Proprioceptive Acuity Assessment Via Joint Position

Matching: From Basic Science to General Practice

Daniel J. Goble
PHYS THER. 2010; 90:1176-1184.
Originally published online June 3, 2010
doi: 10.2522/ptj.20090399

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 Perspective
D.J. Goble, PhD, is Fellow for the
Canadian Institutes for Health Re-
search: Institutes of Aging, housed
in the Department of Physical
Medicine and Rehabilitation, Uni-
versity of Michigan, 325 E. Eisen-
hower, Suite 100, Ann Arbor, MI
48108 (USA). Address all corre-
spondence to Dr Goble at:
dgoble@umich.edu.
[Goble DJ. Proprioceptive acuity
assessment via joint position
matching: from basic science to
general practice. Phys Ther.
2010;90:1176 –1184.]
© 2010 American Physical Therapy
Association
Post a Rapid Response to
this article at:
ptjournal.apta.org
1176 f Physical Therapy Volume 90 Number 8
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Proprioceptive Acuity Assessment Via
Joint Position Matching: From Basic
Science to General Practice
Daniel J. Goble
Over the past several decades, studies of use-dependent plasticity have demonstrated
a critical role for proprioceptive feedback in the reorganization, and subsequent
recovery, of neuromotor systems. As such, an increasing emphasis has been placed
on tests of proprioceptive acuity in both the clinic and the laboratory. One test that
has garnered particular interest is joint position matching, whereby individuals must
replicate a reference joint angle in the absence of vision (ie, using proprioceptive
information). On the surface, this test might seem straightforward in nature. How-
ever, the present perspective article informs therapists and researchers alike of
multiple insights gained from a recent series of position matching studies by the
author and colleagues. In particular, 5 factors are outlined that can assist clinicians in
developing well-informed opinions regarding the outcomes of tests of position
matching abilities. This information should allow for enhanced diagnosis of propri-
oceptive deficits within clinical settings in the future.
August 2010

O
ver the past several decades,
a relative shift has occurred
in the field of physical ther-
apy and rehabilitation medicine. In
contrast to traditional assessments
of physical well-being, which have
focused largely on the ability of in-
dividuals to generate motor output,
a greater emphasis is now being
placed on sensory feedback acuity.
This fundamental change is likely
the result of our growing under-
standing regarding the role sensory
information plays in promoting neu-
ral plasticity through use-dependent
mechanisms. Indeed, it is now well
accepted that a clear relationship ex-
ists between massed physical prac-
tice and the expression of neural rep-
resentations in primary sensorimotor
regions of the brain.1,2
Arguably the most important source
of feedback for promoting neural
plasticity is our sense of propriocep-
tion.3– 6 Proprioception can be de-
fined as the ability of an individual to
determine body segment positions
and movements in space and is
based on sensory signals provided to
the brain from muscle,7–9 joint,10
and skin11,12 receptors. Studies of in-
dividuals who lack proprioceptive
sense (due mainly to large fiber neu-
ropathy) have taught us important
lessons regarding the role of propri-
oceptive feedback during sensorimo-
tor performance. Indeed, despite the
fact that these individuals have mo-
tor systems that remain fully intact,13
“deafferented” people show pro-
found deficits in motor control.
These deficits include, but are not
limited to, poor endpoint accura-
cy,14 reduced control of multiseg-
mental dynamics,15,16 and an inabil-
ity to perform extended movement
sequences.13
Although other methods (eg, identi-
fication of imposed movement direc-
tion or measurement of movement
detection threshold) are available, an
increasingly utilized tool for the as-
August 2010
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Factors Affecting Position Matching
sessment of proprioceptive acuity in
clinical situations is the joint position
matching task.17–33 In this test, a pa-
tient is asked to re-create (ie, match)
a reference joint angle (ie, position)
in the absence of vision. The accu-
racy of matching is subsequently de-
termined in a variety of ways, ranging
from the use of specialized biome-
chanical equipment to more qualita-
tive visual inspection by a trained
observer.
