title: Development and reliability of a measure evaluating dynamic proprioception during walking with a robotized ankle-foot orthosis, and its relation to dynamic postural control.
abstract: Proprioception is important for proper motor control. As the central nervous system modulates how sensory information is processed during movement (sensory gating), proprioceptive tests performed at rest do not correlate well with performance during dynamic tasks such as walking. Proprioception therefore needs to be assessed during movement execution.
  
  
  
  1) To develop a test evaluating the ability to detect movement errors during walking, and its test-retest reliability; 2) to quantify the relationship between proprioceptive threshold (obtained with this new test) and performance in a standardized dynamic balance task.
  
  
  
  Thirty healthy subjects walked on a treadmill while wearing a robotized ankle-foot orthosis (rAFO) for 2 bouts of 6min on 2 evaluation sessions (test-retest reliability). Force perturbations resisting ankle dorsiflexion during swing were applied to the ankle via the rAFO (150ms duration, variable amplitude). Participants pushed a button when they detected the perturbations. The Star Excursion Balance Test (SEBT) was used to evaluate dynamic balance.
  
  
  
  Angular differences between perturbed and non-perturbed gait cycles were used to quantify movement error. Detection threshold was defined as the minimal movement error at which 50% of the perturbations were perceived. Intraclass correlation coefficients (ICCs) estimated test-retest reliability, and Pearson coefficients were used to determine the correlation between detection threshold and SEBT.
  
  
  
  Detection threshold was 5.31±2.12°. Good reliability (ICC=0.70) and a moderate to strong correlation to SEBT (r=-0.57 to -0.76) were found.
  
  
  
  Force perturbations produced by the robotized AFO provides a reliable way of evaluating proprioception during walking.
authors.affiliation: Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Institut de Réadaptation en Déficience Physique de Québec (IRDPQ), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, Quebec G1M 2S8, Canada.
authors.forename: Amélie
authors.initials: A
authors.lastname: Fournier Belley
authors.affiliation: Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Institut de Réadaptation en Déficience Physique de Québec (IRDPQ), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, Quebec G1M 2S8, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Bouffard
authors.affiliation: Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Institut de Réadaptation en Déficience Physique de Québec (IRDPQ), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, Quebec G1M 2S8, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: Brochu
authors.affiliation: Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, G1V 0A6, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Institut de Réadaptation en Déficience Physique de Québec (IRDPQ), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, Quebec G1M 2S8, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Mercier
authors.affiliation: Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, G1V 0A6, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Institut de Réadaptation en Déficience Physique de Québec (IRDPQ), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, Quebec G1M 2S8, Canada.
authors.forename: Jean-Sébastien
authors.initials: JS
authors.lastname: Roy
authors.affiliation: Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, G1V 0A6, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Institut de Réadaptation en Déficience Physique de Québec (IRDPQ), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, Quebec G1M 2S8, Canada. Electronic address: laurent.bouyer@rea.ulaval.ca.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bouyer
mesh_terms: D000328:Adult; D000842:Ankle / Q000503:physiopathology*; D000843:Ankle Joint / Q000502:physiology; D005080:Exercise Test / Q000379:methods* / Q000592:standards; D005260:Female; D061826:Foot Orthoses; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D011434:Proprioception / Q000502:physiology*; D015203:Reproducibility of Results; D012371:Robotics / Q000295:instrumentation*; D012684:Sensory Thresholds / Q000502:physiology; D016138:Walking / Q000502:physiology*; D055815:Young Adult
keywords: Ankle-foot orthosis; Gait; Postural control; Proprioception; Robotics; Star excursion balance test