New method of measuring wrist joint position sense avoiding cutaneous and visual inputs

Background. Aspects of afferent inputs, generally termed proprioception, are being increasingly studied. Extraneous factors such as cutaneous inputs can dramatically interfere while trying to design studies in order to determine the participation of the different structures involved in proprioception in the wrist position sense. We tried to determine validity and repeatability of a new wrist joint position measurement device using methodology designed to minimize extraneous factors and isolate muscle and joint inputs. Methods. In order to test the reliability of the system, eighty young-adult subjects without musculoskeletal or neurologic impairments affecting the right upper extremity were tested using a custom made motion tracking system. Testing consisted of two conditions: active reproduction of active placement and passive reproduction of passive placement. Subjects performed two repetitions of each target position (10, 20, and 30° of flexion and extension) presented in a random order. Test- retest reliability was then tested. Results. The average constant error in the passive condition was -0.7° 4.7° as compared to the active condition at 3.7° 5.1°. Average absolute error in the passive condition was 4.9° 2.9° compared to the active condition in which absolute error was 5.9° 3.5°. Discussion. Test-retest repeatability in both conditions was less than the 5° magnitude typical of clinical goniometry. Errors in the active condition (less than 2°) were slightly smaller than the passive condition, and the passive condition was also associated with poorer consistency between apparatus sensors and skin sensors. Conclusions. The current system for measurement of wrist joint proprioception allows the researcher to decrease extraneous influences that may affect joint position sense awareness, and will help in future study aiming to determine precisely the role of the different structure involved in proprioception.