Although the validity and reliability
of position matching tests have rarely
been evaluated,17,34,35 it is generally
well accepted that the magnitude of
matching errors can be a useful indi-
cator of proprioceptive acuity. More
specifically, those individuals who are
prone to making large position match-
ing errors are thought to be, at least
in some way, proprioceptively defi-
cient. The purpose of this perspective
article is to express to clinicians and
clinical researchers alike that, despite
their relative efficacy, some caution
is necessary when designing and
interpreting the results of position
matching studies. The foundation
for this assertion lies in a recent
series of studies conducted by me
and my colleagues that assessed, in
detail, the position matching abilities
of individuals with and without dis-
abilities.36 – 42 Taken together, the re-
sults of these studies emphasize that
position matching tasks are not as
straightforward as they might appear
initially and that matching errors are
significantly influenced by a number
of experimental factors. In this arti-
cle, a summary of 5 of these factors
and their clinical relevance is pro-
vided. It is hoped that this informa-
tion will aid therapists in future as-
sessments of proprioceptive acuity,
both in the clinic and in the
laboratory.
An Overview of the Basic
Experimental Setup
The experimental factors described
in this perspective article were elu-
Volume 90 Number 8
cidated through numerous studies
conducted in the same laboratory
(see acknowledgments) over the
past 5 years. For each experiment,
an elbow position matching para-
digm was used involving a custom-
made motorized manipulanda sys-
tem (Fig. 1; see video available
online at ptjournal.apta.org). Partici-
pants were blindfolded (to prevent
the use of vision) and seated with
head supported and forearms resting
on 2 aluminum levers. The levers
were attached below the pivot point
of the elbow to a ball bearing system
that allowed near-frictionless move-
ment of the forearm about the elbow
joint in the horizontal plane. Refer-
ence elbow positions were estab-
lished either by a torque motor sys-
tem or through movement of the
lever by the experimenter via a han-
dle attached to its distal end.
Elbow position (ie, angle) data were
continuously transduced into a volt-
age signal via potentiometers located
below the ball bearing system (ie,
elbow joint). This analog signal was
digitally sampled by a laptop com-
puter and displayed on the comput-
er’s screen in real time. The online
display gave the experimenter a con-
tinuous estimate of joint position
throughout the experimental ses-
sion. Testing sessions consisted of 30
to 75 matching trials presented in a
pseudo-randomized order for the
condition of interest. Data were
saved to the computer’s hard drive,
which allowed for more precise cal-
Available With
This Article at
ptjournal.apta.org
• Video: Animation of basic
experimental setup.
• Audio Abstracts Podcast
This article was published ahead of
print on June 3, 2010, at
ptjournal.apta.org.
Physical Therapy f 1177
Factors Affecting Position Matching
Figure 1.
Animated version of the basic setup used for determining the experimental factors
influencing proprioceptive position matching (see video available online at ptjournal.
apta.org).
culation of matching error using
computer algorithms off-line. The
preferred measure of matching accu-
racy was absolute error, defined as
the absolute difference between the
reference and matching elbow joint
angles in degrees.
Factor 1: Type of Position
Matching Task
There are 2 types of position match-
ing tasks that have commonly been
used for the assessment of proprio-
ceptive acuity in clinical and re-
search situations. In the first task
type, a reference joint angle initially
is provided to the participant for a
short period of time (usually several
seconds). Then, the joint is brought
back to the “start” angle, and the
participant is asked to replicate the
previously experienced reference
position using the same (ie, ipsilat-
eral) arm. This so-called “ipsilateral
matching” task is contrasted by the
second commonly used task type,
known as “contralateral matching.”
Contralateral matching involves
matching of a reference joint angle
with the opposite (ie, contralateral)
limb. In this case, the previously estab-
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lished target joint angle remains at the
reference position throughout match-
ing and can serve as an “on-line” refer-
ence to aid in participant matching.
