Visual and proprioceptive feedback improves knee joint position sense

Joint position sense (JPS), one method to assess proprioception, is the ability to replicate a target limb position. Feedback is commonly used to improve motor performance but it has not been demonstrated to improve JPS. The purpose of this study was to determine if feedback decreases error associated with knee JPS at three movement velocities. Healthy volunteers sat with their hip and knees flexed. The knee was passively extended at three velocities (0.5, 2, and 10 degrees/s). Subjects were instructed to stop knee motion, via a thumb switch, at a 20 degrees knee flexion target. Following movement, each subject received visual and proprioceptive feedback indicating final leg position relative to the target position. Movement velocities and times (4 s, 5 s, 6 s) were randomly presented so subjects could not predict the target position. Measures of JPS included constant error (CE), absolute error (AE), variable error (VE), and percent correct (%CORR). Significant decreases in CE, AE, and VE as well as an increase in %CORR were demonstrated. The majority of JPS improvement (85%) occurred by the tenth trial. Short-term improvements in JPS may be the result of temporary CNS adaptations via feedback that was provided to subjects. Long-term learning of JPS enhancement needs further investigation.