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Proprioception ( ), also referred to as kinaesthesia (or kinesthesia), is the
sense A sense is a biological system used by an organism for sensation, the process of gathering information about the world through the detection of stimuli. (For example, in the human body, the brain which is part of the central nervous system re ...
of self-movement, force, and body position. It is sometimes described as the "sixth sense". Proprioception is mediated by proprioceptors, mechanosensory
neuron A neuron, neurone, or nerve cell is an electrically excitable cell that communicates with other cells via specialized connections called synapses. The neuron is the main component of nervous tissue in all animals except sponges and placozoa ...
s located within
muscle Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of mus ...
s,
tendon A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability ...
s, and
joint A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw- ...
s. Most animals possess multiple subtypes of proprioceptors, which detect distinct kinematic parameters, such as joint position, movement, and load. Although all mobile animals possess proprioceptors, the structure of the sensory organs can vary across species. Proprioceptive signals are transmitted to the
central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all p ...
, where they are integrated with information from other
sensory systems The sensory nervous system is a part of the nervous system responsible for processing sensory information. A sensory system consists of sensory neurons (including the sensory receptor cells), neural pathways, and parts of the brain involve ...
, such as the visual system and the
vestibular system The vestibular system, in vertebrates, is a sensory system that creates the sense of balance and spatial orientation for the purpose of coordinating movement with balance. Together with the cochlea, a part of the auditory system, it constitut ...
, to create an overall representation of body position, movement, and acceleration. In many animals, sensory feedback from proprioceptors is essential for stabilizing body posture and coordinating body movement.


System overview

In vertebrates, limb velocity and movement (muscle length and the rate of change) are encoded by one group of sensory neurons (
Type Ia sensory fiber A type Ia sensory fiber, or a primary afferent fiber is a type of afferent nerve fiber. It is the sensory fiber of a stretch receptor called the muscle spindle found in muscles, which constantly monitors the rate at which a muscle stretch cha ...
) and another type encode static muscle length ( Group II neurons). These two types of sensory neurons compose
muscle spindles Muscle spindles are stretch receptors within the body of a skeletal muscle that primarily detect changes in the length of the muscle. They convey length information to the central nervous system via afferent nerve fibers. This information can be ...
. There is a similar division of encoding in invertebrates; different subgroups of neurons of the Chordotonal organ encode limb position and velocity. To determine the load on a limb, vertebrates use sensory neurons in the Golgi tendon organs: type Ib afferents. These proprioceptors are activated at given muscle forces, which indicate the resistance that muscle is experiencing. Similarly, invertebrates have a mechanism to determine limb load: the Campaniform sensilla. These proprioceptors are active when a limb experiences resistance. A third role for proprioceptors is to determine when a joint is at a specific position. In vertebrates, this is accomplished by
Ruffini ending The Bulbous corpuscle or Ruffini ending or Ruffini corpuscle is a slowly adapting mechanoreceptor located in the cutaneous tissue between the dermal papillae and the hypodermis. It is named after Angelo Ruffini Angelo Ruffini (Pretare of Arquata ...
s and
Pacinian corpuscles Pacinian corpuscle or lamellar corpuscle or Vater-Pacini corpuscle; is one of the four major types of mechanoreceptors (specialized nerve ending with adventitious tissue for mechanical sensation) found in mammalian skin. This type of mechanorece ...
. These proprioceptors are activated when the joint is at a threshold, usually at the extremes of joint position. Invertebrates use hair plates to accomplish this; a row of bristles located along joints detect when the limb moves.


Reflexes

The sense of proprioception is ubiquitous across mobile animals and is essential for the motor coordination of the body. Proprioceptors can form reflex circuits with motor neurons to provide rapid feedback about body and limb position. These mechanosensory circuits are important for flexibly maintaining posture and balance, especially during locomotion. For example, consider the
stretch reflex The stretch reflex (myotatic reflex), or more accurately "muscle stretch reflex", is a muscle contraction in response to stretching within the muscle. The reflex functions to maintain the muscle at a constant length. The term deep tendon reflex is ...
, in which stretch across a muscle is detected by a sensory receptor (e.g.,
muscle spindle Muscle spindles are stretch receptors within the body of a skeletal muscle that primarily detect changes in the length of the muscle. They convey length information to the central nervous system via afferent nerve fibers. This information can be ...
, chordotonal neurons), which activates a motor neuron to induce muscle contraction and oppose the stretch. During locomotion, sensory neurons can reverse their activity when stretched, to promote rather than oppose movement.


