Terminology of joint sensation

The terminology related to joint sensation is often misunderstood and used inappropriately, which has led to confusion and a lack of appreciation for these mechanisms during rehabilitation. Articular sensations are described as proprioception and kinesthesia. There is considerable discrepancy in the definitions of these two terms as related to their physiological functions. Mountcastle and Willis define proprioception as the conscious awareness of limb position, while they define kinesthesia as the aware- ness of joint motion. On the other hand, Bastian defines the kinesthetic mechanism as a complex of sensations including those in which movement is not featured, while Sherrington describes the proprioceptive sense as including vestibular sensations and inputs from muscles and joints that are not necessarily perceived. We define proprioception as a specialized variation of the sensory modality of touch that encompasses the sensations of joint movement (kinesthesia) and joint position (joint position sense).

Conscious proprioception is essential for proper joint function in sports, activities of daily living, and occupational tasks. Unconscious proprioception modulates muscle function and initiates reflex stabilization. Much effort has been dedicated to elucidate the mechanical function of articular structures and the corresponding mechanical deficits that occur secondary to disruption of these structures. Articular structures also have a significant sensory function that plays a role in dynamic joint stability, acute and chronic injury, pathological wearing, and rehabilitation training.

4.1. Listen to the text “Terminology of Joint Sensation”.

4.2. Read and translate the text “Terminology of Joint Sensation”.

4.3. Answer the questions to the text “Terminology of Joint Sensation”.

1. What could be the reason to confusion and a lack of appreciation for joint sensation mechanisms during rehabilitation? 2. How are articular sensations described as? 3. There is not considerable discrepancy in the definitions of proprioception and kinesthesia, is there? 4. Do different researchers share the similar opinion while defining proprioception? 5. What is the definition of proprioception here? 6. Where is conscious proprioception essential? 7. What does unconscious proprioception modulate and initiate? 8. How much effort has been dedicated to elucidate the mechanical function of articular structures? 9. What kind of function do articular structures have?

4.4. Find English equivalents for the following.

различие; суставные структуры; заключать в себе; прикосновение; вторичный; ощущение/чувство; повседневная деятельность; ощущающий / осознанный; термин; значительный; путаница/неразбериха; понимание/оценка; осознание /осведомлённость; конечность; фигурировать/отводить важное место, воспринимать/ощущать/чувствовать; посвящать; производственные задачи; начинать/инициировать; усилие; разъяснять/проливать свет; разрушение; происходить; иннервация/ связь нервных волокон с органом; в острой форме; недопонимание; приводить к; суставной

4.6. Insert prepositions if necessary.

1. The extrinsic innervation … joints follows Hilton's law. 2. It states that joints are innervated … articular branches … the nerves supplying the muscles that cross the joint. 3. The afferent innervation … joints is based … peripheral receptors located … articular, muscular, and cutaneous structures. 4. Articular receptors include nociceptive free nerve … endings and proprioceptive mechanoreceptors.

4.7. Fill in the gaps with articles if necessary.

1. Several authors have identified mechanoreceptors in … cruciate ligaments (CL) of … cat knee joint. 2. Schultz et al. were … first to identify mechanoreceptors in … human CL. 3. Using gold chloride, Bielshowky, and Bodian staining techniques, these investigators histologically examined ACL obtained from cadavers at … time of total knee arthroplasty and demonstrated … presence of mechanoreceptors in … CL. 4. Using … modified gold chloride technique Schutte et аl. and Zimny et al. further characterized these ACL receptors into three morphological types of mechanoreceptors (Ruffini endings, Ruffini corpuscles or Golgi tendon organs, and pacinian corpuscles) and free-nerve endings. 5. Others have demonstrated … similar mechanoreceptors in cat knee menisci. 6. In their extensive study of … innervation of joints, Freeman and Wyke histologically identified … three types of mechanoreceptors in … capsular and ligamentous structures of cat ankle joints. 7. … presence of mechanoreceptors in human ankle joints has not yet been demonstrated. 8. Finally, … three distinct mechanoreceptors have recently been histologically identified by Vangsness and Ennes in … glenoid labrum and … glenohumeral ligaments of … shoulder, suggesting that these structures possess.. anatomical basis for perceiving joint position and motion.

4.8. Open the brackets and use a verb in appropriate tense and voice form.

1. Developing a rehabilitation program that (to incorporate) proprioceptively mediated muscular control of joints (to necessitate) an appreciation for the central nervous system’s influence on motor activities. 2. Joint afferents (to contribute) to central nervous system function at three distinct levels of motor control. 3. At the spinal level, reflexes (to subserve) movement patterns that (to receive) from higher levels of the nervous system. 4. This action (to provide) for reflex splinting during conditions of abnormal stress about the joint and (to have) significant implications for rehabilitation. 5. The muscle spindles (to play) a major role in the control of muscular movement by adjusting activity in the lower motor neurons. 6. Partial de-afferentation of joint afferent receptors also (to alter) the musculature's ability to provide co-contraction joint stabilization by antagonistic and synergistic muscles, thus resulting in the potential for re-injury.

Proprioception testing device for shoulder testing.

4.9. Use the sentences below in Present Perfect Tense. Give their negative and

interrogative forms.

1. The second level of motor control is at the brain stem, where joint afference is relayed to maintain posture and balance of the body.

2. The input to the brain stem about this information emanates from the joint proprioceptors, the vestibular centers in the ears, and from the eyes.

4.10. Ask questions to italic words.

1. The final aspect of motor control includes the highest level of central nervous system function (motor cortex, basal ganglia, and cerebellum) and is mediated by cognitive awareness of body position and movement. 2. These higher centers initiate and program motor commands for voluntary movements. 3. Movements that are repeated can be stored as central commands and can be performed without continuous reference to consciousness. 4. Although considerable controversy still exists relative to the role of joint and muscle receptors in the perception of joint movement, deep pressure, at the very least, can be consciously appreciated during joint motion.

4.11. Use the words from a box to fill in the gaps.

encourage; receptors; central; muscle afferents; maximally; sudden; without visual input

1. With these three levels of motor control in mind, mediated in part by joint and … …, one can begin to develop rehabilitation activities to address proprioceptive deficiencies. 2. The objectives must be to stimulate the joint and muscle … to encourage maximum afferent discharge to the respective … nervous system level. 3. At the spinal level, activities that … reflex joint stabilization should be addressed. 4. Such activities include … alterations in joint positioning that necessitate reflex muscular stabilization. 5. Balance and postural activities, both with and … … …, will enhance motor function at the brain stem level. 6. Consciously performed joint positioning activities, especially at joint end ranges, will … stimulate the conversion of conscious to unconscious motor programming.

4.12. Give a talk on the text “Terminology of Joint Sensation”.