Reliability of position sense testing assessed with a fully automated system

Position sense testing has increased as a tool for augmenting evaluation of joint injury. In the present study, we investigated the inter-day reliabil ity for four different types of position sense tests using a fully automate d system. The tests included (I) passive presentation/active replication, ( 2) passive presentation/passive replication, (3) semi-passive presentation/ semi-passive replication (where semi-passive denotes passive movement durin g antagonist muscle contraction), and (4) active presentation/active replic ation. The absolute difference between presented target and replicated posi tion was used as a measure of position sense accuracy. Ten healthy subjects who were blindfolded and seated with the arm in a moveable rig performed t he tests on two occasions, separated by 3-4 days. For each type of position sense test, horizontal abduction from a starting position of 0 degrees (re lative to the sagittal plane) to target positions of 32 degrees and 64 degr ees, and horizontal adduction from a starting position of 80 degrees to 48 degrees and 16 degrees were conducted. A two-way ANOVA revealed no differen ces in absolute error between days or between testing procedures. However, intra-class correlations (ICC), which are most often used to express test-r etest reliability, were moderate at best, ranging from 0.40 to 0.61 for the four types of position sense tests. Hence, the present study indicates tha t the ability of repositioning tests to detect alterations in proprioceptiv e function is limited, suggesting that their use in clinical evaluation be approached with prudence.