Conscious and non-conscious

In humans, a distinction is made between ''conscious'' proprioception and ''non-conscious'' proprioception: * Conscious proprioception is communicated by the
dorsal column-medial lemniscus pathway Dorsal (from Latin ''dorsum'' ‘back’) may refer to: * Dorsal (anatomy), an anatomical term of location referring to the back or upper side of an organism or parts of an organism * Dorsal, positioned on top of an aircraft's fuselage * Dorsa ...
to the
cerebrum The cerebrum, telencephalon or endbrain is the largest part of the brain containing the cerebral cortex (of the two cerebral hemispheres), as well as several subcortical structures, including the hippocampus, basal ganglia, and olfactory bulb. ...
. * Non-conscious proprioception is communicated primarily via the
dorsal spinocerebellar tract The spinocerebellar tract is a nerve tract originating in the spinal cord and terminating in the same side (ipsilateral) of the cerebellum. Origins of proprioceptive information Proprioceptive information is obtained by Golgi tendon organs and ...
and
ventral spinocerebellar tract The spinocerebellar tract is a nerve tract originating in the spinal cord and terminating in the same side (ipsilateral) of the cerebellum. Origins of proprioceptive information Proprioceptive information is obtained by Golgi tendon organs and ...
, to the
cerebellum The cerebellum (Latin for "little brain") is a major feature of the hindbrain of all vertebrates. Although usually smaller than the cerebrum, in some animals such as the mormyrid fishes it may be as large as or even larger. In humans, the cerebe ...
. * A non-conscious reaction is seen in the human proprioceptive reflex, or righting reflex—in the event that the body tilts in any direction, the person will cock their head back to level the eyes against the horizon. This is seen even in infants as soon as they gain control of their neck muscles. This control comes from the
cerebellum The cerebellum (Latin for "little brain") is a major feature of the hindbrain of all vertebrates. Although usually smaller than the cerebrum, in some animals such as the mormyrid fishes it may be as large as or even larger. In humans, the cerebe ...
, the part of the brain affecting balance.


Mechanisms

Proprioception is mediated by mechanically sensitive proprioceptor neurons distributed throughout an animal's body. Most vertebrates possess three basic types of proprioceptors:
muscle spindle Muscle spindles are stretch receptors within the body of a skeletal muscle that primarily detect changes in the length of the muscle. They convey length information to the central nervous system via afferent nerve fibers. This information can be ...
s, which are embedded in
skeletal muscle Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of m ...
s, Golgi tendon organs, which lie at the interface of muscles and tendons, and joint receptors, which are low-threshold mechanoreceptors embedded in joint capsules. Many invertebrates, such as insects, also possess three basic proprioceptor types with analogous functional properties: chordotonal neurons, campaniform sensilla, and hair plates. The initiation of proprioception is the activation of a proprioceptor in the periphery. The proprioceptive sense is believed to be composed of information from
sensory neuron Sensory neurons, also known as afferent neurons, are neurons in the nervous system, that convert a specific type of stimulus, via their receptors, into action potentials or graded potentials. This process is called sensory transduction. The ...
s located in the
inner ear The inner ear (internal ear, auris interna) is the innermost part of the vertebrate ear. In vertebrates, the inner ear is mainly responsible for sound detection and balance. In mammals, it consists of the bony labyrinth, a hollow cavity in th ...
(motion and orientation) and in the
stretch receptor Stretch receptors are mechanoreceptors responsive to distention of various organs and muscles, and are neurologically linked to the Medulla oblongata, medulla in the brain stem via Afferent nerve fiber, afferent nerve fibers. Examples include stre ...
s located in the
muscles Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of musc ...
and the joint-supporting ligaments (stance). There are specific nerve receptors for this form of perception termed "proprioceptors", just as there are specific receptors for pressure, light, temperature, sound, and other sensory experiences. Proprioceptors are sometimes known as adequate stimuli receptors. Members of the
transient receptor potential Transient receptor potential channels (TRP channels) are a group of ion channels located mostly on the plasma membrane of numerous animal cell types. Most of these are grouped into two broad groups: Group 1 includes TRPC ( "C" for canonical), TR ...
family of
ion channel Ion channels are pore-forming membrane proteins that allow ions to pass through the channel pore. Their functions include establishing a resting membrane potential, shaping action potentials and other electrical signals by gating the flow of ...
s have been found to be important for proprioception in
fruit flies Fruit fly may refer to: Organisms * Drosophilidae, a family of small flies, including: ** ''Drosophila'', the genus of small fruit flies and vinegar flies ** ''Drosophila melanogaster'' or common fruit fly ** '' Drosophila suzukii'' or Asian frui ...
, nematode worms,
African clawed frog The African clawed frog (''Xenopus laevis'', also known as the xenopus, African clawed toad, African claw-toed frog or the ''platanna'') is a species of African aquatic frog of the family Pipidae. Its name is derived from the three short claws o ...
s, and
zebrafish The zebrafish (''Danio rerio'') is a freshwater fish belonging to the minnow family (Cyprinidae) of the order Cypriniformes. Native to South Asia, it is a popular aquarium fish, frequently sold under the trade name zebra danio (and thus often ca ...
.
PIEZO2 Piezo-type mechanosensitive ion channel component 2 is a protein that in humans is encoded by the PIEZO2 gene. It has a homotrimeric structure, with three blades curving into a nano-dome, with a diameter of 28 nanometers. Function Piezos are ...
, a nonselective cation channel, has been shown to underlie the mechanosensitivity of proprioceptors in mice. Humans with loss-of-function mutations in the
PIEZO2 Piezo-type mechanosensitive ion channel component 2 is a protein that in humans is encoded by the PIEZO2 gene. It has a homotrimeric structure, with three blades curving into a nano-dome, with a diameter of 28 nanometers. Function Piezos are ...
gene exhibit specific deficits in joint proprioception, as well as vibration and touch discrimination, suggesting that the
PIEZO2 Piezo-type mechanosensitive ion channel component 2 is a protein that in humans is encoded by the PIEZO2 gene. It has a homotrimeric structure, with three blades curving into a nano-dome, with a diameter of 28 nanometers. Function Piezos are ...
channel is essential for mechanosensitivity in some proprioceptors and low-threshold mechanoreceptors. Although it was known that finger kinesthesia relies on skin sensation, recent research has found that kinesthesia-based haptic perception relies strongly on the forces experienced during touch. This research allows the creation of "virtual", illusory haptic shapes with different perceived qualities.