Although the choice between ipsilat-
eral and contralateral limb matching
tasks may seem trivial, this is most
certainly not the case. For example,
in ipsilateral matching tasks, where
the same arm serves to establish both
the reference and matching loca-
tions, it is inherently necessary for
participants to use memory in order
to accurately match the target posi-
tion. This reliance on memory is due
to the fact that no single limb can
concurrently provide a reference
joint angle while performing match-
ing of that angle. Given the memory
component to this type of task, cli-
nicians should exercise caution
when ipsilateral matching is used to
assess proprioceptive acuity in indi-
viduals who are prone to having
memory issues. Indeed, it is likely
that, in this situation, some portion
of the matching error measured ac-
tually reflects cognitive or memory
deficits, rather than any decrease in
proprioception itself.
The use of contralateral matching
tasks eliminates the need for memory-
based matching because the reference
joint angle is available throughout the
task from the opposing limb. Despite
this advantage, however, contralateral
position matching tasks are subject to
limitations of their own. First, due to
the involvement of both arms in the
task, it is difficult to ascertain whether
the measured error arises from the ref-
erence arm, the matching arm, or
both. Additionally, based on the ana-
tomical pathways involved in the
transmission of peripheral proprio-
ceptive input to the brain, it is al-
most certain that matching using the
opposite limb requires greater inter-
hemispheric communication (or
transfer) compared with ipsilateral
matching. Specifically, propriocep-
tive information from the reference
limb is directed initially to the pri-
mary somatosensory region of the
cerebral cortex in the contralateral
hemisphere (eg, right arm reference
information first received by the left
hemisphere).43,44 Before this infor-
mation can be used to direct action
of the opposite limb, which also is
controlled by the opposing hemi-
sphere, it must cross the hemi-
spheric divide. This crossing likely
occurs via the transcallosal pathways
of the corpus callosum.45 The en-
hanced need for interhemispheric
transfer in contralateral matching
tasks, therefore, represents another
significant cognitive factor that may
influence position matching perfor-
mance in certain clinical populations.
Indeed, individuals with asymmetric
brain injuries or individuals with tran-
scallosal degeneration would seem to
be particularly disadvantaged for con-
tralateral matching tasks.
The influence of task type on posi-
tion matching has been tested di-
rectly by the author and colleagues
in several groups of young individu-
als who were healthy.37,39 – 41 These
studies compared both the ipsilateral
and contralateral position matching
August 2010
 Factors Affecting Position Matching

tasks described above, as well as a

third type of matching task that com-
bines elements of ipsilateral and con-
tralateral matching. In the third task,
participants are given a reference
(elbow) joint angle on one side of
the body and required to memorize
this position over the course of sev-
eral seconds. The reference joint po-
sition then is taken away from the
participants by changing the joint
angle just prior to their making a
mirror image match of the reference
angle with the opposite arm (ie, re-
quiring interhemispheric transfer).
Compared with the ipsilateral and con-
tralateral tasks, which involve only
memory or interhemispheric commu-
nication demands, respectively, the
third task (also known as “contralat-
eral remembered” matching) is con-
sidered to be more challenging, as it
requires both memory and interhemi-
spheric transfer components.
Figure 2.
Figure 2 shows exemplary data from Average (SE) absolute errors for various types of position matching tasks.
previously unpublished work dem- IHT⫽interhemispheric transfer.
