Kinematic and Kinetic Predictors of Y-Balance Test Performance

BackgroundThe Y-Balance Test (YBT) assesses dynamic stability and neuromuscular control of the lower extremity. Several authors have analyzed kinematic predictors of YBT performance with conflicting results, but the influence of kinetic factors is not well understood.PurposeTo examine kinematic predictors of YBT performance and determine the joint kinetics which predict YBT performance.Study DesignCross-sectional study.MethodsThirty-one physically active individuals performed YBT trials on a force plate while whole body kinematics were recorded using a motion capture system. Sagittal, frontal, and transverse plane joint kinematics and joint moments were calculated at maximum reach in each YBT reach direction. Variables correlated with reach distances at the p < 0.2 level were entered into a stepwise linear regression.ResultsIn the anterior direction, knee flexion and torso rotation (R²=0.458, p<0.001) and knee extensor and hip abductor moments (R²=0.461, p<0.001) were the best kinematic and kinetic predictors of reach distance. In the posterior medial direction, hip flexion, ankle dorsiflexion, and ankle rotation accounted for 45.8% of the variance in reach direction (p<0.001) while hip and knee extensor, and hip abductor moments explained 72.6% of the variance in reach distance (p<0.001). In the posterior lateral direction, hip flexion and pelvic rotation (R²=0.696, p<.001) and hip extensor moments (R²=0.433, p=0.001) were the best kinematic and kinetic predictors of reach distance.ConclusionThe ability to generate large hip and knee joint moments in the sagittal and frontal plane are critical for YBT performance.Level of Evidence3.     

Effect of Togu-exercise on Lumbar Back Strength of Women with Chronic Low Back Pain

[Purpose] The present study analyzed the effect of the Togu exercise program on the lumbar back strength of middle-aged women who did not perform regular exercise, and presents an effective exercise method for middle-aged women with chronic low back pain symptom. [Subjects] The subjects were 16 women with chronic low back pain attending N University, Chungcheong-do, Korea. [Methods] Height, weight, body fat, and body mass index (BMI) were measured using a body composition analyzer (Inbody 720, Biospace, Korea), which utilizes bioelectrical impedance analysis. Using isokinetic lumbar muscle strength measurement equipment [Isomed 2000, Back system, (Germany)], peak torque/body weight, total work and average power of flexion and extension of the lumbar region were measured. For lumbar stabilization exercises, an air cushion (Germany), jumper (Germany), and aero step (Germany) were employed. First, warm-up exercise was conducted for 10 minutes, followed by 10 sets of the 3 main exercises using the above tools with 10-second rest intervals. The main exercise was done for 40 minutes in total. [Results] The paired sample t-test showed significant in the Togu exercise group peak torque of flexion, peak torque of extension, total work of flexion, total work of extension, average power of flexion, average power of extension, after the exercise showed a significant difference in the Togu exercise group. [Conclusion] The trunk muscle actiation program for middle-aged women had a significant effect on muscle strength and low back pain. Therefore the trunk muscle activation program is effective at increasing muscular strength of middle-aged women, and the results suggest improve muscle strength is effectively stabilizaties the lumbar region.Key words: Isokinetic, Lumbar stabilization, Togu     

Lower Extremity Kinematics of the Y-Balance Test in Healthy and ACL Injured Adolescent Females

BackgroundAdolescent females are at significant risk for sustaining an ACL injury. The Y-Balance Test (YBT) is frequently used to evaluate neuromuscular control and lower extremity function. However, few studies have quantified 2D lower extremity kinematics during performance of the YBT, and there is an absence of kinematic data specific to at-risk adolescent females.PurposeTo examine lower extremity joint kinematics during execution of the YBT by healthy and ACL-injured adolescent females.Study DesignProspective cohort.MethodsTwenty-five healthy and ten ACL-injured (mean time from injury 143 days) adolescent females were assessed using the YBT. Sagittal and frontal plane knee and ankle motion was video recorded during execution of the YBT anterior reach movement. Ankle dorsi-flexion, knee flexion, and knee valgus angles were quantified via kinematic analysis. ANOVAs with a post hoc Bonferroni correction were used to compare YBT scoring (%LL) and kinematic data between groups. Pearson product-moment correlations determined the relationship between kinematic data and YBT scoring.ResultsHealthy and ACL-injured subjects demonstrated similar YBT scores and lower extremity kinematic data. Healthy subjects demonstrated a weak positive correlation between ankle dorsiflexion and YBT scoring, and a weak negative correlation between knee valgus and YBT scoring. These relationships did not exist for ACL-injured subjects. Kinematic data for both groups also demonstrated a large degree of variability, regardless of YBT score.ConclusionsAdolescent females frequently utilize a variety of lower extremity movement strategies when performing a functional movement task, and scoring on the YBT offers limited insight regarding lower extremity joint kinematics and ACL-injury risk in a physically active adolescent female population.Level of EvidenceLevel 3.     