Anatomy

Proprioception of the head stems from the muscles innervated by the
trigeminal nerve In neuroanatomy, the trigeminal nerve ( lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and che ...
, where the GSA fibers pass without synapsing in the
trigeminal ganglion A trigeminal ganglion (or Gasserian ganglion, or semilunar ganglion, or Gasser's ganglion) is the sensory ganglion at the base of each of the two trigeminal nerves (CN V), occupying a cavity ( Meckel's cave) in the dura mater, covering the tri ...
(first-order sensory neuron), reaching the mesencephalic tract and the
mesencephalic nucleus of trigeminal nerve The mesencephalic nucleus of trigeminal nerve is involved with reflex proprioception of the periodontium and of the muscles of mastication in the jaw that functions to prevent biting down hard enough to lose a tooth. To subserve this reflex protect ...
. Proprioception of limbs often occurs due to receptors in
connective tissue Connective tissue is one of the four primary types of animal tissue, along with epithelial tissue, muscle tissue, and nervous tissue. It develops from the mesenchyme derived from the mesoderm the middle embryonic germ layer. Connective tiss ...
near joints.


Function


Stability

An important role for proprioception is to allow an animal to stabilize itself against perturbations. For instance, for a person to walk or stand upright, they must continuously monitor their posture and adjust muscle activity as needed to provide balance. Similarly, when walking on unfamiliar terrain or even tripping, the person must adjust the output of their muscles quickly based on estimated limb position and velocity. Proprioceptor reflex circuits are thought to play an important role to allow fast and unconscious execution of these behaviors, To make control of these behaviors efficient, proprioceptors are also thought to regulate reciprocal inhibition in muscles, leading to agonist-antagonist muscle pairs.


Planning and refining movements

When planning complex movements such as reaching or grooming, animals must consider the current position and velocity of their limb and use it to adjust dynamics to target a final position. If the animal's estimate of their limb's initial position is wrong, this can lead to a deficiency in the movement. Furthermore, proprioception is crucial in refining the movement if it deviates from the trajectory.


Development

In adult fruit flies, each proprioceptor class arises from a specific
cell lineage Cell lineage denotes the developmental history of a tissue or organ from the fertilized embryo. This is based on the tracking of an organism's cellular ancestry due to the cell divisions and relocation as time progresses, this starts with the orig ...
(i.e. each chordotonal neuron is from the chordotonal neuron lineage, although multiple lineages give rise to sensory bristles). After the last cell division, proprioceptors send out axons toward the central nervous system and are guided by hormonal gradients to reach stereotyped synapses. The mechanisms underlying
axon guidance Axon guidance (also called axon pathfinding) is a subfield of neural development concerning the process by which neurons send out axons to reach their correct targets. Axons often follow very precise paths in the nervous system, and how they mana ...
are similar across invertebrates and vertebrates. In mammals with longer gestation periods,
muscle spindles Muscle spindles are stretch receptors within the body of a skeletal muscle that primarily detect changes in the length of the muscle. They convey length information to the central nervous system via afferent nerve fibers. This information can be ...
are fully formed at birth. Muscle spindles continue to grow throughout post-natal development as muscles grow.


Mathematical models

Proprioceptors transfer the mechanical state of the body into patterns of neural activity. This transfer can be modeled mathematically, for example to better understand the internal workings of a proprioceptor or to provide more realistic feedback in neuromechanical simulations. Various proprioceptor models of complexity have been developed. They range from simple phenomenological models to complex structural models, in which the mathematical elements correspond to anatomical features of the proprioceptor. The focus has been on
muscle spindle Muscle spindles are stretch receptors within the body of a skeletal muscle that primarily detect changes in the length of the muscle. They convey length information to the central nervous system via afferent nerve fibers. This information can be ...
s, but Golgi tendon organs and insects hair plates have been modeled too.


