The Role of Proprioception in the Management and Rehabilitation of Athletic Injuries

Rehabilitation continues to evolve with the increased emphasis on patient management and proprioceptive training. Proprioception can be defined as a special ized variation of the sensory modality of touch that encompasses the sensation of joint movement (kines thesia) and joint position (joint position sense). Numer ous investigators have observed that afferent feedback to the brain and spinal pathways is mediated by skin, articular, and muscle mechanoreceptors. Examining the effects of ligamentous injury, surgical intervention, and proprioceptiveiy mediated activities in the rehabil itation program provides an understanding of the com plexity of this system responsible for motor control. It appears that this neuromuscular feedback mechanism becomes interrupted with injury and abnormalities, and approaches restoration after surgical intervention and rehabilitation. Rehabilitation programs should be de signed to include a proprioceptive component that ad dresses the following three levels of motor control: spinal reflexes, cognitive programming, and brainstem activity. Such a program is highly recommended to promote dynamic joint and functional stability. Thus far, current knowledge regarding the basic science and clinical application of proprioception has led the pro fession of sports medicine one step closer to its ulti mate goal of restoring function.

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