Proprioseptisen

Proprioseptisen is the sense by which the brain perceives the position and movement of the body and its parts. It is sometimes called proprioception or kinesthesis. Proprioceptors in muscles, tendons, joints and to a lesser extent skin provide afferent signals to the nervous system. The brain integrates these signals with visual and vestibular information to form a coherent body schema.

Anatomy and pathways: main receptors are muscle spindles (sensitive to stretch) and Golgi tendon organs (tension), plus joint capsule receptors; several types of cutaneous receptors can contribute. Signals travel via group Ia, Ib, and II afferent fibers to the spinal cord, and ascend in the dorsal columns and spinocerebellar tracts to the brain. In the brain, proprioceptive information is processed in the somatosensory cortex and integrated in the cerebellum and parietal areas to guide movement.

Functions: proprioception enables posture and balance, limb orientation, movement accuracy, and motor learning. It operates in parallel with vision and vestibular inputs to control gait, reaching, and grasp.

Clinical relevance and testing: proprioceptive deficits occur in peripheral neuropathies (e.g., diabetes), stroke, multiple sclerosis, aging, and after musculoskeletal injuries. Clinically assessed with joint-position sense tests (e.g., finger or big toe repositioning with eyes closed), vibration sense, and balance tests like the Romberg test. Proprioceptive impairment can manifest as proprioceptive ataxia or poor coordination.

Training and rehabilitation: proprioceptive training uses balance and coordination exercises, plyometrics, and neuromuscular facilitation to improve joint position sense and stability, particularly after ankle sprains, ACL injuries, or stroke. Training often emphasizes closed-eye tasks and progressive perturbations to challenge proprioceptive integration.