Muscle spindles

Poppelle and Bowman used linear system theory to model mammalian muscle spindles Ia and II afferents. They obtained a set of de-afferented muscle spindles, measured their response to a series of sinusoidal and step function stretches, and fit a transfer function to the spike rate. They found that the following Laplace transfer function describes the firing rate responses of the primary sensory fibers for a change in length: H(s) = K_1 \frac The following equation describes the response of secondary sensory fibers: H(s) = K_2 \frac More recently, Blum et al. showed that the muscle spindle firing rate is modeled better as tracking the force of the muscle, rather than the length. Furthermore, muscle spindle firing rates show history dependence which cannot be modeled by a linear time-invariant system model.


Golgi tendon organs

Houk and Simon provided one of the first mathematical models of a Golgi tendon organ receptor, modeling the firing rate of the receptor as a function of the muscle tension force. Just as for muscle spindles, they find that, as the receptors respond linearly to sine waves of different frequencies and has little variance in response over time to the same stimulus, Golgi tendon organ receptors may be modeled as linear time-invariant systems. Specifically, they find that the firing rate of a Golgi tendon organ receptor may be modeled as a sum of 3 decaying exponentials: r(t) = K + A\exp(-at) + B \exp(-b t) + C \exp(-c t)u(t) where r(t) is the firing rate and u(t) is a step function of force. The corresponding Laplace transfer function for this system is: H(s) = K\left(1 + \frac + \frac + \frac \right) For a
soleus In humans and some other mammals, the soleus is a powerful muscle in the back part of the lower leg (the calf). It runs from just below the knee to the heel, and is involved in standing and walking. It is closely connected to the gastrocnemius mu ...
receptor, Houk and Simon obtain average values of K=57 pulses/sec/kg, A=0.31, a=0.22 sec−1, B=0.4, b=2.17 sec−1, C=2.5, c=36 sec−1 . When modeling a stretch reflex, Lin and Crago improved upon this model by adding a logarithmic nonlinearity before the Houk and Simon model and a threshold nonlinearity after.


Impairment


Permanent

Proprioception is permanently impaired in patients with joint hypermobility or Ehlers-Danlos syndrome (a genetic condition that results in weak connective tissue throughout the body). It can also be permanently impaired from viral infections as reported by Sacks. The catastrophic effect of major proprioceptive loss is reviewed by Robles-De-La-Torre (2006). Proprioception is also permanently impaired in physiological aging (presbypropria) and
autism spectrum disorder The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental condition (or conditions) characterized by difficulti ...
.
Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms beco ...
is characterized by a decline in motor function as a result of neurodegeneration. It is likely that some of the symptoms of Parkinson's disease are in part related to disrupted proprioception. Whether this symptom is caused by degeneration of proprioceptors in the periphery or disrupted signaling in the brain or spinal cord is an open question. People who have a limb
amputated Amputation is the removal of a limb by trauma, medical illness, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on indiv ...
may still have a confused sense of that limb's existence on their body, known as
phantom limb syndrome A phantom limb is the sensation that an amputated or missing limb is still attached. Approximately 80 to 100% of individuals with an amputation experience sensations in their amputated limb. However, only a small percentage will experience painf ...
. Phantom sensations can occur as passive proprioceptive sensations of the limb's presence, or more active sensations such as perceived movement, pressure, pain, itching, or temperature. There are a variety of theories concerning the etiology of
phantom limb A phantom limb is the sensation that an amputated or missing limb is still attached. Approximately 80 to 100% of individuals with an amputation experience sensations in their amputated limb. However, only a small percentage will experience pain ...
sensations and experience. One is the concept of "proprioceptive memory", which argues that the brain retains a memory of specific limb positions and that after amputation there is a conflict between the visual system, which actually sees that the limb is missing, and the memory system which remembers the limb as a functioning part of the body. Phantom sensations and phantom pain may also occur after the removal of body parts other than the limbs, such as after amputation of the breast, extraction of a tooth (phantom tooth pain), or removal of an eye (
phantom eye syndrome The phantom eye syndrome (PES) is a phantom pain in the eye and visual hallucinations after the removal of an eye ( enucleation, evisceration). Symptoms Many patients experience one or more phantom phenomena after the removal of the eye: *Pha ...
).


