Proprioception and Coordination Assessment

Question 1

What are we measuring and why? (proprioception)

Answer 1

Awareness of the position of our limb, relies on our somatosensory system and our vestibular system.

Ruffini and pacinian corspucle activated by stimulus, local depolaristion, then travels along afferent fibres to CNS.

Question 2

How to tell whether measurement is normal? (proprioception)

Answer 2

compare to the good side
whether they can do the mirroring correctly or not
whether they get the correct answers

Question 3

What principles are used in carrying out the technique? (proprioception)

Answer 3

tactile input from physio minimal and can also bring light touch into it.

if patient has stroke, you move the affected side and ask them to replicate on the other side.

mirroring may be hard in bilateral presentation like MS as both sides affected, so use single joint more.

mirroring-move limb and then ask them to do the same on the other side. (eyes closed)

single joint- e.g. get them to say whether bent or straight, avoid predicted outcome by resetting at mid joint, also tested through smaller degrees as well using terms like ‘more bent’ (eyes closed)

lower limb can be done on end of the plinth, making it more or less flexed

Question 4

What structures/processes are being assessed? (proprioception)

Answer 4

ruffini corpuscle

pacinian corpuscle

golgi tendon organs (small bundles of collagen fibres with sensory neurons in between)s (info on muscle force)

muscle spindles (info on muscle length)

Question 5

Precautions and contraindications? (proprioception)

Answer 5

any injuries

any pain

any skin conditions

Question 6

What are you measuring and why? (coordination)

Answer 6

closed loop system.
CNS-feedforward-movement effectors-feedback-CNS
cerebellum is important for coordination and balance by giving motor corrections to primary motor cortex.

Question 7

How to tell whether measurement is normal? (coordination)

Answer 7

make sure they don’t slow down, miss the target or have shakiness of the arm
test opposite limb and compare
make sure they stay in contact with the shin.

Question 8

What principles are used in carrying out the technique? (coordination)

Answer 8

finger-nose test
-get pt to ask to touch finger with index finger and then touch nose, then to make harder you could speed it up and then move your finger throughout.

heel-shin test
pt lying down, ask them to place heel just below knee cap and run heel down front of shin to ankle and then back up, keeping in contact, make sure they arent resting their foot though. (say to ‘try and be as light as you can)

test both sides for these tests

Question 9

What structures/processes are being assessed? (coordination)

Answer 9

cerebellum function

Question 10

Precautions and contraindications? (coordination)

Answer 10

any injuries to either arm

severe pain