Correlation between Pediatric Balance Scale and Functional Test in Children with Cerebral Palsy

[Purpose] To investigate the correlation of functional balance with the functional performance of children with cerebral palsy. [Subjects and Methods] This was a cross-sectional study of children with cerebral palsy with mild to moderate impairment. The children were divided into 3 groups based on motor impairment. The evaluation consisted of the administration of the Pediatric Balance Scale (PBS) and the Pediatric Evaluation Disability Inventory. Correlations between the instruments were determined by calculating Pearson’s correlation coefficients. [Results] In Group 1, a strong positive correlation was found between the PBS and the mobility dimension of the Pediatric Evaluation Disability Inventory (r=0.82), and a moderate correlation was found between the PBS and self-care dimension of the Pediatric Evaluation Disability Inventory (r=0.51). In Group 2, moderate correlations were found between the PBS and both the self-care dimension (r=0.57) and mobility dimension (r=0.41) of the Pediatric Evaluation Disability Inventory. In Group 3, the PBS was weakly correlated with the self-care dimension (r=0.11) and moderately correlated with the mobility dimension (r=0.55). [Conclusion] The PBS proved to be a good auxiliary tool for the evaluation of functional performance with regard to mobility, but cannot be considered a predictor of function in children with cerebral palsy.Key words: Cerebral palsy, Children, Postural balance     

A Study of Effect of the Compound Physical Activity Therapy on Muscular Strength in Obese Women

[Purpose] The aim of this study was to determine how compound physical activity affects muscular strength of middle-aged obese women. [Subjects] The research subjects were 40–50 year-old middle-aged women with excess body fat (30%). [Methods] The subjects were randomly assigned to two group, the experimental group and the control group. The experimental group performed two types of exercise programs for 16 weeks. Aerobic physical activity was performed 5 times per week, and anaerobic physical activity was performed every two days, and the exercise program each day was composed of a warm-up, the main exercise, and cooldown. The type of exercise focused on walking at a quick pace, and the intensity of the exercise focused on long periods of exercise at low intensity with the level of HRmax being 40–60%. The weight training, which was useful for beginners, as a type of kinetic load exercise, was applied with a composition recommended by the ACSM for muscle fitness (intensity of 40–60% of 1 RM and 10–15 repetitions). SPSS version 16.0 was used to analyze the data by ANCOVA and the t-test. [Results] The chest, leg, and abdominal strengths were significantly increased in the experimental group, and this indicates that compound physical activity is effective for improvement of muscular strength. [Conclusion] In conclusion, there were significant differences between groups in terms of muscular strength.Key words: Therapy, Muscular, Strength     

Verification of the Correlation between Cognitive Function and Lower Limb Muscle Strength for the Community-dwelling Elderly

[Purpose] The purpose of this study was to evaluate the lower limb muscle strength of the community-dwelling elderly, with or without cognitive decline, using isometric knee extension strength (IKES) and the 30-second chair stand test (CS-30). [Subjects] A total of 306 community-dwelling elderly participated in this study. Assessment items were the CS-30, IKES, Mini-Mental State Examination (MMSE), and Trail-Making Test Part A (TMT-A). [Methods] Participants were divided into three groups according to their MMSE score: cognitive impairment (MMSE ≤ 24), cognitive decline (MMSE 25 to 27), and normal (MMSE ≥ 28). We compared IKES and CS-30 among the three groups. [Results] IKES was not significantly different among the three groups. However, the CS-30 was significantly different among the three groups. Upon further analysis the CS-30 score of each group, when adjusted for age and TMT-A, did not indicate a significant difference. [Conclusion] These results suggest that the lower limb muscle strength of the elderly does not differ with cognitive decline. Moreover, we suggest that when using the CS-30 score as an indicator of lower limb muscle strength attentional function should be taken into account.Key words: Isometric knee extension strength, CS-30, Attentional function     