Temporary

Proprioception is occasionally impaired spontaneously, especially when one is tired. Similar effects can be felt during the hypnagogic state of consciousness, during the onset of sleep. One's body may feel too large or too small, or parts of the body may feel distorted in size. Similar effects can sometimes occur during
epilepsy Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrica ...
or
migraine Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
auras. These effects are presumed to arise from abnormal stimulation of the part of the
parietal cortex The parietal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The parietal lobe is positioned above the temporal lobe and behind the frontal lobe and central sulcus. The parietal lobe integrates sensory inform ...
of the
brain A brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as Visual perception, vision. I ...
involved with integrating information from different parts of the body. Proprioceptive illusions can also be induced, such as the Pinocchio illusion. Temporary impairment of proprioception has also been known to occur from an overdose of
vitamin B6 Vitamin B6 is one of the B vitamins, and thus an essential nutrient. The term refers to a group of six chemically similar compounds, i.e., " vitamers", which can be interconverted in biological systems. Its active form, pyridoxal 5′-phosp ...
(pyridoxine and pyridoxamine). Most of the impaired function returns to normal shortly after the amount of the vitamin in the body returns to a level that is closer to that of the physiological norm. Impairment can also be caused by
cytotoxic Cytotoxicity is the quality of being toxic to cells. Examples of toxic agents are an immune cell or some types of venom, e.g. from the puff adder (''Bitis arietans'') or brown recluse spider (''Loxosceles reclusa''). Cell physiology Treating c ...
factors such as
chemotherapy Chemotherapy (often abbreviated to chemo and sometimes CTX or CTx) is a type of cancer treatment that uses one or more anti-cancer drugs (chemotherapeutic agents or alkylating agents) as part of a standardized chemotherapy regimen. Chemother ...
. It has been proposed that even common
tinnitus Tinnitus is the perception of sound when no corresponding external sound is present. Nearly everyone experiences a faint "normal tinnitus" in a completely quiet room; but it is of concern only if it is bothersome, interferes with normal hearin ...
and the attendant hearing frequency-gaps masked by the perceived sounds may cause erroneous proprioceptive information to the balance and comprehension centers of the brain, precipitating mild confusion. Temporary loss or impairment of proprioception may happen periodically during growth, mostly during adolescence. Growth that might also influence this would be large increases or drops in bodyweight/size due to fluctuations of fat (
liposuction Liposuction, or simply lipo, is a type of fat-removal procedure used in plastic surgery. Evidence does not support an effect on weight beyond a couple of months and does not appear to affect obesity-related problems. In the United States, lipo ...
, rapid fat loss or gain) and/or muscle content (
bodybuilding Bodybuilding is the use of progressive resistance exercise to control and develop one's muscles (muscle building) by muscle hypertrophy for aesthetic purposes. It is distinct from similar activities such as powerlifting because it focuses ...
,
anabolic steroid Anabolic steroids, also known more properly as anabolic–androgenic steroids (AAS), are steroidal androgens that include natural androgens like testosterone as well as synthetic androgens that are structurally related and have similar effects ...
s, catabolisis/
starvation Starvation is a severe deficiency in caloric energy intake, below the level needed to maintain an organism's life. It is the most extreme form of malnutrition. In humans, prolonged starvation can cause permanent organ damage and eventually, de ...
). It can also occur in those that gain new levels of flexibility,
stretching Stretching is a form of physical exercise in which a specific muscle or tendon (or muscle group) is deliberately flexed or stretched in order to improve the muscle's felt elasticity and achieve comfortable muscle tone. The result is a feeling ...
, and
contortion Contortion (sometimes contortionism) is a performance art in which performers called contortionists showcase their skills of extreme physical flexibility. Contortion acts often accompany acrobatics, circus acts, street performers and other liv ...
. A limb's being in a new range of motion never experienced (or at least, not for a long time since youth perhaps) can disrupt one's sense of location of that limb. Possible experiences include suddenly feeling that feet or legs are missing from one's mental self-image; needing to look down at one's limbs to be sure they are still there; and falling down while walking, especially when attention is focused upon something other than the act of walking.


Diagnosis

Impaired proprioception may be diagnosed through a series of tests, each focusing on a different functional aspect of proprioception. The Romberg's test is often used to assess balance. The subject must stand with feet together and eyes closed without support for 30 seconds. If the subject loses balance and falls, it is an indicator for impaired proprioception. For evaluating proprioception's contribution to motor control, a common protocol is joint position matching. The patient is blindfolded while a joint is moved to a specific angle for a given period of time and then returned to neutral. The subject is then asked to move the joint back to the specified angle. Recent investigations have shown that hand dominance, participant age, active versus passive matching, and presentation time of the angle can all affect performance on joint position matching tasks. For passive sensing of joint angles, recent studies have found that experiments to probe psychophysical thresholds produce more precise estimates of proprioceptive discrimination than the joint position matching task. In these experiments, the subject holds on to an object (such as an armrest) that moves and stops at different positions. The subject must discriminate whether one position is closer to the body than another. From the subject's choices, the tester may determine the subject's discrimination thresholds. Proprioception is tested by American
police officer A police officer (also called a policeman and, less commonly, a policewoman) is a warranted law employee of a police force. In most countries, "police officer" is a generic term not specifying a particular rank. In some, the use of the ...
s using the
field sobriety testing Field sobriety tests (FSTs), also referred to as standardized field sobriety tests (SFSTs), are a battery of tests used by police officers to determine if a person suspected of impaired driving is intoxicated with alcohol or other drugs. ''FSTs ...
to check for
alcohol intoxication Alcohol intoxication, also known as alcohol poisoning, commonly described as drunkenness or inebriation, is the negative behavior and physical effects caused by a recent consumption of alcohol. In addition to the toxicity of ethanol, the main ...
. The subject is required to touch his or her nose with eyes closed; people with normal proprioception may make an error of no more than , while people with impaired proprioception (a symptom of moderate to severe alcohol intoxication) fail this test due to difficulty locating their limbs in space relative to their noses.


