In this literature review an explanation of proprioception and proprioceptive training will be presented. Various skill acquisition theories will be examined and the correlation of the proprioceptive system to the visuomotor systems will be analyzed. Current research into the use of proprioception for skill acquisition/motor learning will be discussed. Finally, an examination of what other areas could be explored to strengthen the understanding of how the brain uses proprioception to improve motor patterns will be presented.
The body uses sensory sensitivity signals to dynamically transmit information to the central nervous system. The perception of stimulus to the body is received by numerous proprioceptors that are in place throughout the body. Proprioceptors are located inside muscles, joints, tendons, ligaments, capsules, membranes, and the inner ear. Movement of the body stimulates the proprioceptors and they begin to transmit a constant flow of information to the central nervous system. Information for proper motor patterns in regards to the degree, direction, and rate of change of the movement would not be possible without the body’s proprioceptors. The information is sent to both the conscious and unconscious levels. (Hamilton, Weimar, & Luttgens, 2012) Konczak et al. suggested that conscious perception of body, limb motion, and positioning be referred to as kinesthesia, while proprioception be reserved for these same actions when performed unconsciously. Unconscious proprioceptive reflexes occur when there is a stimulus to receptors in skeletal muscles, tendons, joints, or the inner ear. Kinesthesia occurs when there are sensations to the receptors in the joint capsules and ligaments. Memory and kinesthesia are the basis of volition movement and skill acquisition. (Hamilton, Weimar, & Luttgens, 2012)
Proprioception is the sensation of joint movement and position. (Lephart et al., 1997) Location, muscle force, muscle effort, heaviness, viscosity, and the control of movement are tasks all performed with information gathered from proprioception and transmitted to the central nervous system. (Taylor, 2009) Proprioception is vital for the neural control of movement. Without proprioception one would lose control of muscle tone, posture, and it would have negative effects on the temporal and spatial impacts of volition movements. (Aman, Elangovan, Yeh, & Konczak, 2015) Without the constant flow of information going to the central nervous system, completing any motor patterns would be a near impossibility.
Improving proprioception can be achieved through various forms of proprioceptive training techniques. Constraining other modalities such as vision, forces the athlete to rely on their sensorimotor and somatosensory skills to achieve motor pattern outcomes. The majority of studies that were analyzed by Aman, Elangovan, Yeh, & Konczak saw proprioceptive function improvement rates above 20%. Evidence showed that utilizing training methods with a combination of passive and active movement with and without exteroceptive feedback were the most beneficial. Proprioceptive training regimens that lasted six weeks or longer tended to show higher improvements in motor and proprioceptive functions. (Aman, Elangovan, Yeh, & Konczak, 2015)
There is enough evidence to show the benefits of proprioceptive training. The issue among various research is the lack of a common agreement on the definition of proprioception and kinesthesia. Numerous researchers interchange proprioception and kinesthesia to mean the same thing. While others have completely individual specific definitions of each word. There is even a disagreement on what exactly constitutes as proprioceptive training. The creation of widely accepted universal definitions would be beneficial to clear up confusion and clarify further research into the area of proprioception and kinesthesia.
According to Magill and Anderson, skill acquisition is the knowledge of which neurological and behavioral variables influence the adaptation of the central nervous system in response to learning a motor skill. This requires the athlete to solve a motor skill problem by correctly moving joints and body segments in attempt to achieve a perceived goal. Skill acquisition is multi-sensory and proprioception helps gather and transmit the information needed to develop movement patterns. Nikolai Bernstein stated in his famous quote regarding movement patterns “Repetition without repetition,” meaning no two movement patterns will ever be the same. Using Bernstein’s theory an athlete would need to create a new movement solution for every motor problem they encountered. In order for an athlete to solve motor problems consistently, the athlete must be exposed to as many modifications to the task as possible. (Bernstein, 1996) The Dynamic Systems Theory proposes that motor behavior is the result of complex interactions between a variety of systems in the environment, the task, and the body. The athlete prefers to stay in the attractor state and when a change in constraints occurs the athlete is forced to self-organize in order to continue to stay in the attractor state. (Colombo-Dougovito, 2016 & Newell, 1991) There are numerous redundant pathways that achieve the same movement goals. New constraints create the need for self-organization and influence growth in the area of adaptability for the athlete. (Colombo-Dougovito, 2016) Gentile’s Stages of Motor Learning points out that an athlete will adapt to the regulatory and non-regulatory conditions of the environment and the task in order to solve the motor problem. The athlete must explore a wide range of movement solutions and engage in cognitive problem solving.
Movement solutions are shaped by the task, environment, and the body. In order to constantly create movement solutions an athlete needs to be able to collect information to calculate the ideal movement solution. Gentile and Bernstein both agree on the environment and the task shaping the adaptation of the athlete. In order to engage in cognitive problem solving the proprioceptive system will engage gathering information via sensory input. The athlete can then utilize the sensory input to calculate the required movement pattern.
