Sakai Yoshihito, Watanabe Tsuyoshi, Wakao Norimitsu, Matsui Hiroki, Osada Naoaki, Sugiura Takaya, Morita Yoshifumi, Kawai Keitaro, Ito Tadashi, Yamazaki Kazunori
Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya, Japan.
Spine Surg Relat Res. 2022 Apr 12;6(5):422-432. doi: 10.22603/ssrr.2021-0269. eCollection 2022 Sep 27.
Proprioception is a deep sensation that perceives the position of each part of the body, state of movement and muscle contraction, and resistance and mass applied to the body. Proprioceptive feedback influences movement and positional accuracy, resulting in key somatosensory functions for human postural control. Proprioception encompasses signals received from proprioceptors located in the skin, subcutaneous tissue, muscles, tendons, and joint capsules, commonly known as mechanoreceptors. The muscle spindle, a crucial proprioceptor, is stretched during eccentric contraction of muscle, thus generating an action potential on afferent fibers to convey a proprioceptive information to the sensorimotor cortex in the brain. For exercise therapy in patients with locomotor disease, proprioception serves an essential function for motor control; thus, this should be considered to obtain effective muscle output. As postural control is achieved by proprioceptive function according to the balance between the lower limb and trunk, relative proprioceptive weighting ratio can help clarify proprioceptive control using muscle response to mechanical vibration. The absence of proprioceptive information congruent with motor intention activates cortical center monitoring incongruence of sensation, leading to pathological pain. Therapeutic procedures may aim to restore the integrity of cortical information processing in musculoskeletal chronic pain. Poor proprioception is one of the main causes of decreased postural balance control in elderly patients with low back pain (LBP). It has been hypothesized that proprioception of the lower limbs deteriorates with age-related muscle mass loss (sarcopenia), which increases the proprioceptive burden on the lumbar spine. Accurate diagnosis of the proprioceptive function is important for establishing a treatment procedure for proprioceptive recovery, and further prospective research is required to clarify the relationship between proprioception and LBP improvement.
本体感觉是一种深部感觉，它能感知身体各部位的位置、运动状态和肌肉收缩情况，以及施加于身体的阻力和质量。本体感觉反馈会影响运动和位置准确性，从而成为人体姿势控制的关键躯体感觉功能。本体感觉包括从位于皮肤、皮下组织、肌肉、肌腱和关节囊的本体感受器接收到的信号，这些感受器通常被称为机械感受器。肌梭是一种关键的本体感受器，在肌肉离心收缩时会被拉伸，从而在传入纤维上产生动作电位，将本体感觉信息传递到大脑的感觉运动皮层。对于运动疾病患者的运动疗法而言，本体感觉对运动控制起着至关重要的作用；因此，在获得有效的肌肉输出时应考虑到这一点。由于姿势控制是通过下肢和躯干之间平衡的本体感觉功能实现的，相对本体感觉加权比有助于利用肌肉对机械振动的反应来阐明本体感觉控制。与运动意图不一致的本体感觉信息缺失会激活监测感觉不一致的皮层中枢，导致病理性疼痛。治疗程序可能旨在恢复肌肉骨骼慢性疼痛中皮层信息处理的完整性。本体感觉不佳是老年腰痛（LBP）患者姿势平衡控制下降的主要原因之一。据推测，下肢的本体感觉会随着与年龄相关的肌肉质量流失（肌肉减少症）而恶化，这会增加腰椎的本体感觉负担。准确诊断本体感觉功能对于建立本体感觉恢复的治疗程序很重要，还需要进一步的前瞻性研究来阐明本体感觉与LBP改善之间的关系。