Training

Proprioception is what allows someone to learn to walk in complete darkness without losing balance. During the learning of any new skill, sport, or art, it is usually necessary to become familiar with some proprioceptive tasks specific to that activity. Without the appropriate integration of proprioceptive input, an artist would not be able to brush paint onto a canvas without looking at the hand as it moved the brush over the canvas; it would be impossible to drive an automobile because a motorist would not be able to steer or use the pedals while looking at the road ahead; a person could not
touch type Touch typing (also called blind typing, or touch keyboarding) is a style of typing. Although the phrase refers to typing without using the sense of sight to find the keys—specifically, a touch typist will know their location on the keyboard thro ...
or perform ballet; and people would not even be able to walk without watching where they put their feet.
Oliver Sacks Oliver Wolf Sacks, (9 July 1933 – 30 August 2015) was a British neurologist, naturalist, historian of science, and writer. Born in Britain, Sacks received his medical degree in 1958 from The Queen's College, Oxford, before moving to the Uni ...
reported the case of a young woman who lost her proprioception due to a viral infection of her
spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the sp ...
. At first she could not move properly at all or even control her tone of voice (as voice modulation is primarily proprioceptive). Later she relearned by using her sight (watching her feet) and
inner ear The inner ear (internal ear, auris interna) is the innermost part of the vertebrate ear. In vertebrates, the inner ear is mainly responsible for sound detection and balance. In mammals, it consists of the bony labyrinth, a hollow cavity in th ...
only for movement while using hearing to judge voice modulation. She eventually acquired a stiff and slow movement and nearly normal speech, which is believed to be the best possible in the absence of this sense. She could not judge effort involved in picking up objects and would grip them painfully to be sure she did not drop them. The proprioceptive sense can be sharpened through study of many disciplines.
Juggling Juggling is a physical skill, performed by a juggler, involving the manipulation of objects for recreation, entertainment, art or sport. The most recognizable form of juggling is toss juggling. Juggling can be the manipulation of one object ...
trains reaction time, spatial location, and efficient movement. Standing on a wobble board or balance board is often used to retrain or increase proprioceptive abilities, particularly as
physical therapy Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, pat ...
for ankle or knee injuries.
Slacklining Slacklining refers to the act of walking, running or balancing along a suspended length of flat webbing that is tensioned between two anchors. Slacklining is similar to slack rope walking and tightrope walking. Slacklines differ from tightwir ...
is another method to increase proprioception. Standing on one leg (stork standing) and various other body-position challenges are also used in such disciplines as
yoga Yoga (; sa, योग, lit=yoke' or 'union ) is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India and aim to control (yoke) and still the mind, recognizing a detached witness-consciou ...
,
Wing Chun Wing Chun (Chinese: 詠春 or 咏春, lit. "singing spring"), sometimes spelled Ving Tsun, is a concept-based fighting art, form of Southern Chinese kung fu and close-quarters system of self-defense. In Mandarin, it is pronounced "Yong Chun. ...
and
tai chi Tai chi (), short for Tai chi ch'üan ( zh, s=太极拳, t=太極拳, first=t, p=Tàijíquán, labels=no), sometimes called " shadowboxing", is an internal Chinese martial art practiced for defense training, health benefits and meditation. ...
. The vestibular system of the inner ear, vision and proprioception are the main three requirements for balance. Moreover, there are specific devices designed for proprioception training, such as the exercise ball, which works on balancing the abdominal and back muscles.


