Inter- and intrarater reliability of two proprioception tests using clinical applicable measurement tools in subjects with and without knee osteoarthritis

Isabel A.C. Baert
Musculoskeletal Science & Practice
June 2018 Volume 35, Pages 105–109

Highlights

  • Proprioception tests that are easily accessible in clinical practice are needed.
  • Knee joint position sense can be tested using an analogue inclinometer.
  • This method is reliable (ICCs 0.65-0.95) and recommended for clinical practice.
  • Errors are low testing in multiple positions, calculating mean repositioning error.
  • Measuring knee force sensation using handheld dynamometry seems not reliable

Abstract

Background

The therapeutic value of proprioceptive-based exercises in knee osteoarthritis (KOA) management warrants investigation of proprioceptive testing methods easily accessible in clinical practice.

Objective

To estimate inter- and intrarater reliability of the knee joint position sense (KJPS) test and knee force sense (KFS) test in subjects with and without KOA.

Design

Cross-sectional test-retest design.

Method

Two blinded raters performed independently repeated measures of the KJPS and KFS test, using an analogue inclinometer and handheld dynamometer, respectively, in eight KOA patients (12 symptomatic knees) and 26 healthy controls (52 asymptomatic knees). Intraclass correlation coefficients (ICCs; model 2,1), standard error of measurement (SEM) and minimal detectable change with 95% confidence bounds (MDC95) were calculated.

Results

For KJPS, results showed good to excellent test-retest agreement (ICCs 0.70–0.95 in KOA patients; ICCs 0.65–0.85 in healthy controls). A 2° measurement error (SEM 1°) was reported when measuring KJPS in multiple test positions and calculating mean repositioning error. Testing KOA patients pre and post therapy a repositioning error larger than 4° (MDC95) is needed to consider true change. Measuring KFS using handheld dynamometry showed poor to fair interrater and poor to excellent intrarater reliability in subjects with and without KOA.

Conclusions

Measuring KJPS in multiple test positions using an analogue inclinometer and calculating mean repositioning error is reliable and can be used in clinical practice. We do not recommend the use of the KFS test to clinicians. Further research is required to establish diagnostic accuracy and validity of our KJPS test in larger knee pain populations.

Journal Reference

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