Proprioceptive Training with Visual Feedback Improves Upper Limb Function in Stroke Patients: A Pilot Study

Proprioceptive deficit is one of the common sensory impairments following stroke and has a negative impact on motor performance. However, evidence-based training procedures and cost-efficient training setups for patients with poststroke are still limited. We compared the effects of proprioceptive training versus nonspecific sensory stimulation on upper limb proprioception and motor function rehabilitation. In this multicenter, single-blind, randomized controlled trial, 40 participants with poststroke hemiparesis were enrolled from 3 hospitals in China. Participants were assigned randomly to receive proprioceptive training involving passive and active movements with visual feedback (proprioceptive training group [PG]; n = 20 ) or nonspecific sensory stimulation (control group [CG]; n = 20 ) 20 times in four weeks. Each session lasted 30 minutes. A clinical assessor blinded to group assignment evaluated patients before and after the intervention. The primary outcome was the change in the motor subscale of the Fugl-Meyer assessment for upper extremity (FMA-UE-M). Secondary outcomes were changes in box and block test (BBT), thumb localization test (TLT), the sensory subscale of the Fugl-Meyer assessment for upper extremity (FMA-UE-S), and Barthel Index (BI). The results showed that the mean change scores of FMA-UE were significantly greater in the PG than in the CG ( p = 0.010 for FMA-UE-M, p = 0.033 for FMA-UE-S). The PG group was improved significantly in TLT ( p = 0.010 ) and BBT ( p = 0.027 ), while there was no significant improvement in TLT ( p = 0.083 ) and BBT ( p = 0.107 ) for the CG group. The results showed that proprioceptive training was effective in improving proprioception and motor function of the upper extremity in patients with poststroke. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR2000037808).

Proprioceptive Training versus Progressive Adaptive Physical Activity on Balance in Subjects with Sub-Acute Stroke

Background: Post-stroke, gait and balance are often affected increasing the risk of fall, social isolation and sedentary lifestyle. Proprioceptive training has always been a part of post-stroke rehabilitation which has seen to improve muscle strength, balance and gait. Progressive adaptive physical activity has also shown to improve balance, cardiovascular fitness and gait after stroke. This study aims to compare the effect of proprioceptive training and progressive adaptive physical activity on balance in sub-acute stroke subjects. Method: 30 subacute stroke subjects were randomly assigned to one of the two groups. Group A received proprioceptive training while Group B received progressive adaptive physical activity for 30 minutes, 3 times a week for eight weeks. Subjects in both the groups were assessed for balance using Berg Balance Scale and Functional Reach Test prior to the intervention and post-intervention. Result: Both the groups showed significant improvement in the pre to post FRT and BBS scores (p<0.001). Post-intervention, when compared between groups, Group A showed better improvement than Group B on the FRT scores (p<0.001) but no difference was seen in the BBS scores (p value>0.05). Conclusion: Proprioceptive training is found to be more effective than the progressive adaptive physical activity in improving balance among sub-acute stroke subjects. Key words: Stroke, Balance, proprioceptive training, progressive adaptive physical activity.

Proprioceptive Training to Improve Static and Dynamic Balance in Elderly

Background: The risk of falls is a major cause of disability in older adults. A single fall, for the elderly, increases the risk of frequent falls and often causes an increased fear of falling again, which can become debilitating. Objectives: The purpose of the present study was to test the effects of 12 weeks of proprioceptive training on the static and dynamic balance of older adults who have experienced at least one fall without compromising consequences. Method: The sample consisted of older adults, aged 60 to 80 years, randomly divided into two groups: an experimental group, which followed a proprioceptive training protocol at a physiotherapy studio, and a control group, which did not observe any treatment. Static and dynamic balance assessment was performed pre-and post-intervention. The tests administered were the Berg Balance Test for the evaluation of static balance, and the Four-Square Step Test, for dynamic balance. A questionnaire to assess confidence and fear of falling was administered at the end of the protocol. Independent sample t-test was performed to analyze differences between groups and two-way ANOVA to test the null hypothesis of no change different over time between groups (interaction intervention × time). A Chi-Square was performed to analyze perceptions. Conclusions: The results showed that 12 weeks of proprioceptive training effectively improved dynamic and static balance in older adults. The perceptions of the experimental group were more positive than the other one, in terms of the importance of physical activity to prevent the risk of falls, fear of falling again, and experience of falls during the last 12 weeks.

The efficiency of proprioceptive training in preventing injuries to team athletes: A systematic review

The aim of this systematic review was to evaluate the effectiveness of proprioceptive training in the prevention of lower extremity injuries, especially the ankle and knee joint, in team athletes. PRISMA recommendations were applied for this research. PubMed, ScienceDirect, and BioMed Central were used to identify relevant studies. The methodological quality of studies was assessed using the Physiotherapy Evidence Database-PEDro scale. Only 7 research met the eligibility criteria, and their outcomes were presented. Proprioceptive training has been shown to be very effective in preventing ankle injuries, especially in recurrent ankle sprains. However, in 3 of 4 studies lacked the effects of proprioceptive training in the prevention of knee and ACL injuries. Based on the results of the analyzed research, I can conclude that proprioceptive training is a very effective training tool in the prevention of ankle sprains in the population of team athletes, but proprioceptive training is not sufficient as the only training component in preventing knee injuries.

