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Testing joint-position sense: does it matter how you hold the toe?
  1. Chris Allen
  1. Correspondence to Dr Chris Allen, Department of Neurology, Addenbrooke’s Hospital, Hills Rd, Cambridge CB2 0QQ, UK; cmca100{at}

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When testing ‘joint-position sense’, I was drilled not to hold the toe or finger on its top and bottom, or else the patient would detect its position from the differential pressure above and below the digit. The ‘proper’ way to test it was to hold the digit by its sides, while the patient said whether the digit was being moved up or down. Subsequently, I was surprised to notice experienced neurologists holding the digit the ‘correct’ way only when formally demonstrating a patient’s signs. In the relative privacy of their clinic, they unashamedly grasped the toe top and bottom. Were these eminent creatures doing it all wrong?

Proprioception (proprius, belonging to one’s own self) is a complex perception and not synonymous with joint-position sense.1 Joint-position sense is not …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed. This paper was reviewed by Mary Reilly, London, UK, and Martin Samuels, Boston, Massachusetts, MA, USA.

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