Lower Extremity and Trunk Electromyographic Muscle Activity During Performance of the Y-Balance Test on Stable and Unstable Surfaces

BackgroundThe Star Excursion Balance Test (SEBT) has been used as a rehabilitation exercise. To improve its efficacy, efficiency, and method variations, the Y-Balance Test (YBT) with anterior (A), posterolateral (PL), and posteromedial (PM) directions of the SEBT has been recommended. Electromyographic activity has been reported to change when the same task is performed on various surfaces.Hypothesis/PurposeTo compare the EMG activity of trunk and LE muscles during the performance of the YBT on stable and unstable surfaces.Study DesignCross-Sectional study.MethodsHealthy adults with no history of chronic ankle instability were recruited for the study. Surface electromyography was collected for bilateral (ipsilateral [i] and contralateral [c]) rectus abdominis (RA), external oblique (EOB), erector spinae (ES). While, gluteus maximus (GMAX), gluteus medius (GMED), medial hamstrings (MH), biceps femoris (BF), vastus medialis (VM), rectus femoris (RF), vastus lateralis (VL), anterior tibialis (AT), and medial gastrocnemius (MG) on the stance leg (ipsilateral side), during the performance of the YBT. The unstable surface was introduced using a Thera-Band stability trainer. Differences in electromyography were examined for each reach direction and muscle between the stable and unstable surfaces (p≤ 0.05).ResultsTwenty (10 male, 10 female) subjects participated (age: 27.5 ± 4.0 years, height:167 ± 1.0 cm, weight: 66.5 ± 13.0 kg, body fat: 14.1 ± 6.2%). Significantly higher muscle activity for the unstable surface (p<0.05) with moderate to large effect sizes were observed for the following muscles in the A direction: GMED, GMAX, VM, RF, and MG; PL direction: iEOB, iES, cES, GMED, BF, VM, RF, and MG; and PM direction iEOB, iES, GMED, BF, VM, and RF. Significantly higher muscle activity for the stable surface (p = 0.007) was observed in MH muscle in the A direction. No significant differences (p>0.05) between the stable and unstable surfaces were observed in iRA, cRA, cEOB, VL, and AT for any of the directions of the YBT.ConclusionAn increase in muscle activity was observed during YBT on unstable versus stable surfaces for some muscles.Level of Evidence2B     

The Effects of Abdominal Hollowing in Lower-limb PNF Pattern Training on the Activation of Contralateral Muscles

[Purpose] The purpose of this study was to determine the effects of abdominal hollowing during lower-limb proprioceptive neuromuscular facilitation (PNF) training on the activation of contralateral muscles. [Subjects] Twenty male college students without symptoms or signs of muscular or nervous disease participated in this experiment after signing a consent form. [Methods] All the subjects were measured with electromyography (EMG) in a muscle activation test before and after abdominal hollowing. In the PNF program, the lower-limb pattern of PNF training, was maintained for 5 seconds, followed by a 2-minute break. This was repeated three times. The resting time between sets was 30 minutes. Surface EMG (Keypoint, Medtronic Inc., USA) was used for the measurements, and the highest value of three measurements was used in the analysis. [Result] The results revealed a significant change in the muscular activation of the opposite-side lower limbs. The muscular activations of the vastus lateralis, tibialis anterior, semitendinosus and gastrocnemius were increased significantly after the abdominal hollowing. [Conclusion] The findings suggest that abdominal hollowing in PNF pattern training can be effective at promoting muscular activation of the contralateral muscles. To promote muscular activation of the opposite side in lower-limb PNF pattern training, abdominal hollowing should be considered to improve the effect of PNF pattern training.Key words: PNF pattern, Abdominal hollowing, Contralateral muscle activation     

Strength deficits of the shoulder complex during isokinetic testing in people with chronic stroke

OBJECTIVES:

To examine the strength deficits of the shoulder complex after stroke and to characterize the pattern of weakness according to type of movement and type of isokinetic parameter.

