Proprioception is the body’s ability to sense its location, movements, and actions...

It’s the reason we’re able to move freely without consciously thinking about our environment.

Examples of proprioception include being able to walk or kick without looking at your feet or being able touch your nose with your eyes closed.

Proprioceptors are the specialised sensory receptors on nerve endings found in muscles, tendons, joints and the inner ear. Proprioceptors detect subtle changes in the environment, movement, position, tension and force, the main function being to prevent injury.

Some things can affect proprioception. Temporary impairment can come from drinking too much alcohol, which is why a sobriety test involves touching your nose while standing on one foot.

Injuries or medical conditions that affect the muscles, nerves, and the brain can cause long-term or permanent proprioception impairment. Age-related changes also affect proprioception.

Proprioception anatomy

Proprioception is basically a continuous loop of feedback between sensory receptors throughout your body and your nervous system.

Sensory receptors are located on our skin, joints, and muscles. When we move, our brain senses the effort, force, and heaviness of our actions and positions and responds accordingly.

What does poor proprioception mean?

Normal proprioception lets you move freely without giving your movements a second thought. Decreased proprioception is when there is a reduction in the sense that tells the body where you are in space which can lead to symptoms that can interfere with even the simplest activities.

Motor coordination and balance are abilities that decline during the ageing process, at least partially, by the deterioration of proprioception. The proprioceptive system, part of the somatosensory system (the sensory system concerned with the conscious perception of touch, pressure, pain, temperature, position, movement, and vibration, which arise from the muscles, joints, skin, and fascia) is specifically involved in the sensory control of balance.

Impaired proprioception leads to less accurate detection of body position changes increasing the risk of fall, and to abnormal joint biomechanics during functional activities so, over a period of time, degenerative joint disease may result.

Symptoms of proprioception disorder

A proprioception disorder or injury could cause a number of signs and symptoms, including:

Balance issues, such as having trouble standing on one foot or frequent falls while walking or sitting

Uncoordinated movement, such as not being able to walk in a straight line

Clumsiness, such as dropping or bumping into things

Poor postural control, such as slouching or having to place extra weight on a table for balance while sitting

Trouble recognizing your own strength, such as pressing on a pen too hard when writing or not being able to gauge the force needed to pick something up

Avoiding certain movements or activities, such as climbing stairs or walking on uneven surfaces because of a fear of falling

Causes for impaired proprioception

Proprioception dysfunction can be caused by injuries and disorders that affect any part of the proprioceptive system between the sensory receptors that send the signals to the parts of the brain that receive and interpret them.

The risk of proprioception loss increases as we age due to a combination of natural age-related changes to the nerves, joints, and muscles, making daily tasks harder and increasing the risk of injury and falls.

Examples of injuries and conditions that can cause proprioceptive deficit include:

  • brain injuries
  • herniated disc
  • arthritis
  • multiple sclerosis (MS)
  • stroke
  • autism spectrum disorder (ASD)
  • diabetes
  • peripheral neuropathy
  • Parkinson’s disease
  • Huntington’s disease
  • joint injuries, such as ankle or knee sprain
  • joint replacement surgery
  • Parkinson’s disease

How is proprioception evaluated?

Proprioception is generally assessed by measuring both joint position sense (JPS) and the sense of limb movement. JPS determines the person’s ability to comprehend a presented joint angle and then, once removed, actively or passively reproduce the same joint angle. Sense of limb movement determines detection of passive motion of the limb. Both components of proprioception are important for the generation of smooth and coordinated movements, maintenance of normal body posture, regulation of balance and postural control, and motor learning and relearning.

One or more proprioception tests may be used depending on the area of the body affected.

Some proprioception tests include:

Romberg test This is the most commonly used diagnostic test for proprioceptive abnormalities. To do the test, you stand unsupported for 30 seconds with your heels together and your eyes closed. If you lose your balance during that time, it’s considered a positive result.

Field sobriety test This may involve one or a series of tests often used by police officers to evaluate suspected drunk drivers. One such test involves closing your eyes and touching your nose with each of your index fingers. The standardized field sobriety test (SFST) is a battery of three tests. It includes the horizontal gaze nystagmus (HGN) test, which involves following a slowly moving pen or other object with your eyes; the walk-and-turn (WAT) test, in which you walk a few steps in a straight line with one foot in front of the other; and the one leg stand (OLS) test, which is simply standing with one foot raised off the floor.

Thumb finding test For this test, the tester will place one of your hands in a certain position. Then, you’ll be asked to touch the placed thumb with your other thumb and forefinger while your eyes are shut.

Sequential finger touching This test is often used on children and adults. To perform the test, touch each of your fingers to your thumb, starting with your forefinger.

Distal proprioception test The tester will hold the sides of your big toe and perform up and down movements while you watch. You then have to repeat the same movement with your eyes closed.

Other diagnostic tests may be suggested if an underlying medical condition or injury is suspected. These may include one or more of the following:

  • blood tests
  • X-rays
  • CT scan or MRI scan
  • electromyography
  • nerve conduction velocity

Treatment for problems with proprioception

Proprioception treatment depends on the underlying cause, and it may require treating a medical condition or injury.

Along with treating any underlying condition, successful proprioception treatment also involves other therapies and exercises to help gain strength and improve balance and coordination.

Treatment options include:

  • physical therapy, which can address any underlying injury or condition and involves activities to improve motor skills, strength, and balance
  • occupational therapy to learn how to manage daily tasks while living with proprioception dysfunction
  • somatosensory stimulation training, such as vibration therapy
  • exercises, such as balance exercise
  • tai chi, which improves lower limb proprioception, according to recent research
  • yoga, which improves balance and muscle strength

Proprioceptive training has been shown to be effective in treating proprioception caused by a number of conditions and injuries. There’s evidence that proprioception training can also be used as a preventive measure to reduce the risk of injuries. Results vary from person to person, depending on a variety factors, such as the cause, age, and overall health.

 

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