Reestablishing Neuromuscular Control and Proprioception Neuromuscular control is
Re-establishing Neuromuscular Control and Proprioception
�Neuromuscular control is the mind’s attempt to teach the body conscious control of a specific movement �Relies on CNS to interpret and integrate sensory and movement information and then control muscles and joints to produce coordinated movement
Neuromuscular Control �Following injury, the body forgets how to integrate information �Re-establishing neuromuscular control requires repetition of same movement, step by step until it becomes automatic (progression from simple to difficult tasks) �Closed kinetic chain (CKC) exercises are essential for reestablishing control but can be difficult
Neuromuscular Control �Must relearn normal functional movement and timing after injury - may require several months �Critical throughout rehab - most critical early in process to avoid re-injury
Proprioception �Re-establishing proprioception and kinesthesia should be the primary concern when working on Neuromuscular Control �Proprioception is the ability to determine position of joint in space �Kinesthesia is the ability to detect movement (sensation/feeling) �Kinesthesia and proprioception are mediated by mechanoreceptors in muscle and joints, cutaneous tissue, visual and vestibular input �Neuromuscular control relies on CNS to integrate all areas to produce coordinated movement
Mechanoreceptors= structures that generate nerve impulses. They are influenced by touch, pressure, vibration and stretch. �Joint Mechanoreceptors � Ruffini’s endings (deep in skin) � Pacinian corpuscles (superficial layer of skin) � Free nerve endings (connective tissues) �Sensitive to changes in shape and the rate or direction of movement �Muscle Mechanoreceptors �Muscle spindles (skeletal)- sensitive to changes in length of muscle �Golgi tendon organs (tendons) - sensitive to changes in tissue tension
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