The value of joint position sense has been identified in a previous article and here we move on to considering the evaluation of a deficiency and what the physiotherapist is going to do about it. It is very likely that the physio will focus on the patient’s most common symptoms following trauma or illness, including muscle fatigue, loss of joint function and pain. The physiotherapist will consider whether proprioceptive care is needed until they respond to therapy. Without retraining the nervous and joint systems of the body to correctly obtain, perceive and act on proprioceptive stimuli, complete recovery of the patient to their normal activities, whether athletic or functional, cannot occur.Learn more by visiting Physio Botany
Our arms are designed for one primary purpose, to place our hands above our vision in a functional pose so that we can see our action and correct it. In order to analyze the effects of our efforts in real time and re-design our motor operations to bring us closer to our target, an efficient and precise feedback loop is required. A big part of being human is being able, with our extraordinarily precise hands and detailed binocular vision, to control the universe. It is important to consider where our individual hand joints are at any one time if we are going to use them effectively. Touch typing, which I am actually doing, is an ability that I have to be aware of where my hands are and where my fingers are going next.
The physiotherapist will assess upper limb proprioception by asking the patient to close their eyes and then placing their good arm in a particular position. If the physiotherapist has set the location, the patient is asked to place their other affected arm as near as possible in the same position. A individual whose sense of joint position is unchanged may mirror one arm’s position very accurately by using the other. After this test, any deficiencies in the ability to comprehend the location of the arm joints would be evident.
Proprioception is modified for various uses in the legs and lower body than in the arms, with the lower body role based on weight bearing and walking. The weakness in the legs from loss of proprioception can be very dangerous as it affects autonomous coordination and equilibrium. A good example of this problem is shown by a patient I used to treat with multiple sclerosis who had trouble when it was dark.
My patient recounted a scenario that has probably happened to all of us: we go into a bathroom and the light is already on, so we immediately switch off the light when we lock the door. The answer is simple for us. We just turn the light on again. It was more complicated for him.