Proprioception Exercise Essay

Objectives: Proprioception was studied after TKA, in both posterior cruciate ligament (PCL)-retaining and posterior stabilizing (PS) prosthetic designs.

In the first half of my undergrad I have worked towards earning a degree in biology and chemistry with the aim of getting into medical school. After a summer of shadowing 12 different areas in the medical field, I have recently gained an interest in the specialty of orthopedics. With experience in both the surgical and clinical settings in this specialty, I became fascinated with the diagnosis and treatment of deformities or functional impairments to the movement systems of the body, primarily the skeletal system and its associated structures such as muscles and ligaments. Kinesiology is defined as the study of the principles of anatomy, physiology, and mechanics in relation to human movement. Therefore, orthopedic doctors often diagnose and treat injuries that can be explained by principles of kinesiology. Kinesiology is often split up into three separate disciplines: musculoskeletal anatomy, neuromuscular physiology and biomechanics. Each of these disciplines is applied in the field of orthopedics to aid in accurate diagnoses.

In regards to mobility, the glenohumeral (GH) joint is one of the best the human body has to offer. It allows for the range of motion needed for the activities of daily living that we have all grown accustomed to. In order to execute these motions, however, the shoulder joint needs a stable base of support. This is one of the primary roles of the scapula and its surrounding musculature. When the GH joint is injured, however, scapular muscle-activation, and therefore stability and function, is theoretically altered. Many shoulder rehabilitation programs focus on restoring proper coordination of these muscles, especially those involved with scapular upward-rotation. Until recently, however, there has not been much research supporting the relationship between muscle-activation ratios and shoulder injuries, nor the ability to preferentially activate scapular muscles using rehabilitation exercises. Furthermore, the purpose of this study was to determine if there are differences in muscle-activation ratios between healthy individuals and those with GH injuries, as well as evaluate muscle-activation during particular rehabilitation exercises (Moeller, Huxel Bliven, & Snyder Valier, 2014).

The purpose of this analysis is to evaluate a program of therapy designed to return to ambulation a patient post-lateral ankle ligament reconstruction. The components of the anatomical analysis- joints and actions, muscles, types of contractions, biomechanics, neuromuscular considerations, and safety- will help to further understanding so that a program of therapy will be properly and correctly administered to an individual recovering from a lateral ankle ligament reconstruction surgery.

Proprioceptive rehabilitation methods look to return the ankle to its previous risk factor level, and return it to its previous function level. Scott et. al (1997) says that afferent feedback to the brain and spinal pathways is mediated by skin, articular, and muscle mechanoreceptors. Rehabilitation aims to re-establish those spinal pathways so that movements can be performed fully again. Scott et. al (1997) believes that rehabilitation programs should be designed to include a proprioceptive component that addresses the following three levels of motor control: spinal reflexes, cognitive programming, and brainstem activity. A program which is set out in this way is highly recommended to promote and return dynamic joint and functional stability. Another study, conducted by Lephart (1995), examined the role of proprioceptive training in the treatment of injuries, and also looked at recent developments in the area of proprioceptive rehabilitation methods. Lephart (1995) notes that ligaments play a major role in normal joint kinematics, providing mechanical restraint to abnormal joint movement when a stress is placed on the joint. Following injury to these tissues there is a loss of mechanical stability to the joint, resulting in changes to normal kinematics. Management of these sport-related injuries focuses on restoring joint kinematics by enhancing muscular stabilisation through rehabilitation. By restoring joint stability through rehabilitation, the athlete should be able to return to playing sport, while the chance of re-injury will be reduced. Some believe that rehabilitation of ankle injuries should be set and individualised for each athlete as no athlete or injury is the same, and react differently to different exercises. Carl (2002) said that in the acute phase, the focus should be on controlling the inflammation and once pain is gone and

This allows the patient to develop sufficient endurance required to proceed with TMR myoelectric prosthetic training. As a result of the redirected pathways from the brain to the host muscle, the OT must have in-depth knowledge of peripheral nerve distribution in order to perform the appropriate strengthening exercises. In addition, the therapist must know the details of the surgery and the possible effects for every patient since each case is unique. An occupational therapist’s knowledge of TMR is also advantageous for a myriad of patients who are physically active, due to the commonality of shoulder dislocations. Patients with prosthetics have an increased number of EMG signals, which result from more intuitive, controlled upper body movements with less effort[p1] . Additionally, these developed prosthetic movements are more efficient and fluid without the necessity of switching between degrees of freedom. Patients with TMR demonstrate increased performance in comparison to conventional myoelectric control (Stubblefield, 2009). For example, TMR patients were 50 percent faster in a clothespin-moving test and improved in the Assessment of Motor and Process Skills. Due to the twofold effects of surgical and postoperative therapy intricacy, TMR provides the opportunity for clinical skill enhancement through the guidance of occupational therapists and thus