Proprioceptive Training for Skill Acquisition
Very little is known about how proprioception changes with skill acquisition/motor learning. (Ostry et al. 2010) Recent research has examined the link between motor learning and sensory function of various arm movements. Research findings have been consistent with showing that motor learning is associated with the systematic change to an athlete’s proprioception. The benefits of proprioceptive training were shown to improve movement speed and mitigate positioning errors. Research findings support the notion that motor learning can be enhanced with proprioceptive training. Passive proprioceptive training was shown to have the greatest benefit towards motor learning. (Wong, Kistemaker, Chin, and Gribble, 2012) For clarification, passive training is training in which an outside source manipulates the athlete’s movement pattern. Active training is when the athlete is allowed to utilize their joints and body segments to create their own movement pattern.
It is widely recognized that sensory information is utilized by the brain to more accurately produce motor commands. Numerous research studies have been conducted to analyze the use of proprioception for motor learning/skill acquisition. Wong, Wilson, and Gribble studied the opposite. They looked at how proprioceptive acuity changed after recent motor learning. Wong, Wilson, and Gribble found that following active motor learning, proprioceptive acuity improved in the workspace of the arm explored during motor learning. Passive motor learning and motor learning performed in a different location showed no proprioceptive improvement.
Seeing how closely related skill acquisition is to proprioception, it would seem that training one aspect certainly directly enhances the other. It is interesting to note that passive proprioception training showed the greatest benefits towards motor learning while active motor learning improved proprioception. Further investigation into the correlations between these two modalities is needed. Comparing the role of visuomotor functions to the role of proprioceptive functions and their correlations to skill acquisition would also be beneficial. How much is skill acquisition dependent upon these two systems? Or within a given motor task how much of the task is reliant upon visuomotor and how much of the task is reliant upon proprioception? As mentioned before skill acquisition is multi-sensory, but does improving one modality improve the dynamics of the entire system?
Visuomotor and Proprioception
The role of proprioception in regards to visuomotor adaptations is still unclear. Results from Ingram et al. (2000) suggested that proprioception is not required for visuomotor adaptations to occur. Proprioception played an important role in reaching movements during the study, but in the absence of proprioception visual attention was necessary to monitor movements. (Ingram et al. 2000) Another study suggested that intaking simultaneous visual and proprioceptive information is vital for altering neural representations of visuomotor maps. (Shabbott & Sainburg, 2010) This would fit into the idea of multi-sensory input being critical for skill acquisition. It would be interesting to further research whether visuomotor input or proprioceptive input would result in faster skill acquisition. Or if the two work better in conjunction with each other. If one system has a deficit does the other become stronger due to the deficiency of the other system? For example, if an athlete has a deficiency in proprioception, would the visuomotor system become stronger to pick up the slack?
Proprioception is the ability to sense joint movement & position in space, while skill acquisition is the learning of a motor skill which requires knowledge of joint movement patterns & positioning. Proprioceptive training and skill acquisition go hand in hand. Skill acquisition is multi-sensory. Bernstein’s Dynamic Systems Theory and concept that no two movements are ever alike supports the idea of proprioceptors constantly sending a stream of information to the central nervous system. The athlete constantly processes proprioceptive information to self-organize and create ideal movement solutions. Chiel, Ting, Ekeberg, and Hartmann stated that there was a clear interaction between the nervous system and the biomechanics of the body. Both are interacting with a complex and changing environment. Research showed the skill acquisition enhances proprioception and that proprioceptive training enhances skill acquisition. Using a variety of modalities and constraints will improve skill acquisition and proprioception.
When starting to utilize proprioceptive training for skill acquisition it is important that a coach understand what limitations or possible deficits could affect proprioception improvements or delay skill acquisition. Discovering an athlete’s deficits in regards to depth perception and eye dominance would be beneficial for improving proprioception and the speed of skill acquisition. Movement solutions could be miscalculated due to the deficit in depth perception. Hand-eye dominance has shown to delay skill acquisition of certain tasks. Rifleman who were crossed hand-eye dominant did not learn new marksmanship skills as quickly as those with matched hand-eye dominance. (Jones, Classe, Hester, & Harris, 1996) In contrast a study done on laparoscopic surgeons showed that hand-eye dominance did not affect the surgeons ability to perform the surgical task. Rather it was depth perception that hindered the surgeons’ abilities. Surgeons with depth perception deficits were able to improve their depth perception. (Suleman et al., 2010) Why does hand-eye dominance matter in the acquisition of skills for riflemen, but not for laparoscopic surgeons? What other skills are affected by hand-eye dominance? Finally, are there some skills that actually benefit from crossed hand-eye dominance? Investigation into the correlation of depth perception and proprioception and how crossed-eye dominance affects skill acquisition is needed.
Further exploration into the correlation between visuomotor skills and proprioception would help determine the role each system plays into motor learning. Also, determining if all the sensory input signals are combined when sent to the central nervous system or if the body receives the input separately could answer questions in regards to motor control. If the signals are sent separately, then is one input given priority over the other? Or is all input taken and calculated as a whole dynamic system and used to calculate the best solution?
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