onstrating the effects of task type on
absolute elbow position matching er-
rors in 10 individuals who were
healthy. Overall, clear differences in mands of the particular type of Contrary to the above hypothesis,
matching error are evident among all matching task being performed. however, one of the more intriguing
3 task conditions, with the smallest and consistent findings to arise from
errors evident in the ipsilateral Factor 2: Limb Preference the work of my colleagues and me is
matching task involving memory de- Handedness is the tendency to pre- a nonpreferred arm advantage for
mand. In contrast, absolute match- fer one arm versus the other arm for proprioceptive position matching
ing errors in the contralateral task, performing various activities of daily tasks. Inspired by previous research
requiring more interhemispheric in- living and is one of the most obvious within the realm of psychology,51–54
teraction, are greater than those in examples of lateralized brain func- my colleagues and I have explored in
the ipsilateral case, despite not hav- tion in humans.46 Based largely on some depth the extent to which el-
ing a memory component. In the questionnaires such as the Edin- bow position matching errors differ
contralateral remembered condition, burgh Handedness Inventory of Old- for the left and right arms of left-
where cognitive demands included field,47 it has been estimated that handed42 and right-handed37– 40,55 in-
both memory and interhemispheric 90% of the population is right- dividuals. In initial studies,37–39 the 3
communication, absolute errors are handed for tasks such as handwrit- matching tasks described in the pre-
approximately twice as large as in ing, throwing a ball, or eating with a vious section (ie, ipsilateral, con-
the ipsilateral condition and about spoon.48 –50 Given the robust and en- tralateral, and contralateral remem-
one third greater than in the con- during nature of this phenomenon, a bered) were used to manipulate the
tralateral matching task. Taken to- logical prediction might be that the proprioceptive demands (ie, the
gether, these results provide strong preferred right arm of right-handed need for memory or interhemi-
evidence that tests of position people would demonstrate a posi- spheric transfer of proprioceptive in-
matching are not simple measures of tion matching advantage over the formation) placed on the partici-
proprioceptive acuity alone. Rather, nonpreferred left arm. pants. The results of this work
they also reflect the cognitive de-

August 2010 Volume 90 Number 8 Physical Therapy f 1179

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Factors Affecting Position Matching
showed that not only was matching
more accurate by the nonpreferred
arm across all task types but the mag-
nitude of arm asymmetry favoring
the nonpreferred arm also was rela-
tively increased with greater cogni-
tive demands. Specifically, although
preferred arm errors were progres-
sively larger when comparing the
contralateral condition with the ipsi-
lateral and contralateral remembered
conditions, nonpreferred arm match-
ing errors were similar in magnitude
across all tasks.
To ensure that the handedness ef-
fects seen in initial studies of posi-
tion matching truly were due to pro-
prioceptive processing, rather than a
generally greater ability of the non-
preferred arm to match elbow posi-
tions, a follow-up experiment was
conducted. In this study,40 young
participants who were healthy were
asked to match 15- and 30-degree
elbow extension positions according
to both the ipsilateral and contralat-
eral remembered task types. In one
set of conditions, target elbow an-
gles were matched visually by having
participants point with a laser on a
projection screen to targets that re-
quired the target amount of elbow
extension. In another set of condi-
tions, matching relied solely on pro-
prioceptive information. Based on
this design, it was shown that non-
preferred arm position matching ad-
vantages were evident only in the
proprioceptive version of the match-
ing experiment. Indeed, in the visual
version, the reverse trend was iden-
tified (ie, a preferred arm advantage
was seen for matching). These re-
sults suggest that the preferred and
nonpreferred arms rely to a different
extent on visual versus propriocep-
tive information, as might be benefi-
cial for performing activities of daily
living requiring both hands. Typi-
cally, the preferred arm requires vi-
sual information for the fine manip-
ulation of objects. In contrast, the
nonpreferred arm more often is held
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outside of visual attention, where it
must rely on proprioceptive feed-
back to perform tasks such as hold-
ing objects in a particular position.56
The nonpreferred arm position
matching advantages seen in adults
who are healthy also appear to have
meaning for position matching as-
sessments of proprioceptive acuity
in clinical populations. There is cur-
rently evidence in the literature that
enhanced nonpreferred left arm
matching is linked to a right-
hemisphere specialization for the
processing of proprioceptive inputs.
