Osteoporosis 3. The Importance Of Proprioception.

Proprioception is an awareness of ones own body in space. The receptors that are key in one’s proprioceptive ability are found in the ligaments, tendons and joints. When these receptors are triggered they send signals to the central nervous system (Burke, 2007). If proprioceptive training is utilised, it is likely to result in improved mobility and improved postural control. Proprioception (along with resistance training) has been proven to reduce the number of falls by up to 38% and therefore improve quality of life (Teixeira et al., 2010).

An increase in fall risk may be seen in osteoporosis. A common cause of this in the reduced sensitivity, and therefore proprioceptive abilities, of the paravertebral muscles due to the hyperkyphosis caused by vertebral fractures (Vasconcelos et al., 2010).

Postural correction is an important factor in proprioceptive ability (Castro, 2000). Gait can be retrained by working the muscles that it involves – these may included the gluteus maximus, hip flexors, knee extensors and the hallux extensors (Silva and Mannrich, 2009). Exercises that can improve gait are; walking, small jumps on the spot (if one does not have an increased fracture risk), unilateral coordination exercises and rocking of the body weight from one leg to the other (Bilar and Pillare, 2003). Ballroom dancing is an effective, fun activity that can involves many of these exercises (Pereira et al., 2008).

Tai-chi Chuan has also been found effective in improving knee extensor strength and therefore balance (Chyu et al., 2010). With this comes an improved gait (due to increased tread width) improved trunk stability, and a decreased number of falls (Pereira et al., 2008).

References

Burke RE. Sir Charles Sherrington’s. The integrative action of the nervous system: a centenary appreciation. Brain. 2007;130(Pt 4):887-94.

Teixeira L, Peccin S, Silva K, Teixeira T, Imoto AM, Magalhães J, et al. The effectiveness of progressive load training associated to the proprioceptive training in topics in osteoporosis. 2010;46:216-39.

Vasconcelos FM, Trevisan DC, Costa GC, Matos MS, Reis JG, Abreu DCC. Thoracic kyphosis degree and its interference with static balance and dynamic task in elderly women. Geriatria & Gerontologia. 2010; 4(4):194-202.

Castro MP. Thoracic kyphosis treated with global posture reeducation. Arq Ciênc Saúde Unipar. 2000;4(2):159-64.

Silva ACLG, Mannrich G. Pilates on rehabilitation: a systematic review. Fisioter Mov. 2009;22(3):449-55.

Bilar EM, Pillare AC. Osteoporosis. Etiology, diagnosis and treatment. Physical exercise and rehabilitation in the prevention and treatment of osteoporosis. Lirani-Galvão APR, Moreira-Pfrimer LDM, Marin RV, Oliveira ML, Pedrosa-Castro MAC, Lazaretti-Castro M. In: Chapter 10; 1ª Edition, Biomedical. 2003; p. 217-34.

Chyu MC, James CR, Sawyer SF, Brismée JM, Xu KT, Poklikuha G, et al. Effects of tai chi exercise on posturography, gait, physical function and quality of life in postmenopausal women with osteopenia: a randomized clinical study. Clin Rehabil. 2010;24(12):1080-90.

Pereira MM, Oliveira RJ, Silva MAF, Souza LHR, Vianna LG. Effects of Tai Chi Chuan on knee extensor muscle strength and balance in elderly women. Rev Bras Fisioter. 2008;12(2):121-6.