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Traumatic injuries and fractures resulting from falls by elderly individuals have become a major issue for the government bodies responsible for health, medical care, and social welfare because they markedly reduce the individuals’ ability to engage in activities of daily living. Major causes of such falls by elderly individuals are decreased balance ability and impairment associated with aging. Proprioceptive information obtained by movement of the lower extremity muscles and joints are important for maintaining balance. However, there have been very few studies concerned with further quantifying lower extremity proprioceptive sense, which for elderly individuals is important for maintaining standing balance. The objectives of this study were to develop the first device to quantitatively evaluate changes in the proprioceptive threshold (motion sense and joint position sense) that is associated with changes in the angle of the ankle during standing and, based on this evaluation, establish methods of evaluating and training joint sense that are needed to improve balance ability by using a new device.
The subjects were five elderly individuals (mean 71.4 years) and seven young individuals (mean 20.6 years) who were not proficient at sports. A new device was used to evaluate the motion sense and the joint position sense during plantar flexion, dorsiflexion, inversion, and eversion of the ankle with the individual in the standing position. The device was shown to be capable of measuring ankle proprioceptive sense during standing to 1 degree of accuracy. The subject stood with their dominant foot on the motor-driven foot plate of the device. Next, the motor-driven plate was inclined at a specified angular velocity, and the subject was instructed to stop the plate by pressing a button near their hand when they felt that the inclination angle matched that of the non-dominant leg. Four movement directions were used for the ankle: dorsiflexion, plantar flexion, eversion, and inversion. The two dorsiflexion angles used were 5 and 10 degrees; the three plantar flexion angles were 5, 10, and 15 degrees; the two eversion angles were 5 and 10 degrees; and the three inversion angles were 5, 10, and 15 degrees. The two angular velocities used were 1 and 2 degrees/sec. For the analysis, the inclination angle of the non-dominant foot was used as the set angle, and the angle at which the subject stopped the plate was used as the stop angle. The error (| set angle - stop angle |) was the test parameter. The minimum error value obtained in the two trials was recorded.
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