{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:03:58Z","timestamp":1787828638935,"version":"build-2784847793"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023674","name":"Deanship of Scientific Research, King Khalid University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023674","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Fibromyalgia syndrome (FMS) is characterized by chronic musculoskeletal pain, fatigue, and sensory disturbances, often leading to impaired proprioception and postural control. This study aimed to examine joint reposition sense (JRS) at the hip, knee, and ankle, alongside limits of stability (LOS), in elderly individuals with FMS using digital inclinometers and computerized posturography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 108 participants (54 with FMS, 54 age-matched healthy controls) were assessed. JRS was assessed at standardized joint angles of the hip (60\u00b0 flexion), knee (45\u00b0 flexion), and ankle (15\u00b0 plantarflexion) using calibrated digital inclinometers, while LOS parameters\u2014reaction time, maximum excursion, and directional control\u2014were recorded with dynamic posturography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants with FMS showed significantly higher joint position errors at the hip (mean difference = 2.53\u00b0), knee (2.51\u00b0), and ankle (2.24\u00b0) (p &amp;lt; 0.001, Cohen\u2019s d &amp;gt; 1.8). LOS parameters were also impaired in the FMS group, with slower reaction time (\u0394 = 0.97\u00a0s), reduced maximum excursion (\u0394 = \u22123.44%), and lower directional control (\u0394 = \u221222.64%) (all p &amp;lt; 0.001). JRS errors negatively correlated with LOS metrics, particularly at the hip and knee. Regression analysis confirmed JRS as a significant predictor of postural control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Lower limb proprioceptive deficits significantly impact postural stability in individuals with FMS. Targeted proprioceptive training, especially at the hip and knee, may improve functional balance and reduce fall risk in this population.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fbioe.2025.1622679","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T08:14:26Z","timestamp":1757492066000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Joint-level proprioceptive deficits and postural instability in Fibromyalgia: a biomechanical assessment using digital inclinometry and dynamic posturography"],"prefix":"10.3389","volume":"13","author":[{"given":"Praveen Kumar","family":"Kandakurti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi Shankar","family":"Reddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani Hassan","family":"Alnakhli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Batool A.","family":"Alkhamis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghada M.","family":"Koura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad A.","family":"ALMohiza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal M.","family":"Alyazedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debjani","family":"Mukherjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram Sreenivasa","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1177\/00315125221089069","article-title":"Joint specificity and lateralization of upper limb proprioceptive perception","volume":"129","author":"Abi Chebel","year":"2022","journal-title":"Percept. Mot. Ski."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2791","DOI":"10.3390\/jcm12082791","article-title":"Mediation effect of kinesiophobia on the relationship between cervical joint position sense and limits of stability in individuals with fibromyalgia syndrome: a cross-sectional study using mediation analysis","volume":"12","author":"Alshahrani","year":"2023","journal-title":"J. Clin. Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3390\/life13010175","article-title":"Mediation effect of pain on the relationship between kinesiophobia and postural control: comparison and correlations in individuals with fibromyalgia syndrome and asymptomatic individuals\u2014a cross-sectional study","volume":"13","author":"Asiri","year":"2023","journal-title":"Life"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.3390\/diagnostics10121047","article-title":"Brain and muscle: how central nervous system disorders can modify the skeletal muscle","volume":"10","author":"Dalise","year":"2020","journal-title":"Diagnostics"},{"key":"B5","volume-title":"Neuromuscular performance during lifespan: assessment methods and exercise interventions","author":"Faude","year":"2019"},{"key":"B6","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1007\/s00296-021-05081-1","article-title":"The relationship between cervical proprioception and balance in patients with fibromyalgia syndrome","volume":"42","author":"Gucmen","year":"2022","journal-title":"Rheumatol. Int."},{"key":"B7","doi-asserted-by":"publisher","first-page":"213","DOI":"10.32598\/ptj.10.4.431.3","article-title":"Effect of six weeks of neuromuscular and performance balance training on balance and performance lower extremity climber girls","volume":"10","author":"Homaye Razavi","year":"2020","journal-title":"Phys. Treatments-Specific Phys. Ther. J."},{"key":"B8","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1097\/rhu.0b013e318190f991","article-title":"Fibromyalgia is associated with impaired balance and falls","volume":"15","author":"Jones","year":"2009","journal-title":"JCR J. Clin. Rheumatology"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1041434","DOI":"10.3389\/fneur.2023.1041434","article-title":"Cerebello-cortical functional connectivity may regulate reactive balance control in older adults with mild cognitive impairment","volume":"14","author":"Kannan","year":"2023","journal-title":"Front. Neurology"},{"key":"B10","article-title":"Role of dynamic postural control using functional movement assessments in individuals with chronic ankle instability: systematic review and matched case-control study (Master\u2019s thesis)","author":"Legendre","year":"2020"},{"key":"B11","doi-asserted-by":"publisher","first-page":"553","DOI":"10.12965\/jer.1938280.140","article-title":"The effects of Pilates and yoga participant\u2019s on engagement in functional movement and individual health level","volume":"15","author":"Lim","year":"2019","journal-title":"J. Exerc. rehabilitation"},{"key":"B12","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/j.berh.2007.03.007","article-title":"Pathophysiological mechanisms in chronic musculoskeletal pain (fibromyalgia): the role of central and peripheral sensitization and pain