METHOD:

Twelve chronic stroke survivors and 12 age-matched healthy controls had their shoulder strength measured using a Biodex isokinetic dynamometer. Concentric measures of peak torque and work during shoulder movements were obtained in random order at speeds of 60°/s for both groups and sides. Type of movement was defined as scapulothoracic (protraction and retraction), glenohumeral (shoulder internal and external rotation) or combined (shoulder flexion and extension). Type of isokinetic parameter was defined as maximum (peak torque) or sustained (work). Strength deficits were calculated using the control group as reference.

RESULTS:

The average strength deficit for the paretic upper limb was 52% for peak torque and 56% for work. Decreases observed in the non-paretic shoulder were 21% and 22%, respectively. Strength deficit of the scapulothoracic muscles was similar to the glenohumeral muscles, with a mean difference of 6% (95% CI -5 to 17). Ability to sustain torque throughout a given range of motion was decreased as much as the peak torque, with a mean difference of 4% (95% CI -2 to 10).

CONCLUSIONS:

The findings suggest that people after stroke might benefit from strengthening exercises directed at the paretic scapulothoracic muscles in addition to exercises of arm elevation. Clinicians should also prescribe different exercises to improve the ability to generate force and the ability to sustain the torque during a specific range of motion.     

Test of Intrarater and Interrater Reliability for the Star Excursion Balance Test

[Purpose] The aim of this study was to examine the intrarater and interrater reliability of the Star Excursion Balance Test (SEBT), thereby increasing understanding of its efficient utilization. [Subjects and Methods] There were 67 subjects (49 female; 18 male). For the SEBT, eight lines were made using tape at 45-degree angles from the center of a circle. The experiment was conducted in the following order: the anterior, anterior-medial, medial, posterior-medial, posterior, posterior-lateral, lateral, and anterior-lateral directions. Intraclass correlation coefficients (ICC) (3,1) were used to evaluate the intrarater and interrater reliability (2,1) for each reach distance, while the standard error of measurement (SEM) and smallest detectable distance (SDD) were employed to assess absolute reliability. [Results] For intraratar reliability, the ICC values for all directions ranged from 0.88 to 0.96, SEM values ranged from 2.41 to 3.30, and SDD values ranged from 6.68 to 9.15. For interrater reliability, the ICC values for all directions ranged from 0.83 to 0.93, SEM values ranged from 3.19 to 4.26, and SDD values ranged from 8.85 to 11.82 [Conclusion] The SEBT is a highly reliable tool for measuring dynamic balance. Measurements for intrarater reliability are more reliable than measurements for interrater reliability. When measurement for eight directions was difficult, the SEBT was used. While the anterior, posteromedial, and posterolateral directions employed in the Y Balance Test Kit^TM can be utilized, this study recommends using the reverse Y Balance Test Kit^TM method with the posterior direction, not the anterior direction.Key words: Star excursion balance test (SEBT), Dynamic balance, Reliability     

Physiotherapy for Women with Stress Urinary Incontinence: A Review Article

[Purpose] This review article is designed to expose physiotherapists to a physiotherapy assessment of stress urinary incontinence (SUI) and the treatment and possibly preventive roles that they might play for women with SUI. Specifically, the goal of this article is to provide an understanding of pelvic floor muscle function and the implications that this function has for physiotherapy treatment by reviewing articles published in this area. [Methods] A range of databases was searched to identify articles that address physiotherapy for SUI, including the Cochrane Library, Medline, and CINAHL. [Results] According to the articles identified in our databases research, greater improvements in SUI occur when women receive a supervised exercise program of at least three months. The effectiveness of physiotherapy treatment is increased if the exercise program is based on some principles, such as intensity, duration, resembling functional task, and the position in which the exercise for pelvic floor muscles is performed. Biofeedback and electrical stimulation may also be clinically useful and acceptable modalities for some women with SUI. [Conclusion] We concluded that the plan for physiotherapy care should be individualized for each patient and include standard physiotherapy interventions.Key words: Incontinence, Physiotherapy     

Systematic Review and Meta-Analysis of the Y-Balance Test Lower Quarter: Reliability,Discriminant Validity,and Predictive Validity