History of study

In 1557, the position-movement sensation was described by
Julius Caesar Scaliger Julius Caesar Scaliger (; April 23, 1484 – October 21, 1558), or Giulio Cesare della Scala, was an Italian scholar and physician, who spent a major part of his career in France. He employed the techniques and discoveries of Renaissance humanism ...
as a "sense of locomotion". In 1826,
Charles Bell Sir Charles Bell (12 November 177428 April 1842) was a Scottish surgeon, anatomist, physiologist, neurologist, artist, and philosophical theologian. He is noted for discovering the difference between sensory nerves and motor nerves in the spin ...
expounded the idea of a "muscle sense", which is credited as one of the first descriptions of physiologic feedback mechanisms. Bell's idea was that commands are carried from the brain to the muscles, and that reports on the muscle's condition would be sent in the reverse direction. In 1847, the London neurologist Robert Todd highlighted important differences in the anterolateral and
posterior column Posterior may refer to: * Posterior (anatomy), the end of an organism opposite to its head ** Buttocks, as a euphemism * Posterior horn (disambiguation) * Posterior probability The posterior probability is a type of conditional probability that r ...
s of the spinal cord, and suggested that the latter were involved in the coordination of movement and balance. At around the same time,
Moritz Heinrich Romberg Moritz Heinrich Romberg (11 November 1795 – 16 June 1873) was a German physician and neurologist, born in Meiningen, who published his classic textbook in sections between 1840 and 1846; Edward Henry Sieveking translated it into English in 185 ...
, a Berlin neurologist, was describing unsteadiness made worse by eye closure or darkness, now known as the eponymous
Romberg's sign Romberg's test, Romberg's sign, or the Romberg maneuver is a test used in an exam of neurological function for balance, and also as a test for driving under the influence of an intoxicant. The exam is based on the premise that a person requires ...
, once synonymous with tabes dorsalis, that became recognised as common to all proprioceptive disorders of the legs. In 1880,
Henry Charlton Bastian Henry Charlton Bastian (26 April 1837 in Truro, Cornwall, England – 17 November 1915 in Chesham Bois, Buckinghamshire) was an English physiologist and neurologist. Biography Bastian was born at Truro, Cornwall and graduated from Universi ...
suggested "kinaesthesia" instead of "muscle sense" on the basis that some of the afferent information (back to the brain) comes from other structures, including tendons, joints, and skin. In 1889, Alfred Goldscheider suggested a classification of kinaesthesia into three types: muscle, tendon, and articular sensitivity. In 1906, the term ''proprio-ception'' (and also '' intero-ception'' and ''extero-ception'') is attested in a publication by
Charles Scott Sherrington Sir Charles Scott Sherrington (27 November 1857 – 4 March 1952) was an eminent English neurophysiologist. His experimental research established many aspects of contemporary neuroscience, including the concept of the spinal reflex as a system ...
involving
receptors Receptor may refer to: *Sensory receptor, in physiology, any structure which, on receiving environmental stimuli, produces an informative nerve impulse *Receptor (biochemistry), in biochemistry, a protein molecule that receives and responds to a n ...
. He explains the terminology as follows:
The main fields of distribution of the
receptor Receptor may refer to: *Sensory receptor, in physiology, any structure which, on receiving environmental stimuli, produces an informative nerve impulse *Receptor (biochemistry), in biochemistry, a protein molecule that receives and responds to a n ...
organs fundamentally distinguishable seem, therefore, to be two, namely, a ''surface'' field constituted by the surface layer of the organism, and a ''deep'' field constituted by the tissues of the organism beneath the surface sheet.
..br /> ''the stimulations occurring in hedeep field is that the stimuli are traceable to actions of the organism itself'', and are so in much greater measure than are the stimulations of the surface field of the organism. Since in the deep field the stimuli to the receptors are delivered by the organism ''itself'', the deep receptors may be termed ''proprio-ceptors'', and the deep field a field of proprio-ception.
Today, the "exteroceptors" are the organs that provide information originating outside the body, such as the eyes, ears, mouth, and skin. The interoceptors provide information about the internal organs, and the "proprioceptors" provide information about movement derived from muscular, tendon, and articular sources. Using Sherrington's system, physiologists and anatomists search for specialised nerve endings that transmit mechanical data on joint capsule, tendon and muscle tension (such as Golgi tendon organs and
muscle spindles Muscle spindles are stretch receptors within the body of a skeletal muscle that primarily detect changes in the length of the muscle. They convey length information to the central nervous system via afferent nerve fibers. This information can be ...
), which play a large role in proprioception. Primary endings of muscle spindles "respond to the size of a muscle length change and its speed" and "contribute both to the sense of limb position and movement". Secondary endings of muscle spindles detect changes in muscle length, and thus supply information regarding only the sense of position. Essentially, muscle spindles are stretch receptors. It has been accepted that cutaneous receptors also contribute directly to proprioception by providing "accurate perceptual information about joint position and movement", and this knowledge is combined with information from the muscle spindles.


Etymology

Proprioception is from
Latin Latin (, or , ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally a dialect spoken in the lower Tiber area (then known as Latium) around present-day Rome, but through ...
'' proprius'', meaning "one's own", "individual", and '' capio'', ''capere'', to take or grasp. Thus to grasp one's own position in space, including the position of the limbs in relation to each other and the body as a whole. The word ''kinesthesia'' or ''kinæsthesia'' (''kinesthetic sense'') refers to movement sense, but has been used inconsistently to refer either to proprioception alone or to the brain's integration of proprioceptive and vestibular inputs. Kinesthesia is a modern medical term composed of elements from Greek; ''kinein'' "to set in motion; to move" (from PIE root *keie- "to set in motion") + ''aisthesis'' "perception, feeling" (from PIE root *au- "to perceive") + Greek abstract noun ending ''-ia'' (corresponds to English ''-hood'' e.g. motherhood).


