Proprioceptive rehabilitation of upper limb dysfunction in movement disorders: A clinical perspective

Abstract

Movement disorders (MDs) are frequently associated with sensory abnormalities. In par-ticular, proprioceptive deficits have been largely documented in both hypokinetic (Parkin-son’s disease) and hyperkinetic conditions (dystonia), suggesting a possible role in their pathophysiology. Proprioceptive feedback is a fundamental component of sensorimotor integration allowing effective planning and execution of voluntary movements. Rehabilita-tion has become an essential element in the management of patients with MDs, and there is a strong rationale to include proprioceptive training in rehabilitation protocols focused on mobility problems of the upper limbs. Proprioceptive training is aimed at improving the integration of proprioceptive signals using “task-intrinsic” or “augmented feedback.” This perspective article reviews the available evidence on the effects of proprioceptive stimulation in improving upper limb mobility in patients with MDs and highlights the emerg-ing innovative approaches targeted to maximizing the benefits of exercise by means of enhanced proprioception.