The most convincing work done in
this area to date is that of Naito and
colleagues,44,57 who used a tendon
vibration paradigm in combination
with neuroimaging to map regions of
the brain responsible for processing
input from key proprioceptors—the
muscle spindles. Given that the basis
for proprioceptive performance lies
more directly within the right hemi-
sphere, it may be expected that in-
dividuals with right-hemisphere
damage would be more prone to
proprioceptive deficits than individ-
uals with left-hemisphere injury. My
colleagues and I36 recently tested
this hypothesis for the ipsilateral el-
bow matching abilities of children
with hemiplegic cerebral palsy. In
agreement with our hypothesis, we
found that, compared with children
who were developing typically,
only those individuals with right-
hemisphere injuries showed in-
creased position matching errors of
the affected arm and, to a lesser ex-
tent, the unaffected arm. These pre-
liminary results suggest the need for
differential treatment of lateralized
brain injuries in the clinic, with a
greater emphasis placed on proprio-
ception in those individuals with
right-hemisphere damage.
Factor 3: Reference Position
Establishment
The means by which the reference
joint angle is established also is an
important factor to consider in tests
of position matching ability. This
consideration includes not only the
magnitude of the reference joint an-
gle but also the characteristics of
how the joint was displaced to pro-
duce that angle. Studies by me and my
colleagues have regularly made com-
parisons of matching errors at dif-
ferent reference joint angles.38 – 40,42
Based on this work, we found that a
clear relationship exists between the
target amplitude and the magnitude
of matching error, with further tar-
gets inducing greater matching er-
rors (ie, poor performance). For ex-
ample, in one study,38 20 young
adults who were healthy were asked
to match targets that were either 20
or 40 degrees from the start elbow
joint position. Regardless of whether
the preferred or nonpreferred arm
served as the reference, absolute er-
rors were found to be, on average,
66% greater for the larger target am-
plitude. One hypothesis that has
been put forth to explain this finding
is that the increased errors seen with
larger target amplitudes reflect in-
creased sensorimotor noise when
movement requires an increased
neural control signal.58 Nevertheless,
clinicians and researchers are en-
couraged to take great care when
conducting position matching stud-
ies, ensuring that target amplitudes
are matched across all populations of
individuals tested and within each
particular experimental condition.
Beyond the influence of target ampli-
tude on position matching perfor-
mance, experiments from as early as
the 1960s demonstrated that partici-
pants make smaller errors when
matching a reference position that is
established through their own active
movement, rather than the same tar-
get position determined passively by
the experimenter.59 – 61 This effect is
thought to be the consequence of 2
movement-related features. First, the
sensitivity of muscle spindles (key
proprioceptors) is enhanced during
August 2010

Figure 3.
Average (SE) absolute errors in the ipsilateral matching of 30-degree targets for different
cross sections of the human life span.
active movements via the gamma
motor system.62 Second, an “efferent
copy” of the motor command used
to get to the target position may be
called upon to inform subsequent
matching movements.63,64 In addi-
tion to improvements in matching
error with actively determined tar-
gets, work by Goble and Brown37
suggests that matching strategy also
is altered based on the means by
which the reference angle is estab-
lished (ie, active versus passive). In-
deed, regardless of matching task (ie,
ipsilateral, contralateral, or contralat-
eral remembered), elbow joint refer-
ence positions determined actively
by movement of the participant
(rather than passively by the experi-
menter) appear to lead to target
movements that are faster and
smoother. Although these increases
in speed and smoothness did not re-
sult in fewer errors in their study, it
seems likely that this change in strat-
egy reflected the higher confidence
participants had in their ability to
August 2010
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Factors Affecting Position Matching
match actively determined reference
positions.
Given that most position matching
assessments conducted in clinical
environments use passive displace-
ment of the joint to the target angle
(usually by the experimenter), an-
other point of concern for clinical
researchers is the “tau effect.” The
tau effect, initially described in stud-
ies of movement extent estima-
tion,65,66 manifests as a strong interde-
pendence between time and space,
such that movements of longer dura-
tion are perceived as traveling farther
than those of shorter duration. For po-
sition matching experiments, this find-
ing implies that, if during the establish-
ment of the target joint angle an
experimenter takes a long versus a
short amount of time, the participants
will perceive the target as being fur-
ther from the starting joint angle than
it actually is. The tau effect was con-
firmed recently in a set of elbow posi-
tion matching trials conducted with
Volume 90 Number 8
young participants who were
healthy.67 Using a motorized system,
each participant’s elbow joint was dis-
placed to the same reference position,
but at speeds that were faster or
slower than or the same as the speed
at which the elbow was subsequently
moved back to the target location for
matching. It was shown that matching
error was systematically biased by the
speed at which the reference position
was established. Taken together, the
results described in this section under-
score the need for clinicians to take
great care when establishing reference
joint positions. Keeping potential ex-
perimental biases in mind when per-
forming proprioceptive assessments
via position matching will improve
proprioceptive sensibility estimates.