Plants and bacteria

Although they lack neurons, a form of proprioception has also been described in some plants (
angiosperms Flowering plants are plants that bear flowers and fruits, and form the clade Angiospermae (), commonly called angiosperms. The term "angiosperm" is derived from the Greek words ('container, vessel') and ('seed'), and refers to those plants ...
).
Terrestrial plant A terrestrial plant is a plant that grows on, in, or from land. Other types of plants are aquatic (living in water), epiphytic (living on trees) and lithophytic (living in or on rocks). The distinction between aquatic and terrestrial plants i ...
s control the orientation of their
primary growth In botany, secondary growth is the growth that results from cell division in the cambia or lateral meristems and that causes the stems and roots to thicken, while primary growth is growth that occurs as a result of cell division at the tips of ...
through the sensing of several vectorial stimuli such as the light gradient or the
gravitational acceleration In physics, gravitational acceleration is the acceleration of an object in free fall within a vacuum (and thus without experiencing drag). This is the steady gain in speed caused exclusively by the force of gravitational attraction. All bodie ...
. This control has been called
tropism A tropism is a biological phenomenon, indicating growth or turning movement of a biological organism, usually a plant, in response to an environmental stimulus. In tropisms, this response is dependent on the direction of the stimulus (as oppos ...
. A quantitative study of
shoot In botany, a plant shoot consists of any plant stem together with its appendages, leaves and lateral buds, flowering stems, and flower buds. The new growth from seed germination that grows upward is a shoot where leaves will develop. In the sp ...
gravitropism Gravitropism (also known as geotropism) is a coordinated process of differential growth by a plant in response to gravity pulling on it. It also occurs in fungi. Gravity can be either "artificial gravity" or natural gravity. It is a general featu ...
demonstrated that, when a plant is tilted, it cannot recover a steady erected posture under the sole driving of the sensing of its angular deflection versus gravity. An additional control through the continuous sensing of its
curvature In mathematics, curvature is any of several strongly related concepts in geometry. Intuitively, the curvature is the amount by which a curve deviates from being a straight line, or a surface deviates from being a plane. For curves, the can ...
by the organ and the subsequent driving an active straightening process are required. Being a sensing by the plant of the relative configuration of its parts, it has been called proprioception. This dual sensing and control by gravisensing and proprioception has been formalized into a unifying
mathematical model A mathematical model is a description of a system using mathematical concepts and language. The process of developing a mathematical model is termed mathematical modeling. Mathematical models are used in the natural sciences (such as physics, ...
simulating the complete driving of the gravitropic movement. This model has been validated on 11 species sampling the phylogeny of land angiosperms, and on organs of very contrasted sizes, ranging from the small germination of
wheat Wheat is a grass widely cultivated for its seed, a cereal grain that is a worldwide staple food. The many species of wheat together make up the genus ''Triticum'' ; the most widely grown is common wheat (''T. aestivum''). The archaeologi ...
( coleoptile) to the trunk of
poplar trees ''Populus'' is a genus of 25–30 species of deciduous flowering plants in the family Salicaceae, native to most of the Northern Hemisphere. English names variously applied to different species include poplar (), aspen, and cottonwood. The we ...
. Further studies have shown that the cellular mechanism of proprioception in plants involves
myosin Myosins () are a superfamily of motor proteins best known for their roles in muscle contraction and in a wide range of other motility processes in eukaryotes. They are ATP-dependent and responsible for actin-based motility. The first myosin (M ...
and
actin Actin is a family of globular multi-functional proteins that form microfilaments in the cytoskeleton, and the thin filaments in muscle fibrils. It is found in essentially all eukaryotic cells, where it may be present at a concentration of ov ...
, and seems to occur in specialized cells. Proprioception was then found to be involved in other tropisms and to be central also to the control of
nutation Nutation () is a rocking, swaying, or nodding motion in the axis of rotation of a largely axially symmetric object, such as a gyroscope, planet, or bullet in flight, or as an intended behaviour of a mechanism. In an appropriate reference frame ...
. The discovery of proprioception in plants has generated an interest in the popular science and generalist media. This is because this discovery questions a long-lasting ''a priori'' that we have on plants. In some cases this has led to a shift between proprioception and
self-awareness In philosophy of self, self-awareness is the experience of one's own personality or individuality. It is not to be confused with consciousness in the sense of qualia. While consciousness is being aware of one's environment and body and lifest ...
or
self-consciousness Self-consciousness is a heightened sense of awareness of oneself. It is not to be confused with consciousness in the sense of qualia. Historically, "self-consciousness" was synonymous with "self-awareness", referring to a state of awareness that ...
. There is no scientific ground for such a semantic shift. Indeed, even in animals, proprioception can be unconscious; so it is thought to be in plants. Preliminary research indicates that bacteria may display proprioception.


See also

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Notes


References


External links

* {{Sensation and perception Articles containing video clips Sensory systems