Proprioception in musculoskeletal rehabilitation. Part 2: Clinical assessment and intervention.

Proprioception can be hindered in gradual-onset musculoskeletal pain disorders and post trauma. Understanding of the role of proprioception in sensorimotor dysfunction and methods for assessment and interventions is of vital importance in musculoskeletal rehabilitation. In Part 1 of this two-part Masterclass a theory-based overview of the role of proprioception in sensorimotor control, causes and findings of altered proprioception in musculoskeletal conditions, and general principles of assessment and interventions were presented. The goal of this second part is to present specific methods for clinical assessment and interventions to improve proprioception in the spine and extremities.

Clinical assessment of proprioception can be performed using goniometers, inclinometers, laser-pointers, and pressure sensors. Manual therapy, taping, and bracing can immediately improve proprioception and should be used in preparation for exercise interventions. Various types of exercise (active joint repositioning, force sense, co-ordination, muscle performance, balance/unstable surface, plyometric, and vibration training) should be used for long-term enhancement of proprioception.