Factor 4: Participant Age
Age-related changes in the periph-
eral and central nervous system are a
natural consequence of human
growth and development. Peripheral
alterations of proprioceptor size
and number vary across the life span
and affect the quality of the limb posi-
tion signal provided to the brain. On
the other hand, central feedback pro-
cessing of limb position signals is re-
fined throughout a lifetime of experi-
ence. Given that clinical populations
often occupy certain spectra of the life
span (eg, cerebral palsy in children,
stroke in older people), it is important
for clinicians to take into account nat-
ural shifts in acuity with age when
determining the existence of any pro-
prioceptive deficit.
In light of the task-related factors in-
fluencing position matching error
described in the previous sections,
the true relationship between propri-
oceptive matching ability and age is
difficult to ascertain from a simple
meta-analysis of the existing literature.
Rather, comparisons of position
matching performance among various
age groups must be made under ex-
perimental conditions that are very
closely matched. In this case, a com-
Physical Therapy f 1181
Factors Affecting Position Matching
Figure 4.
Demonstration of bias in average (SE) absolute error when position matching occurs in
different locations of the task workspace.
pilation of the data collected by Goble
and colleagues39,40,68 provides an ideal
opportunity to explore the relation-
ship between normal aging and pro-
prioceptive ability. In Figure 3, the av-
erage absolute matching errors are
displayed for different cross-sections
of the age spectrum that were tested
using very similar task parameters (ie,
ipsilateral matching with the preferred
arm of a 30° target). As shown in Fig-
ure 3, the relationship between age
and position matching error is non-
monotonic, with an overall refinement
of position matching ability (ie, de-
crease in absolute error) from child-
hood (ie, age 8 –10 years) through
adolescence to young adulthood. Ab-
solute matching errors then increase
into middle age and continue to rise
with old age.
Although the data provided in Figure
3 clearly demonstrate the pattern of
proprioceptive performance across
the life span, it must be emphasized
the absolute magnitude of the errors
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provided in this (or any) particular
position matching study should not
be considered “norms.” Unless very
similar task parameters (eg, elbow
joint, ipsilateral matching, preferred
arm) are used, it is recommended
that therapists make use of study-
specific normative databases when
making any determination of what
represents pathological performance.
Indeed, failure to compare data under
similar task conditions may result in a
relative underestimation or overesti-
mation of a patient’s matching ability
and a subsequent misdiagnosis of pro-
prioceptive sensibility.
Factor 5: Task Workspace
Task workspace is the relative area
wherein most individuals perform a
given activity of daily living. For most
visually guided upper-limb tasks (eg,
writing, opening a jar, cutting food)
the “common” workspace used by
right-handed individuals is located at
the front of the body at approxi-
mately chest height with the hands
centered to the right of body mid-
line. In light of this seeming “right
shift” of workspace preference for
visual tasks, a question of interest for
me was whether a similar or differ-
ent dependence on workspace ex-
isted for tests of positions matching.
Figure 4 presents previously unpub-
lished data from a study of 10 young
adults who were healthy and who
performed 20-degree elbow joint po-
sition matching tasks in various loca-
tions of the workspace relative to
body midline. Workspace was di-
vided into far left, near left, near
right, and far right of body midline.
