1. 8
The ABCs of Proprioception

2. proprioception: the body’s ability to transmit afferent information regarding position sense, to interpret the information, and to respond consciously or unconsciously to stimulation through appropriate execution of posture and movement

3. Basic Concepts of Proprioception
Targeted after flexibility, strength, and endurance have improved
Involves agility, balance, and coordination

4. Components of Proprioception

5. proprioceptors: afferent nerves that receive and send impulses from stimuli within skin, muscle, joints, and tendons to the central nervous system
An individual’s balance, agility, and coordination are determined by the reception, interpretation, and response that are initiated by proprioceptors.

6. Proprioceptive Receptors
Cutaneous receptors
Fast-adapting- responsible for vibration senses
Slow-adapting I and II-sensory perception such as skin stretching
Muscle and tendon receptors
Muscle spindles
GTOs
(continued)

7. Proprioceptive Receptors
Joint receptors
Ligament receptors
Collaboration of afferent receptors

8. Central Nervous System Proprioceptor Sites
Spinal cord
Brain stem
Cerebral cortex

9. balance: the body’s ability to maintain an equilibrium by controlling the body’s center of gravity over its base of support

10. Balance Necessary for static and dynamic activities
Influenced by strength and by sensory input from CNS
Sensory input
Vestibular system
Oculomotor system
Proprioceptor system
Balance tests: Romberg, stork stand

11. Feedback System for Coordination

12. coordination: the complex process by which a smooth pattern of activity is produced through a combination of muscles acting together with appropriate intensity and timing

13. Coordination Accomplished through a complex neural network
Some muscles stimulated and others inhibited
Timing and intensity of muscle response are key
Strength and proper neural system function are necessary for coordination

14. Components of Coordination
Activity perception
Feedback
Repetition
Inhibition

15. Progression of Coordination Development
Start with static, simple exercises.
Progress to dynamic, more complex exercises.
Accuracy of performance is vital in exercise execution.
Stop when fatigue, lack of coordination begin to appear.

16. agility: the ability to control the direction of a body or its parts during rapid movement

17. Agility
Requires flexibility, strength, power, speed, balance, and coordination
Involves rapid change of direction and sudden stopping and starting
Progression of therapeutic exercise for agility
Activities should resemble the patient’s sport activities

18. Therapeutic Exercise for Proprioception
Balance first, then coordination, then agility
Simple to complex
Initial exercises performed slowly, in controlled situations
Advancement made only after the activity is mastered
Progression: to more complex, sport-like activities
Goal: to perform accurately

19. Lower-Extremity Progression
Stork stands: with eyes open, closed; on unstable surfaces; with distracting upper-extremity activity
Dynamic activities: lateral, then change of direction; combined balance, coordination, agility; distracting upper-extremity activities
Plyometrics
Sport-specific activities

20. Upper-Extremity Progression
Passive and active joint repositioning
PNF rhythmic stabilization
Closed kinetic chain stabilization
Straight-plane and multiplane upper-extremity movements
Rubber tubing activities
Plyometrics
Sport-specific activities