proprioception Flashcards
what is balance
the proces by which the body’s COG is controlled with respect to the base of support, whether that base is stationnary or moving
what are the systems that contribute to balance
visual, vestibular and somatosensory system
what is the visual system’s role in balance
measures the orientation of the head and the eyes in relation to its surrounding onjects thus allows to maintain balance
what info is supplied by the vestibular system
info that measures gravitational, linear, angular accelerations of the head in relation to inertial space
what type of information is not provided by the vestibular system?
orientation information in relation to external objects
does the vestibular system play a major or minor role in balance when the visual and somatosensory systems provide accurte info
minor role
what is proprioception
overall awareness of body position which is independent of vision and essential in preventing injury
how does proprioception function
the nervous system communicated w/ muscles, tendons, joints through different proprioceptirs to sens and alter body position
where are muscle spindles located
parallel to skeletal muscle fibers
what activated muscle spindles and how do they repsond.
any rapid or excessive muscle lengthening (monitor change in tissue length) will cause spindles to provoke a muscle contraction in order to prevent excessive stretch of the muscle
what type of nerves monitor the rate and magnitude of stretch for whuch the muscle spindles respond to
sensory nerves
what happens if the tissue undergoes a strong or fast enough stretch
potential tissue damahe hence the a-MN prompts the surrounding extrafusal fibers to contrct and shorten the muscle thus protecting it
what response is provoked by muscle spindles
myotatic reflex
where are GTO located
woven within the CT of the tendon
what triggers GTO and how does it respond
excessive muscle contraction or passive stretch (change in muscle tension) will provoke GTO and cause inhibition of target muscle along with contraction of antagonist muscle
what happens when a ms generates sufficent tension either through contraction or passive stretch
GTO activate and inhibit ms contraction and prompt ms to relax along with antagonist contraction thus decreasing muscle tension
what reflex is associated with the action of the GTO
inverse myotatic reflex
what is reciprocal inhibition
contraction of one muscle, relaxation of the other.
both GTO and muscles spindles are cqpable of this and allows the body to move and not fight against itself this allows for smooth and coordinated mvmt to take place if the appropriate give and take occurs
what are mechanoreceptors
specialized nerve endings that deform in response to pressure by registering the speed and amount of deformation and indicate the position and mvmt of their associated structures
where are pacinian corpuscle located
skin, CT, muscles and tendons
what triggers pacinian corpuscle and how does it respond
vibration and deep pressure thus allowing to indicate the direction and speed of the body mvmt
where are rufini corpuscle loacted
in the joint capsule
what triggers ruffini corpuscle and how does it respond to the trigger
distortion of joint capsule will allow to indicate the position of the joint in space even w/ eyes closed
what is included in the maintenance of postural equilibrium
sensory detection of body motions
integration of sensorimotor info w/in the CNS
execution of appropriate MSK responses (inhibit or contract)
why is balance important in the rehab proces
because it dictates mvmt strategies w/in the CKC
provide examples of activities that require balance
joint position sense
kinesthesia
proprioception
what happens after an injury to the recruitment pattern and timing of muscular contractions
alterations
what are the 2 main reasons from a clinical stand point why a person may have impaired balance
- position of COG relative to the base of support is not accurately sensed
- the automatic mvmts required to bring the COG to a balanced position are not timely of effectively coordinated
what may cause for automatic mvmts to be done in an uncoordinated or untimely manner?
alteration in the ratio of muscle spindles to GTO activity or disruption in the proprioceptive pathway
what may happen to due to decreased proprioception after injury
-impaired balance and decreased coordination
decreased joint position sense
-tendency of joints to give way
-altered reflexes when performing specific mvmts
what happens in the event that there is a delay in the body’s response time to an unexpected load on dynamic restraints
the static restrain structres undergo excessive forces thus increasing their risk for injury such as a ligament tear or sprain w/ inversion/eversion of the ankle
what is tomberg position
feet together w/ a narrow base of support
what is semi-tendem
stride position (one foot ahead of the other)
what is tandem stande
heel directly in front of toes
what is soleo/solec
standing on 1 leg eyes open/closed
what are the different static standing balance positions done when standing on foam
- eyes open
- eye clsoed
- feet togeter, eyes open
- feet together, eyes closed
why is it important for proprioceptive retraining to be started as early as possible
reduce the risk of injurt reoccurence
what types of exercises are provided in proprioceptive retraining
non-stressful to healing tissue
aims to enhance overall coordination and ease the effectiveness fo strngth and endurance exercises
what is the goal of proprioceptive retraining
restore proximal stability
muscle control
flexibility
what happens during the first phase of proprioceptive retraining
production of static stabilization exercises w/ CKC and unloading (weight shifting)
what type of exercises are implemented in the 1st phase of proprioceptive retraining
isometric exercises of involved joint on even and uneve surfaces
may involve balance retraining and joint reposition exercises
what tools can be used in the first phase to help pt as he/she progresses
how can they be made even more challenging
trampoline balance board swissball wobble board made more challenging by progressing from double limb support to single limb and all while performing sports specific tasks
what happens during the 2nd phase of proprioceptive retrraininhg
concious control of the motion w/o impact and substitue isometric exercises w/ concentric and eccentric exercises through a larger ROM
whhat do we want to stimulate during the 2nd phase of proprioceptive retraining
dynamic postural response and increase muscle stiffness to resist and absorb joint loads
what happens during the 3rd phase of proprioceptive retraining
unconcious control and loading of the joint and introduce both ballistic and impact exercises such as running and jumping
what should the exercises prescribed in proprioceptive retraining involve
sudden alterations in joint positionning that necessitate reflex muscular stabilization and axial loading
rythmic stabilization in both OKC and CKC
use of stable and unstable bases to encourage co-contraction of agonist-antagonists
provide examples of weight shifting exercises for the UE
- stand and lean on treatment table
- 4 point knee position; rock forwards and back and then progress onto unstable objects
- 3 point position
- 2 point position (superman)
- weight shifting on fitter while in a kneeling position
- slide board exercises in quadruped position moving hands forwards and backwards
provide example of LE progression for proprioceptive rehab
-partial WB: walking w/ support and ensuring proper heel-toe mvmt. sitting w/ feet on rocker board and rocking both legs forward and back, then progress to one
-full WB
on floor: feet together, eyes closed, then one leg, add mvmt of the other leg, bouce or throw/catch a ball
mutiaxial rocker using both legs will use a similar progression as above
-minitrampoline: same as above, add hop and land, rythmic hopping
jumping, skipping, running drills
