Factors that influence the angular error in active knee angle reproduction tests: A systematic review and...

Area of Science:

• Biomechanics
• Neuroscience
• Kinesiology

Background:

• Knee proprioception is vital for joint stability and movement control.
• Active knee angle reproduction tests assess joint position sense.
• Understanding factors influencing test accuracy is crucial for clinical application.

Purpose of the Study:

• To systematically review and meta-analyze subject-independent factors affecting absolute angular error in active knee angle reproduction tests.
• To identify key variables that influence the precision of knee proprioception assessment.

Main Methods:

• A systematic review and meta-analysis of studies published before December 20, 2023.
• Inclusion criteria: English/German studies on healthy knee joint proprioception, participants aged 18-60 without lower-limb injury or neurological disorders.
• Risk of bias assessed using the Cochrane risk-of-bias tool.

Main Results:

• 26 studies (1082 participants) were included.
• Significant pooled differences in absolute angular error were found for body orientation, movement direction, and fatigue.
• Lower error in sitting vs. prone position (SMD = -0.56).
• Greater error in knee flexion vs. extension (SMD = 0.71).
• Higher error with general and local muscle fatigue (SMD = 1.39).

Conclusions:

• Fatigue, body orientation, and direction of movement are significant determinants of absolute angular error in knee angle reproduction tests.
• Practitioners must consider test conditions and participant fatigue when interpreting results.
• Consistent and well-documented test protocols are essential for reliable and comparable knee proprioception assessments.