The influence of external loads on movement precision during active shoulder internal rotation movements as measured by 3 indices of accuracy

Context: Using constant, variable, and absolute error to measure movement accuracy might provide a more complete description of joint position sense than any of these values alone. Objective: To determine the effect of loaded movements and type of feedback on shoulder joint position sense and movement velocity. Design: Applied study with repeated measures comparing type of feedback and the presence of a load. Setting: Laboratory. Patients or Other Participants: Twenty healthy subjects (age = 27.2 ± 3.3 years, height = 173.2 ± 18.1 cm, mass = 70.8 ± 14.5 kg) were seated with their arms in a custom shoulder wheel. Intervention(s): Subjects internally rotated 27° in the plane of the scapula, with either visual feedback provided by a video monitor or proprioceptive feedback provided by prior passive positioning, to a target at 48° of external rotation. Subjects performed the internal rotation movements with video feedback and proprioceptive feedback and with and without load (5% of body weight). Main Outcome Measure(s): High-speed motion analysis recorded peak rotational velocity and accuracy. Constant, variable, and absolute error for joint position sense was calculated from the final position. Results: Unloaded movements demonstrated significantly greater variable error than for loaded movements (2.0 ± 0.7° and 1.5 ± 0.4°, respectively) (P < .05), but there were no differences in constant or absolute error. Peak velocity was greater for movements with proprioceptive feedback (45.6 ± 2.9°/s) than visual feedback (39.1 ± 2.1°/s) and for unloaded (47.8 ± 3.6°/s) than loaded (36.9 ± 1.0°/s) movements (P < .05). Conclusions: Shoulder joint position sense demonstrated greater variable error unloaded versus loaded movements. Both visual feedback and additional loads decreased peak rotational velocity.