The elbow on the same side of the
body as the workspace tested per-
formed matching in either an ipsilat-
eral or contralateral fashion. In con-
trast to what typically is seen for
visually guided tasks, proprioceptive
position matching showed greater
performance to the left of body mid-
line, with the smallest errors seen in
the far left workspace. These results,
although subtle in absolute magni-
tude (⬃1°), are in good agreement
with those of a previous study69 in
which a similar far-left advantage
was found for reaching to proprio-
ceptive targets (ie, the unseen finger
of a participant located under a ta-
bletop). In this case, a left work-
space bias in position matching per-
formance also should be accounted
for in the design and interpretation
of position matching studies by cli-
nicians and researchers alike.
Summary and Conclusions
Based on studies of elbow position
matching, this article sought to in-
form clinicians and clinician re-
searchers of various insights gained
from studies conducted by my col-
leagues and me over the past half
decade. Although these insights may
not be fully generalizable to all joints
in the upper and lower extremities,
it remains possible to offer several
“best practice” suggestions regard-
ing how clinically based assessments
August 2010

of proprioceptive function should be
performed.
First, it has been demonstrated that
the choice of ipsilateral versus con-
tralateral matching task (factor 1) is
not trivial, as these tasks have very
different requirements for memory
and interhemispheric communica-
tion, respectively. In this case, pru-
dent selection of matching task,
based on the cognitive abilities of the
individual being tested, will reduce
cognition-based confounds and pro-
vide more accurate assessments of
proprioceptive ability.
Second, there appears to be a left-
arm advantage for position matching
(factor 2) that likely stems from an
enhanced role for the right hemi-
sphere in proprioceptive feedback
processing. The implication of this
finding for clinicians and researchers
is that individuals with right- versus
left-hemisphere injury may be ex-
pected to exhibit greater proprio-
ceptive deficits.
Third, the position matching studies
of the author and colleagues have
shown that the manner by which
target positions are established (fac-
tor 3) can have significant effects on
position matching performance. In
this case, clinician researchers are
advised to take care in ensuring that
tested target amplitudes are of the
same magnitude and established in
the same manner (active versus pas-
sive) and at the same speed across
all participants and experimental
conditions.
Fourth, clinicians and researchers
must be sure to account for natural
shifts in proprioceptive acuity with
age (factor 4), as clinical populations
often fall nearer to one end of the
spectrum compared with other pop-
ulations (eg, people with stroke,
older people).
August 2010
Downloaded from http://ptjournal.apta.org/ by guest on March 18, 2013
Factors Affecting Position Matching
Fifth, there appears to be an effect of
task workspace on position match-
ing (factor 5), such that matching
movements are enhanced when
made to the far left of body midline.
Clinicians and researchers, there-
fore, should perform tests of posi-
tion matching ability within a com-
mon workspace.
Despite the many factors presented,
it was not the intent of this perspec-
tive article to call into question, or
advise against the use of, position
matching tasks in clinical research.
Rather, it is hoped that the informa-
tion provided will help enhance fu-
ture studies within the field of phys-
ical therapy and allow for more
substantive breakthroughs to be
made. Indeed, it is more apparent
than ever that proprioceptive informa-
tion is a key component of the plastic
reorganization of central nervous sys-
tem following injury.1,2 Adequate as-
sessment of proprioceptive acuity,
therefore, will be a critical indicator of
treatment outcomes in future assess-
ments of many disease conditions.
The studies forming the basis for this article
were conducted in the Motor Control Labo-
ratory of Dr Susan Brown at the University of
Michigan. The author gives special thanks to
Dr Brown and all of his former colleagues in
the Motor Control Laboratory for their con-
tributions to this work.
Funding for the author was provided by fel-
lowships from the Flemish Fund for Scientific
Research and the Canadian Institutes of
Health Research: Institute of Aging.
This article was submitted December 3, 2009,
and was accepted April 21, 2010.
DOI: 10.2522/ptj.20090399
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 Proprioceptive Acuity Assessment Via Joint Position
Matching: From Basic Science to General Practice
Daniel J. Goble
PHYS THER. 2010; 90:1176-1184.
Originally published online June 3, 2010
doi: 10.2522/ptj.20090399

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