BackgroundDeficits in dynamic neuromuscular control have been associated with post-injury sequelae and increased injury risk. The Y-Balance Test Lower Quarter (YBT-LQ) has emerged as a tool to identify these deficits.PurposeTo review the reliability of the YBT-LQ, determine if performance on the YBT-LQ varies among populations (i.e., sex, sport/activity, and competition level), and to determine the injury risk identification validity of the YBT-LQ based on asymmetry, individual reach direction performance, or composite score.Study DesignSystematic ReviewMethodsA comprehensive search was performed of 10 online databases from inception to October 30, 2019. Only studies that tested dynamic single leg balance using the YBT-LQ were included. Studies were excluded if the Y-Balance Test kit was not utilized during testing or if there was a major deviation from the Y-Balance test procedure. For methodological quality assessment, the modified Downs and Black scale and the Newcastle-Ottawa Scale were used.ResultsFifty-seven studies (four in multiple categories) were included with nine studies assessing reliability, 36 assessing population differences, and 16 assessing injury prediction were included. Intra-rater reliability ranged from 0.85-0.91. Sex differences were observed in the posteromedial direction (males: 109.6 [95%CI 107.4-111.8]; females: 102.3 [95%CI 97.2-107.4; p = 0.01]) and posterolateral direction (males: 107.0 [95%CI 105.0-109.1]; females: 102.0 [95%CI 97.8-106.2]). However, no difference was observed between sexes in the anterior reach direction (males: 71.9 [95%CI 69.5-74.5]; females: 70.8 [95%CI 65.7-75.9]; p=0.708). Differences in composite score were noted between soccer (97.6; 95%CI 95.9-99.3) and basketball (92.8; 95%CI 90.4-95.3; p <0.01), and baseball (97.4; 95%CI 94.6-100.2) and basketball (92.8; 95%CI 90.4-95.3; p=0.02). Given the heterogeneity of injury prediction studies, a meta-analysis of these data was not possible. Three of the 13 studies reported a relationship between anterior reach asymmetry reach and injury risk, three of 10 studies for posteromedial and posterolateral reach asymmetry, and one of 13 studies reported relationship with composite reach asymmetry.ConclusionsThere was moderate to high quality evidence demonstrating that the YBT-LQ is a reliable dynamic neuromuscular control test. Significant differences in sex and sport were observed. If general cut points (i.e., not population specific) are used, the YBT-LQ may not be predictive of injury. Clinical population specific requirements (e.g., age, sex, sport/activity) should be considered when interpreting YBT-LQ performance, particularly when used to identify risk factors for injury.Level of Evidence1b     

Comparison of Abdominal Muscle Thickness with Vaginal Pressure Changes in Healthy Women

[Purpose] The purpose of this study was to verify the efficacy of a pelvic floor muscle exercise program by comparing subjects’ muscle thickness with changes in vaginal pressure. [Subjects] Two groups of female participants without a medical history of pelvic floor muscle dysfunction were evaluated. The mean age of Group I was 33.5 years and that of Group II was 49.69 years. [Methods] The participants were instructed to perform a pelvic floor muscle contraction. While measuring the vaginal pressure of the pelvic floor muscle, biofeedback was given on five levels, and the thicknesses of the transversus abdominis, external oblique, and internal oblique muscles were measured with ultrasound. [Results] The thickness of the transversus abdominis muscle was significantly increased at 30 cmH₂O in Group I, and at 20 cmH₂O in Group II. The thickness of the internal oblique abdominal muscle significantly increased at maximum contraction in Group II. [Conclusion] Different abdominal muscles contracted depending on vaginal pressure. The result may be used to create and implement an exercise program that effectively strengthens the pelvic floor muscles.Key words: Pelvic floor muscle contraction, Vaginal pressure, Abdominis muscle     

Reliability of Pinch Strength Testing in Elderly Subjects with Unilateral Thumb Carpometacarpal Osteoarthritis

[Purpose] The aim of this study was to examine the test-retest reliability of pinch strength testing in elderly subjects with thumb CMC OA. [Subjects and Methods] A total of 27 patients with unilateral right-thumb CMC OA (mean ± SD age: 81.3 ± 4.7 years) were recruited. Each patient performed three pain-free maximal isometric contractions on each hand on two occasions, one week apart. Three different measurements were taken: tip, tripod, and key pinch strength. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and 95% limits of agreement (LOA) calculations were performed. [Results] Test-retest reliability of measurements of tip, tripod, and key pinch strength was excellent for the affected side (ICC=0.93, 0.96, and 0.99) and the contralateral thumb (ICC=0.91, 0.92, and 0.94). [Conclusions] The present results indicate that maximum pinch strength can be measured reliably using the Pinch Gauge Dynamometer, in patients with thumb CMC OA, which enables its use in research and in the clinic to determine the effect of interventions on improving pinch strength.Key words: Test-retest, Reliability, Pinch strength     

