Development and reliability of a measure evaluating dynamic proprioception during walking with a robotized ankle-foot orthosis, and its relation to dynamic postural control

- Movement error detection threshold in the direction of plantar flexion was 5.31° ± 2.12° at T1 and 5.00° ± 1.63° at T2.
- Test-retest reliability was good (ICC = 0.70; CI95% 0.45-0.85).
- SEBT's PM direction and detection threshold were strongly correlated (r = −0.76).

BackgroundProprioception 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.Objectives1) 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.MethodThirty healthy subjects walked on a treadmill while wearing a robotized ankle-foot orthosis (rAFO) for 2 bouts of 6 min on 2 evaluation sessions (test-retest reliability). Force perturbations resisting ankle dorsiflexion during swing were applied to the ankle via the rAFO (150 ms duration, variable amplitude). Participants pushed a button when they detected the perturbations. The Star Excursion Balance Test (SEBT) was used to evaluate dynamic balance.AnalysisAngular 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.ResultsDetection 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.ConclusionForce perturbations produced by the robotized AFO provides a reliable way of evaluating proprioception during walking.