Does Proprioceptive Training During Knee and Ankle Rehabilitation Improve Outcome?
reprint from Physical Therapy Reviews
Volume 8, Number 1, March 2003, pp. 5-16(12)
– by Baltaci G.; Kohl H.W.
To comprehensively review and critically appraise the available literature from 1966 to January 2001 in order to examine the evidence concerning the efficacy of proprioceptive training during knee and ankle rehabilitation. (Proprioception is the body’s ability to feel a joints’ place and direction of movement in space. Proprioception is used along with vision and the “level” in our ears to keep our balance. Kinesthetic sense is related. It is the your body‘s ability to sense body position, weight bearing and movement of the muscles, tendons and ligaments).
Method: The total number of articles reviewed was 9 and 8 for the knee and ankle, respectively.
For the knee: Five of the nine studies evaluated a proprioceptive rehabilitation programme for anterior cruciate ligament (ACL) deficient patients, three studied a training programme in healthy subjects and athletes involved in soccer and gymnastics and one study was on patients suffering from knee pain. The duration of proprioceptive training ranged from 1–52 weeks.
For the ankle: Three papers investigated the significance of postural stability in healthy subjects receiving a proprioceptive training programme; one studied joint position sense in gymnasts, one study looked at postural stability in dancers, and three studies evaluated patients with functionally instability in the ankle joint.
Results: Eight studies showed the beneficial effects of proprioceptive training during a knee exercise programme; one study showed that joint position sense in the ACL deficient knees with muscular and proprioceptive training remained unchanged. Increased joint proprioceptive sense, muscle strength, knee kinesthesia, muscle tone and the decreased risk of ACL injury have suggested that dynamic joint control training may improve stability by improving joint position sense in healthy and injured-knees. The authors found that improvements in balance performance following a 6-10-week training period appeared to be greater in individuals with previously reported ankle sprains as compared with uninjured participants. The effects of proprioceptive training on muscle reaction times and postural stability have increased during ankle rehabilitation after several weeks. Ankle proprioceptive training has been shown to decrease functional instabilities of the ankle and to decrease the incidence of re-injury.
Conclusions: Specific neuromuscular co-ordination training such as dynamic joint control and kinesthetic awareness may be indicated at 3–4 months following rehabilitation. In other words, balance and coordination drills and exercises will improve the connections between your joints and muscles to and from the brain. This will decrease your risk of rein jury because your reaction time will be quicker.
