Trials needed to assess knee proprioception following stroke.

Background and Purpose. This study explores the number of trials required to identify clinically significant impairments in knee joint position sense and movement sense following stroke. Method. Proprioception was assessed in 33 stroke patients aged 37–87 years. Ten trials for each assessment were performed in sitting and supine positions using both verbal response techniques and contralateral limb matching. Results. Forty-six percent of participants were identified with a proprioceptive deficit. The trial where the first incorrect response occurred varied across individuals and testing positions. Performing only one trial detected proprioceptive impairments in less than 10% patients, and incorrect responses did not always occur in the first 5 trials. In sitting, no participant failed the assessment of knee joint position sense using the verbal response technique after only 6 trials. In supine, no participant failed the assessment of knee movement sense using the verbal response technique after only 6 trials. For the assessment of knee joint position sense in sitting using contralateral limb matching an estimated 9.4% of patients with a deficit would be missed if only 3 trials were used in preference to 5. For assessment of knee joint position sense in sitting, an estimated 18.8% of patients with deficits would be missed if only 3 trials were used rather than 10 trials. Conclusions. Clinicians should perform at least 10 trials in either sitting or supine to quantify joint position sense and movement sense at the knee following stroke. Copyright © 2009 John Wiley & Sons, Ltd.