Which proprioception assessment method best predicts balance ability in healthy young and elderly populations?

AlMutairi, Shareefah (2024). Which proprioception assessment method best predicts balance ability in healthy young and elderly populations? University of Birmingham. Ph.D.

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Abstract

Determining the process through which balance and ankle proprioception are linked has been a relevant topic in the last decade due to the direct clinical implications associated with balance deficits. The overall aim of this thesis was to determine which proprioceptive assessment method best predicts balance ability in healthy young and elderly populations. We started our research with a detailed literature review on proprioception (Chapter 1) to assess the gaps of knowledge in the database on proprioception and its link to balance. We aimed to compare different proprioceptive assessment methods to determine which one best predicted balance performance. We therefore started by developing several proprioceptive assessment methods (described in Chapter 2). We were able to develop two additional assessment methods to test in our balance lab beside joint position reproduction (JPR), which had been developed prior to the commencement of our research. Both assessment methods were variations of the threshold to detection of passive motion (TTDPM) method. The first measured detection threshold as the amplitude at which passive ankle motion was detected, and the second measured reaction time of participants the moment they detected ankle motion. Using these techniques, we performed a series of experimental studies. The first experimental study (Chapter 3) determined whether age-related decline in ankle proprioception, as measured through a JPR task, is affected by muscle strength. Our results indicated that while age significantly affected proprioceptive acuity at the ankle, muscle strength had a significant effect on the proprioceptive performance of middle-aged participants only. Our second experimental study (Chapter 4) established whether isometric contraction influenced ankle proprioception. We found that while there was no difference in ankle proprioceptive acuity between a passive and an isometrically contracted leg, the stability of muscular force output–as measured through torque variability–significantly predicted proprioceptive performance. Our third experimental study (Chapter 5), determined whether ankle proprioception, measured using a reaction-time method, was predictive of postural sway during quiet standing. We found that reaction time significantly predicted standing balance in the anterior-posterior plane when feet were apart. We also found that age significantly correlated with reaction time, with older participants reacting at significantly slower rates than younger participants. In addition, we found a significant interaction between age and vision when we analysed body sway data separately. This indicates that older aged participants relied on vision more than younger participants to maintain their balance during quiet standing. Our findings show that age significantly predicts proprioceptive acuity at the ankle, with older participants consistently performing worse using different proprioceptive assessment methods. They also suggest that more studies are needed on the effect of muscle strength on proprioceptive performance, as our results indicate there is a link between the two.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):