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Evaluation of Knee Position Sense in Children with Motor Disabilities and Children with Typical Development: A
Åsa Bartonek1, Marie Eriksson1, Annika Ericson1,2
1Division of Paediatric Neurology, Department of Women's and Children's Health, Karolinska Institutet, 17176 Stockholm, Sweden.
Insights
Children with Cerebral Palsy (CP) showed difficulties maintaining knee joint position sense, suggesting a need for further proprioception assessment. This impacts understanding limb control in motor disabilities.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Biomechanical Engineering
Background:
- Knee joint position sense is crucial for motor control in children with disabilities.
- Cerebral Palsy (CP), Myelomeningocele (MMC), and Arthrogryposis (AMC) affect motor function.
- Understanding proprioception deficits is key for effective rehabilitation.
Purpose of the Study:
- To investigate knee joint position sense (JPS) in children with motor disabilities.
- To compare JPS between children with CP, MMC, AMC, and typically developing (TD) children.
- To identify specific challenges in maintaining knee joint positions.
Main Methods:
- Assessed JPS-error (difference between criterion and reproduced angles) in sitting.
- Utilized 3D motion capture for precise angle measurements.
- Evaluated JPS at various knee flexion angles (70°, 45°, 20°) and during maintained positions (CAM, RAM).
Main Results:
- No significant group differences in overall JPS-error, CAM, or RAM.
- TD group showed leg differences in CAM at 70°.
- MMC group showed leg differences in RAM at 70°.
- CP group exhibited greater CAM than RAM at multiple knee flexion angles, indicating position maintenance difficulties.
Conclusions:
- Children with CP struggle to maintain specific knee joint positions, highlighting potential proprioceptive challenges.
- These findings underscore the need for complementary proprioception assessments in clinical practice.
- Further research should explore the impact of these proprioceptive deficits on walking mechanics.
Background:
In children with motor disabilities, knee position during walking is often of concern in rehabilitation. This study aimed to investigate knee joint position sense. Thirty-seven children with Cerebral Palsy (CP), 21 with Myelomeningocele (MMC), 19 with Arthrogryposis (AMC), and 42 TD children participated in the study. Knee joint position sense, i.e., the difference between the criterion angle and the reproduced angle (JPS-error), was assessed in sitting while 3D motion capture was recorded at flexed knee 70 (Knee70), 45 (Knee45), and 20 (Knee20) degrees, and after three seconds at maintained criterion angle (CAM) and maintained reproduced angle (RAM). No differences were found between the groups in JPS-error, CAM, and RAM. At Knee70, CAM differed between the right and left legs in the TD group (p = 0.014) and RAM in the MMC group (p = 0.021). In the CP group, CAM was greater than RAM at Knee70 in the left leg (p = 0.002), at Knee45 in both legs (p = 0.004, p = 0.025), and at Knee20 in the right leg (p = 0.038). Difficulties in maintaining the knee position at CAM in the CP group sheds light on the need for complementary judgments of limb proprioception in space to explore the potential influence on knee position during walking.