disinhibition","volume":"21","author":"Nielsen","year":"2007","journal-title":"Best Pract. & Res. Clin. rheumatology"},{"key":"B13","doi-asserted-by":"publisher","first-page":"106880","DOI":"10.1016\/j.cct.2022.106880","article-title":"Lessons in Affect Regulation to Keep Stress and Pain UndeR control (LARKSPUR): design of a randomized controlled trial to increase positive affect in middle-aged and older adults with fibromyalgia","volume":"120","author":"Ong","year":"2022","journal-title":"Contemp. Clin. Trials"},{"key":"B14","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1097\/ajp.0000000000000751","article-title":"Sensory function and pain experience in arthritis, complex regional pain syndrome, fibromyalgia syndrome, and pain-free volunteers","volume":"35","author":"Palmer","year":"2019","journal-title":"Clin. J. Pain"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.3390\/biomedicines11051297","article-title":"Effectiveness of vestibular rehabilitation in improving health status and balance in patients with fibromyalgia syndrome: a single-Blind randomized controlled trial","volume":"11","author":"Peinado-Rubia","year":"2023","journal-title":"Biomedicines"},{"key":"B16","doi-asserted-by":"publisher","first-page":"3157","DOI":"10.1007\/s00221-021-06207-4","article-title":"Two senses of human limb position: methods of measurement and roles in proprioception","volume":"239","author":"Proske","year":"2021","journal-title":"Exp. Brain Res."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1584227","DOI":"10.3389\/fpain.2025.1584227","article-title":"Sensory processing in medically unexplained pain syndrome. A systematic review","volume":"6","author":"Quodling","year":"2025","journal-title":"Front. Pain Res."},{"key":"B18","doi-asserted-by":"publisher","first-page":"3140","DOI":"10.3390\/jcm12093140","article-title":"A cross-sectional study on mediating effect of chronic pain on the relationship between cervical proprioception and functional balance in elderly individuals with chronic neck pain: Mediation analysis study","volume":"12","author":"Raizah","year":"","journal-title":"J. Clin. Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"2764","DOI":"10.3390\/jcm12082764","article-title":"Investigating knee joint proprioception and its impact on limits of stability using dynamic posturography in individuals with bilateral knee Osteoarthritis\u2014a cross-sectional study of comparisons and correlations","volume":"12","author":"Raizah","year":"","journal-title":"J. Clin. Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"e0195111","DOI":"10.1371\/journal.pone.0195111","article-title":"Lower regulatory frequency for postural control in patients with fibromyalgia and chronic fatigue syndrome","volume":"13","author":"Rasouli","year":"2018","journal-title":"Plos one"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.3390\/life12111817","article-title":"Cervical joint position sense and its correlations with postural stability in subjects with fibromyalgia syndrome","volume":"12","author":"Reddy","year":"2022","journal-title":"Life"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e901","DOI":"10.1097\/pr9.0000000000000901","article-title":"Pain matters for central sensitization: sensory and psychological parameters in patients with fibromyalgia syndrome","volume":"6","author":"Rehm","year":"2021","journal-title":"Pain Rep."},{"key":"B23","doi-asserted-by":"publisher","first-page":"555","DOI":"10.3109\/09593980802668050","article-title":"Pilot study assessing balance in women with fibromyalgia syndrome","volume":"25","author":"Russek","year":"2009","journal-title":"Physiother. theory Pract."},{"key":"B24","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.jht.2023.09.011","article-title":"Scapholunate and lunotriquetral joint dynamic stabilizers and their role in wrist neuromuscular control and proprioception","volume":"37","author":"Salva-Coll","year":"2023","journal-title":"J. Hand Ther."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.neurobiolaging.2024.11.009","article-title":"Relationships of functional connectivity of motor cortex, primary somatosensory cortex, and cerebellum to balance performance in middle-aged and older adults","volume":"147","author":"Sansare","year":"2025","journal-title":"Neurobiol. Aging"},{"key":"B26","doi-asserted-by":"publisher","first-page":"925299","DOI":"10.3389\/fnhum.2022.925299","article-title":"Balance impairment in myotonic dystrophy type 1: dynamic posturography suggests the coexistence of a proprioceptive and vestibular deficit","volume":"16","author":"Scarano","year":"2022","journal-title":"Front. Hum. Neurosci."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e0196575","DOI":"10.1371\/journal.pone.0196575","article-title":"Characterization of postural control impairment in women with fibromyalgia","volume":"13","author":"Sempere-Rubio","year":"2018","journal-title":"PLoS One"},{"key":"B28","doi-asserted-by":"publisher","first-page":"e0284800","DOI":"10.1371\/journal.pone.0284800","article-title":"Postural control among individuals with and without chronic obstructive pulmonary disease: a cross-sectional study of motor and sensory systems","volume":"18","author":"Strandkvist","year":"2023","journal-title":"Plos one"},{"key":"B29","doi-asserted-by":"publisher","first-page":"128","DOI":"10.4274\/tftr.75428","article-title":"Fibromyalji sendromu tan\u0131s\u0131 alan ve AlmayanT\u00fcrk kad\u0131nlarda propriyosepsiyon ve denge","volume":"59","author":"Ulus","year":"2013","journal-title":"turkiye fiziksel tip ve rehabilitasyon dergisi-turkish j. phys. med. rehabilitation"},{"key":"B30","volume-title":"Mechanisms of sensory integration during postural adaptation","author":"Young","year":"2020"},{"key":"B31","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1016\/j.berh.2007.03.006","article-title":"Role of central sensitization in symptoms beyond muscle pain, and the evaluation of a patient with widespread pain","volume":"21","author":"Yunus","year":"2007","journal-title":"Best Pract. & Res. Clin. Rheumatology"}],"container-title":["Frontiers in Bioengineering and Biotechnology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2025.1622679\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T08:14:28Z","timestamp":1757492068000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2025.1622679\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,10]]},"references-count":31,"alternative-id":["10.3389\/fbioe.2025.1622679"],"URL":"https:\/\/doi.org\/10.3389\/fbioe.2025.1622679","relation":{},"ISSN":["2296-4185"],"issn-type":[{"value":"2296-4185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,10]]},"article-number":"1622679"}}