This is especially important because individuals with balance related disorders can have ADL impairments, resulting in loss of independence (Meli, 2006). When designing a training program, data from the assessments can be used to: (a) set goals, (b) determine safety parameters/identifying exercise contraindications, (c) modify exercises, and (d) track progress. One method of obtaining assessment information is through collaboration with the individual’s physical therapist (PT). Having access to an evaluation conducted by a PT is a major asset because it will can provide detailed information about positional limitations, previous rehab programing, and other screening information. Research shows that vestibular rehabilitation programs conducted by physical therapists can improve balance and other coordination-based abilities (Nyabenda, Briart et al. 2003; Gottshall, Hoffer et al. 2005). When dealing with a client who has undergone vestibular rehabilitation, it is important to have the original program to help determine exercise progressions and/or regression. If an individual with Meniere’s hasn’t previously conducted a vestibular rehabilitation program, a referral might be necessary. In addition to the data from the PT, trainers may incorporate self-report instruments such as the Dizziness

After the diagnosis from the orthopedic doctor of a posterior elbow dislocation, the athlete was instructed to wear a mobilization brace locked out at thirty degrees until his next follow up appointment. During this time, gentle range of motion activities began involving the wrist and the elbow in both flexion and extension. The athlete also worked on grip strength with putty, increasing the time and intensity as needed. In addition to these activities, isometric elbow contractions added to the intensity of the rehabilitation. After the rehabilitation sessions finished, the athlete iced the injured area.

The goal in this study were for patients to make a speedy recovery with the help of early gait training, and to return to their daily activities after hospital discharge without the risk of falling. Osteoarthritis patients have a high risk of falling, this study rehabilitated patients who were at risk for falling upon hospital discharge after knee surgery. Primary unilateral total knee replacement was performed for patients suffering from osteoarthritis. The population consisted of a convenience sample, also known as a non-probability sample. These patients were easy to target in the hospital, they were suitable for the study in regards to osteoarthritis and needing total knee replacement. This study proved that gait variability did not change that much with preoperative rehabilitation and postoperative rehabilitation. The patient's stability was similar before and after the

Gait is the most important function of daily living activities for all human beings. As physical therapists and researchers we are particularly interested in evaluation of gait. There is a distinct necessity for objective measurement of gait because without it the excellence of treatment decisions is condensed, due to subjective and often unreliable nature of the assessment. Objective measures must be employed to validate efficacy of the treatment protocol, a function that has become imperative since health care resources are becoming more strained and health care providers are held more accountable1. Gait assessment is an everyday responsibility of the therapist, and visual assessment seems unreliable and erratic for the most part. Measurement

The way phantom limb patients get treated is through Mirror Box Therapy, which was developed by the researcher V.S. Ramachandran. This therapeutic process involves a box with two mirrors facing each way, and the patient places their good limb in one box and their stump in the other; then, the patient looks onto the side with the good limb and makes “mirror symmetric” movements. Due to the subject seeing a reflected image of their good limb, it appears the phantom limb is also moving. Through the use of artificial visual feedback, the patient is able to “move” the phantom

Encourage patient to be conscious of body parts and watch feet, use of visual and tactile stimuli assists in reintegration of affected side.

The Jebsen-Taylor hand function test and Jamar dynamometer were the two hand function tests given to participants. The Motor Assessment Scale (MAS) and the Berg Balance Scale (BBS) were also given to participants and recorded the day after making the first FMA evaluation of the video recording. A follow-up assessment was given to participants 3 months after the baseline assessment to calculate the subject’s responsiveness. Data was available for sixteen of the fifty original participants. The sixteen participants continued physical therapy following the baseline

Skilled movements are the second focus area in kinesiology. It involves presentations where accuracy of direction,

The goniometer measure was used to assess the range of motion during this study. The intraclass correlation coefficients (ICC) for test-retest reliability of the shoulder is between .6 and .69. A previous study on the kinesiologic electromyographic have demonstrated that the interrater kappa coefficient for identification of muscles weakness without using a muscle test grade is between .62 to .69 for muscles of the rotator cuff. The interrater reliability for muscle stretch reflexes is around .73, with a specificity value ranging from .95 to .98 and sensitivity ranging from .03- .24. The interrater reliability for dermatomal sensory testing for C5 distribution around .67. The Spurling test for cervical radiculopathy had