In 2013, researchers Oh Sung Kwon and Seung Won Lee conducted a groundbreaking study to assess the impact of repeated passive movement (RPM) and repeated active movement (RAM) exercises on knee joint position sense in patients with hemiplegia. The study, which included 45 participants, revealed notable findings that could influence rehabilitation practices.

The researchers randomly assigned the 45 hemiplegic patients into three groups: a control group with no exercise, an RPM group, and a RAM group, each consisting of 15 subjects. Both exercise groups engaged in movements of the knee joint, ranging from 10 to 100 degrees at a speed of 120°/s. Each session included 60 repetitions over three sets lasting 15 minutes. To measure the outcomes, the team used Passive Angle Repositioning (PAR) and Active Angle Repositioning (AAR) techniques.

The results demonstrated a significant improvement in knee position sense among the RPM group. Specifically, these patients exhibited a decrease in positioning sense error for both PAR and AAR evaluations (p < 0.01). Conversely, the RAM group showed a notable increase in AAR accuracy (p < 0.05).

When comparing the three groups, the RPM group showed the most considerable decrease in both PAR and AAR errors (p < 0.01). The RAM group, while showing improvement in AAR accuracy, also experienced a higher error rate and rate of change compared to the control group, suggesting that the exercise-induced fatigue might have counterproductive effects on proprioception.

The study concludes that while RAM exercises can enhance proprioception in the knee joints of hemiplegic patients, they might also lead to fatigue, which can negate these benefits. On the other hand, RPM exercises consistently improved knee position sense without the adverse effects of fatigue.

These findings highlight the potential for tailored rehabilitation exercises to improve proprioception in hemiplegia patients, suggesting a balanced approach to exercise intensity and duration to maximize benefits while minimizing drawbacks.

Reference: Kwon, O. S., & Lee, S. W. (2013). Effect of continuing repeated passive and active exercises on knee’s position senses in patients with hemiplegia. Neurorehabilitation, 33(3), 391-397.