Plantarflexor and Dorsiflexor Activation during Inclined Walking with and without Modified Mobilization with Movement Using Tape in Women with Limited Ankle Dorsiflexion

[Purpose] This study compared the EMG activities of the plantarflexor and dorsiflexor muscles during inclined walking with and without modified mobilization with movement (modified MWM) using tape in women with limited ankle dorsiflexion. [Subjects] Fifteen women with limited dorsiflexion in their feet (22 feet in total) were recruited for this study. [Methods] The subjects walked with and without modified MWM using tape on a treadmill at 6 degrees with a speed of 1.25 m/s for 5 minutes. The EMG activities of the medial gastrocnemius (GCM) and tibialis anterior (TA) muscles were measured using a surface EMG system. [Results] During incline walking with modified MWM using tape, the mean EMG activity of the GCM significantly increased, and that of the TA decreased between heel strike and heel off. There was no difference between heel off and toe off in the two muscles. [Conclusions] Modified MWM using tape on the talus during incline walking could alter the muscle activities of the GCM and TA between heel strike and heel off in women with limited ankle dorsiflexion.Key words: Ankle dorsiflexion, Inclined walking, Tape     

An Examination of Limb Position for Measuring Toe-grip Strength

[Purpose] The purpose of the present study was to investigate the limb position at which the maximum toe-grip strength could be exerted as well as measurement reproducibility. [Subjects] Twenty healthy young women were selected. [Methods] We measured toe-grip strength under three conditions: 90° hip and knee flexion while sitting, 90° hip flexion and knee extension while sitting, and a standing position. [Results] We found that toe-grip strength was significantly lower in the 90° hip flexion and knee extension sitting position than in the 90° hip and knee flexion sitting position and standing position. Moreover, the 90° hip and knee flexion sitting position produced the best intraclass correlation coefficient (r = 0.813). [Conclusion] The results suggest that 90° hip and knee flexion while sitting is the most suitable limb position for measuring toe-grip strength, as this position allows maximum strength to be exerted and allows measurements to be repeated.Key words: Toe-gripping strength, Reproducibility, Healthy females     

Clinical Usefulness of Shoulder Stability Exercises for Middle-aged Women

[Purpose] This study examined the clinical usefulness of shoulder stability exercises and the effect of stability exercise on the shoulder pain of middle-aged women. [Subjects] Twenty-two middle-aged female subjects were randomly divided into two groups: a shoulder stability exercise group (Experimental group, n=11) and a control group (n=11). [Methods] Subjects in the experimental group performed a shoulder stability exercise, which was designed to correct abnormal location of the scapula, for 40 minutes per day, three times per week, over a period of four weeks. Range of motion, muscle strength, and grasping power were measured to determine the effect of the shoulder stability exercise. The measured parameters were evaluated before and after four weeks of exercise. [Results] Following intervention, range of motion, muscle strength, and grasping power showed greater improvements in the experimental group than in the control group. [Conclusion] The results of this study show that shoulder stability exercise can improve the shoulder function of middle-aged women, and prevent damage to the shoulder joint. We consider this exercise would be useful in clinical rehabilitation.Key words: Middle-aged women, Shoulder dysfunction, Shoulder stability     

Correlation of knee proprioception with muscle strength and spasticity in stroke patients

[Purpose] The purpose of this study was to investigate the relationship of knee proprioception with muscle strength and spasticity in stroke patients. [Subjects and Methods] The subjects were 31 stroke patients. The subjects received an explanation of the procedures and methods and provided informed consent before the experiment. A measurement board was used to determine the the proprioception deficit of the knee as a proprioception test. The proprioception test consisted of a passive and active angle reproduction test. A manual muscle test and modified Ashworth scale were used to evaluate knee muscle strength and spasticity level. The data were analyzed using an independent t-test and Spearman correlation. [Results] The results of this study revealed a significant difference between the affected side and non-affected side in the passive angle reproduction test and a significant difference in the correlation of the proprioception level with muscle strength and spasticity level. [Conclusion] This study indicates that the knee proprioception level is associated with spasticity and muscle strength in stroke patients.Key words: Proprioception, Spasticity, Stroke