 15° and 45° moving into the directions of both flexion and extension. The single- legged hop test was used to identify function in the deficient limb. Results demonstrated statistically signif icant deficits in threshold to detect passive motion for the deficient limb at 15° moving into extension. For the deficient limb, threshold to detect passive motion was significantly more sensitive moving into extension than flexion at a starting angle of 15°; at a starting angle of 15° moving into extension threshold was significantly more sensitive than at a starting angle of 45° moving into extension. We conclude that in deficient limbs proprioception is significantly more sensitive in the end ranges of knee extension (15°) and is significantly more sensitive moving into the direction of extension. To effectively restore reflex stabilization of the lower limb we recommend a rehabilitation program empha sizing performance-based, weightbearing, closed ki netic chain exercise for the muscle groups that act on the knee joint.

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