The Effect of Proprioceptive Training upon the Upper Limbs Strength on Posttraumatic Shoulder Recovery in Weightlifter Women

This paper aims to examine the effects of proprioceptive training upon upper limbs force in the case of female weightlifters. 10 weightlifters from CSS N. Rotaru in Constanța, Romania, took part in an experiment specially designed for this purpose. The experimental group was assigned a proprioceptive training programme of 15 minutes two times per week, for a period of 20 weeks. The tests administered for the assessment of their upper limbs force were push-ups, push-ups on the Bosu ball, and dynamometry testing. Data analysis shows that no significant differences between the experimental group and the control group are visible at the initial test (p> 0.05). In the final evaluation, however, the experimental group obtained better scores than the control group in all tests. These findings indicate that the proprioceptive programme proposed has lead to the enhancement of female weightlifters’ muscular force. In conclusion, the programme is an efficient training tool that can be integrated with the sportswomen’s exercise routine.

Effects of proprioceptive training for people with stroke: A meta-analysis of randomized controlled trials

Objective To evaluate the effectiveness of proprioceptive training on balance performance, trunk control, and gait speed in people with stroke. Methods We searched PubMed, Science Direct, Cochrane, Embase, and Medline for randomized controlled trials that evaluated the effects of proprioceptive training for patients with stroke from the date of each database's inception to July 26, 2021. Two reviewers independently screened the titles and abstracts of potentially eligible articles that were identified on the basis of the search criteria. Methodological quality was determined using version 2 of the Cochrane risk of bias tool for randomized trials. Data were analyzed using Comprehensive Meta-Analysis software. The treatment effect was estimated by calculating Hedges’ g and 95% confidence intervals (CIs) using a random-effects model. Statistical heterogeneity was assessed according to the I2 value. The primary outcome was balance performance and secondary outcomes were trunk control, gait speed, and basic functional mobility. Results In total, 17 trials involving 447 people with stroke were included. Proprioceptive training had a significant effect on balance performance (Hedges’ g = 0.69, 95% CI = 0.36–1.01), gait speed (Hedges’ g = 0.57, 95% CI = 0.19–0.94), trunk control (Hedges’ g = 0.75, 95% CI = 0.33–1.17), and basic functional mobility (Hedges’ g = 0.63, 95% CI = 0.31–0.94) among people with stroke. Conclusion Proprioceptive training may be effective in improving balance performance, gait speed, trunk control, and basic functional mobility among people with stroke.

An Assessment of Balance through Posturography in Healthy about Women: An Observational Study

The incidence of falls in adults constitutes a public health problem, and the alteration in balance is the most important factor. It is necessary to evaluate this through objective tools in order to quantify alterations and prevent falls. This study aims to determine the existence of alteration of balance and the influence of age in a population of healthy women. Static posturography was performed on 49 healthy adult women with no history of falls in four different situations using the Romberg test with the NedSVE/IBV® platform. The variables studied were the body sway area and the anteroposterior and mediolateral displacements. The situation of maximum instability occurred in RGC (p = 0.001), with a significant increase in anteroposterior oscillations regarding the ML (p < 0.001), with no correlation to age. Age alone does not influence the balance in the sample studied, other factors must come together to alter it. The joint cancellation of visual and somatosensory afferents could facilitate the appearance of falls, given that it is a situation of maximum instability. Proprioceptive training is interesting as a preventive strategy for falls.

Proprioceptive Training for Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: There is increased interest in proprioceptive training for knee osteoarthritis (KOA). However, little consensus supports the effectiveness of this intervention.Objective: This meta-analysis aimed to assess the effects of proprioceptive training on symptoms, function, and proprioception in people with KOA.Methods: The PubMed, Cochrane Library, Web of Science, and EMBASE databases were systematically searched from the inception dates to April 16, 2021 for relevant randomized controlled trials (RCTs). Data were pooled by calculating the standardized mean differences (SMDs) and 95% confidence intervals (CIs). A random-effects model was used for the analyses.Results: A total of 24 RCTs involving 1,275 participants were included in our analysis. This study indicated that compared to no intervention, proprioceptive training significantly improved pain, stiffness, physical function, joint position sense (JPS), muscle strength, mobility, and knee ROM (P &lt; 0.05) in people with KOA. When compared to other non-proprioceptive training, proprioceptive training provided better results in terms of JPS (SMD = −1.28, 95%CI: [−1.64, −0.92], I2 = 0%, P &lt; 0.00001) and mobility (timed walk over spongy surface) (SMD = −0.76, 95%CI: [−1.33, −0.18], I2 = 64%, P = 0.01), and other results are similar. When proprioceptive training plus other non-proprioceptive training compared to other non-proprioceptive training, the two groups showed similar outcomes, but there was a greater improvement for JPS (SMD = −1.54, 95%CI: [−2.74, −0.34], I2 = 79%, P = 0.01), physical function (SMD = −0.34, 95%CI: [−0.56, −0.12], I2 = 0%, P = 0.003), and knee ROM (P &lt; 0.05) in the proprioceptive training plus other non-proprioceptive training group. When proprioceptive training plus conventional physiotherapy compared against conventional physiotherapy, the two groups demonstrated similar outcomes, but there was a significant improvement for JPS (SMD = −0.95, 95%CI: [−1.73, −0.18], I2 = 78%, P = 0.02) in the proprioceptive training plus conventional physiotherapy group.Conclusions: Proprioceptive training is safe and effective in treating KOA. There is some evidence that proprioceptive training combined with general non-proprioceptive training or conventional physiotherapy appears to be more effective and should be considered as part of the rehabilitation program. However, given that the majority of current studies investigated the short-term effect of these proprioceptive training programs, more large-scale and well-designed studies with long-term follow up are needed to determine the long-term effects of these proprioceptive training regimes in KOA.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/#recordDetails, PROSPERO, identifier: CRD42021240587.