All Posts tagged proprioception

Balance & Leg Strengthening

Here is a great question from Dr. Ray Sue. I thought you might want to see my response.
 
Hi Jeff,
 
I had a long time elderly patient come in that has been suffering from falls of late.  After going through a battery of tests (for her eyes, ears and CT for her brain) it was determined that she simply needs to get in better condition and gain more strength.
 
My thoughts were to work on her ankle/knee/hip balance and proprioception (with 1 and 2 legged stances with eyes open and closed), strengthen her quads (with ball squats) and her glutes with prone glute squeezes and extensions.  I’ve had her try and do sit and stands but, she definitely has trouble. 
 
Is there anything else you’d recommend or changes to what I’ve recommended?
 
Thanks so much!
Ray
 
Dr Tucker’s RESPONSE: 
I think you are definitely on the right tract. Now lets make it functional!
Additional programming could include this progression:
Single-leg (SL) Balance w/ multiplanar reach with the up leg (she can hold on to a chair)
SL, 1-arm Diagonal movements while holding a light weight in the moving arm
SL windmill moves with the arms
SL Romanian deadlift (partial movement)
Double leg squats (or 1/2 squats or just small knee bends) progressing to SL squat (or 1/2 squats, or just small knee bends) holding something (free weights) in her hands (not holding onto a chair) 
Begin lunge progression or at least stepping forwards and backwards
Begin going up and down a step
Hope this helps. 
Jeff
www.DrJeffreyTucker.com
 

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Researchers encourage proprioceptive exercises for shoulder rehabilitation

Proprioceptive exercises are commonly prescribed for lower extremity rehabilitation. More recently, sensorimotor (SMT) proprioceptive exercises have been used for shoulder rehabilitation. It’s thought that shoulder injury (in particular, shoulder instability) is related to proprioceptive deficits. Researchers speculate that deafferentation (loss of sensory information) from the mechanoreceptors of the shoulder joint capsule and altered proprioceptive information create these sensorimotor deficits (Lephart et al. 1997; Tibone et al. 1997)

A review paper in Athletic Training and Sports Healthcare discussed the adaptations of the sensorimotor system following shoulder rehabilitation. The authors used the PEDro system for inclusion criteria to review 23 articles. The most common techniques the paper reviewed included:

  • Joint repositioning
  • Closed-kinetic chain exercises
  • Proprioceptive Neuromuscular Facilitation (PNF)
  • Plyometrics
  • Joint Perturbations
  • Activation of muscle through elastic tubing, free weights or oscillation

The authors concluded that sensorimotor rehabilitation after shoulder injury is crucial, and that the sensorimotor system is, in fact, trainable. A proprioceptive and sensorimotor training program including Thera-Band® elastic bands and tubing, FlexBar® Oscillation, and closed-kinetic shoulder exercises with Stability Trainers should be included as part of a shoulder rehabilitation or prevention program.

Reference: Myers JB, and Oyama S. 2009. Sensorimotor training for shoulder injury. Athletic Training & Sports Health Care. 1(5):199-208.

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