The Effectiveness of Proprioceptive Training for Improving Motor Performance and Motor Dysfunction: A Systematic Review

Abstract

ObjectiveProprioceptive training is any intervention aiming to improve proprioceptive function with the ultimate goal to enhance motor function and performance. It has been promoted as an approach to enhance athletic performance and as a tool for sensorimotor rehabilitation. Numerous studies sought to provide evidence on the effectiveness of the approach. However, many different training regimes claiming to train proprioception report a variety of sensorimotor measures that are not directly comparable. This, in turn, makes it difficult to assess effectiveness across approaches. It is the objective of this study to systematically review recent empirical evidence to gain an understanding of which outcome measures are most sensitive, which populations may benefit most from proprioceptive training, and what are the effects on proprioceptive and motor systems.MethodsFour major databases were searched. The following inclusion criteria were applied: (1) A quantified pre- and post-treatment measure of proprioceptive function. (2) An intervention or training program believed to influence or enhance proprioceptive function. (3) Contained at least one form of treatment or outcome measure that is indicative of somatosensory function and not confounded by information from other sensory modalities. 4) The study reported of at least one quantified measure of motor performance.ResultsOf the 3,297 articles identified by the database search, 70 studies met the inclusion criteria and were included for further review. Across studies, proprioceptive training led to comparable gains in both proprioceptive (+46%) and motor performance (+45%). The majority of studies (50/70) applied active movement interventions. Interventions applying somatosensory stimulation were most successful in clinical populations. Joint position sense error (JPSE) was the most commonly used proprioceptive measure and presents a reliable and feasible measure for clinical use.ConclusionProprioceptive training can lead to significant improvements in proprioceptive and motor function across a range healthy and clinical populations. Regimens requiring active movement of the trainee tended to be most successful in improving sensorimotor performance. Conclusive evidence on how long training gains are retained is still lacking. There is no solid evidence about the underlying long-term neuroplastic changes associated proprioceptive training.

Feasibility, usability and effectiveness of a robot-assisted finger proprioception therapy

“…The lack of sensitive and reliable outcome measures also makes it difficult to evaluate the effectiveness of new interventions [8,11]. Available therapies targeting proprioception of the upper limb consist of passive and active movement training, where vision is typically constrained so that participants rely on proprioceptive feedback while executing a task involving the hand [12,13]. Other interventions include somatosensory stimulation (e.g., vibration) or somatosensory discrimination training (e.g., discrimination between different shapes or textures) [13,14,[14][15][16].…”

“…Available therapies targeting proprioception of the upper limb consist of passive and active movement training, where vision is typically constrained so that participants rely on proprioceptive feedback while executing a task involving the hand [12,13]. Other interventions include somatosensory stimulation (e.g., vibration) or somatosensory discrimination training (e.g., discrimination between different shapes or textures) [13,14,[14][15][16]. However, these therapies lack standardization and more studies are needed to prove their ef-fectiveness using more sensitive outcome measures, hence proprioceptive therapies are currently often deprioritized in clinical practice [8].…”

A Systematic Review of the Learning Dynamics of Proprioception Training: Specificity, Acquisition, Retention, and Transfer

“…14 The methods of proprioceptive training vary widely between clinical studies, and many studies have investigated the training effect on proprioception without explicitly using the term “proprioceptive training.” Consequently, previous systematic reviews defined proprioceptive training as an intervention or training program believed to influence proprioception. 8,9 or an experimental program specifically oriented to enhance proprioception and balance. 10 However, many types of sensorimotor training programs, even if not specifically designed to challenge proprioception, might affect proprioceptive acuity.…”

“…6,7 Several systematic reviews have found that various forms of proprioceptive training improve proprioception in healthy subjects and patients with various medical conditions. [8][9][10][11] However, these reviews have not analyzed the learning dynamics associated with proprioceptive training. Therefore, we are interested in 4 key aspects of learning that are well-known in motor learning literature: specificity, acquisition, retention, and transfer.…”

“…Consequently, previous systematic reviews defined proprioceptive training as an intervention or training program believed to influence proprioception. 8,9 or an experimental program specifically oriented to enhance proprioception and balance. 10 However, many types of sensorimotor training programs, even if not specifically designed to challenge proprioception, might affect proprioceptive acuity.…”