Reestablishing proprioception

The sensory function of articular structures provides awareness of the body and its relationship with the surrounding environment. This awareness is a specialized variation of the sensory modality of touch known as proprioception.

Proprioception encompasses the sensations of kinesthesia and joint position sense and is mediated by joint, muscle, and cutaneous mechanoreceptors responsible for afferent transmission of joint motion and position. These afferents modulate muscle function and initiate reflex joint stabilization.

After injury to articular structures, partial differentiation has resulted in deficits in the proprioceptive mechanisms. These deficits may lead to an insidious pathological degeneration of joints because of the lack of muscle stabilization and resultant recurrence of injury.

The effects of training on the afferent deficits remain unclear, yet it seems reasonable that clinically stimulating these mechanisms should enhance the dynamics of joint kinematics and decrease the susceptibility to reinjury.

2.1. Listen to the text “Reestablishing Proprioception”.

2.2. Read and translate the text. 2.3. Answer the questions on the text. 1. What provides awareness of the body and its relationship with the surrounding environment? 2. What does proprioception mean? 3. What kinds of sensations does proprioception encompass? 4. Do these afferents modulate muscle function or initiate reflex joint stabilization? 5. When has partial deafferentation resulted in deficits in the proprioceptive mechanisms? 6. Why may these deficits lead to an insidious pathological degeneration of joints? 7. How clear do the effects of training on the afferent deficits remain? 8. What seems reasonable here?

Shoulder proprioception exercise

2.4. Find English equivalents for the following.

проприоцепция (способность регистрировать сигналы, возникающие в

мышцах, сухожилиях и капсулах суставов), кинестезия (чувство движения, восприятие движения, мышечное чувство), чувство/восприятие, суставной /отно-сящийся к суставу), сенсорный (относящийся к чувствительности), осознание/ос-ведомленность, взаимосвязь, окружающая среда, вид ощущения, осязание, окру-жать/заключать, ощущение/чувство восприятия (восприятие сознанием сенсор-ной информации при воздействии на любой из органов чувств), положение сустава, занимать промежуточное положение /служить связующим звеном, кожный, механорецептер (рецептор, регистрирующий механические смещения),

несущий ответственность за, афферентный (находящийся или двигающийся в направлении центра системы, центростремительный, приносящий), передача / проведение/перенос, стимулировать, частичный, приводить к (2), бессимптомно развивающийся/скрытый, отсутствие/нехватка, получающийся в результате, рецидив, неясный, веский/приемлемый/ разумный, усиливать/ повышать, умень-шать, восприимчивость

Modified Rhomberg test. Modified Rhomberg test on foam surface for balance training wearing a neoprene compression sleeve.

Kinesthetic ability trainer (KAT).

2.5. Insert articles if necessary.

1. Ligaments play … major role in normal joint kinematics, providing mechanical restraint to abnormal joint movement when … stress is placed on … joint. 2. … primary concern of … orthopedic surgeon has been … biochemical restoration of these ligaments after injury in … attempt to restore … joint's stability and therefore its kinematics. 3. In restoring normal joint kinematics it is speculated that … recurrent injury will be minimized and progressive joint degeneration can be avoided.

Lower extremity kinesthetic training. Lower extremity kinesthetic training on an unstable platform. A, Both feet.

B, One foot

2.6. Put questions to the words in italic.

1. Kennedy et al. however, observed that in addition to their mechanical restraining function, articular ligaments provide important neurological feedback that directly mediates muscular reflex stabilization about the joint. 2. The neuromuscular controlling mechanism is mediated by articular mechanoreceptors and provides the individual with the proprioceptive sensations of kinesthesia and joint position sense. 3. The neurological feedback for the control of muscular actions protects against excessive strain on passive joint restraints and provides a prophylactic mechanism to recurrent injury. 4. After the joint injury, disruption to these articular mechanoreceptors inhibits normal neuromuscular reflex joint stabilization and contributes to repetitive injuries and the progressive decline of the joint.

2.7. Fill in the gaps with the prepositions if necessary.

1. A rehabilitation program that addresses the need … restoring joint stability cannot be designed until one has a total appreciation … both the mechanical and sensory function … articular structures. 2. Simply restoring mechanical restraints or strengthening the associated muscles neglects the coordinated neuromuscular controlling mechanism required … joint stability during the sudden changes … joint position common to sports activity. 3. A lag time … the neuromuscular reaction time can result in recurrent joint subluxation and deterioration. 4. This chapter will address the issues central to the role of articular structures … providing neuromuscular control … joint stability. 5. The role … joint mechanoreceptors will be specifically elucidated as it pertains to the mediation … the sensations … proprioception, kinesthesia, and joint position awareness.

Reaction cutting manoeuvre

Four-corner sport-specific dribbling drill. Shoulder joint repositioning exercise

2.8. Act out the conversation below.