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 Article 1 Pilates: ancient secrets for modern rehabilitation Article 2 Proprioception and Balance Training Article 3 Pilates and low back pain during pregnancy     |
 The importance of Proprioception and Balance Training as part of your rehabilitation program By Yoav Nagar, D.C. Modern rehabilitation practitioners are starting to understand the importance of proprioception training as an integral part of the post injury training. Proprioception is the position sense of the joints provided by the receptors, sensory devices, located throughout our bodies in the muscles, tendons, ligaments and joints. We need proprioceptors to provide the brain with information about joint position and movement, and in that way reposition them for the continuation of the movement. Proprioceptors assist the musculoskeletal system in generating the appropriate movement to meet the demand that is placed upon the system by gravity, momentum and other external forces, and by that to enhance the quality of the movement. Impaired joint position sense is overlooked in many rehabilitation programs and may be a major risk factor for recurrent injuries after the integrity of the muscles and ligaments has been restored. The patients, therefore, need a general understanding of the proprioceptive system, its importance to joint integrity, and how to emphasize it during rehabilitation and training. Injury to a joint may cause direct or indirect alterations in sensory information provided by proprioceptors. Direct trauma may lead to ligament and capsule tearing, which may damage the receptors in that area and also rupture the nerve fibers because they have less tensile strength than other tissues in the body. The consequent destruction of these receptors and the nerve endings will cause lack of communication between the joint and the brain. These physiological changes will lead to an immediate muscle inhibition around that joint. In order to help us enhance the rehabilitation program, we need to carefully examine the degree of proprioception loss, the consequent muscle inhibition, and the parts of the body including muscles and joints that are compensating for this loss. Proprioception is tested by the ability of the patient to balance on both legs with eyes open and closed, single leg balance, and by combining balance with movement in different directions. After we establish a base line, we can use the tests as exercises and add different devices, which we call drivers. Proprioception training should be done before or in conjunction with rehabilitation exercises. In most cases the improvement from proprioception training will be quick and dramatic, and it will enhance the patient’s regular exercise regimen. The patient will continue to stimulate and enhance the proprioception system if done in combination with specific types of rehabilitative exercises such as pilates training. |