Revision resource for DOPS exam. Proprioception assessment technique. Notes include the rationale and physiology behind the assessment, the contraindications and precautions, how to carry out the technique and more.
Introduce self
Explain procedure and gain consent
o “Hello, I will be assessing your proprioception today, what this is is your
awareness of your limbs are in space, when you are not directly looking at
them. Therefore, in order to accurately assess this I will ask you to keep your
eyes closed throughout the duration of the assessment, does that sound okay?”
o “Before we begin, I just need to check a few things. Have you had any recent
injuries, do you have any pain, any skin conditions”
Mirroring
E.g. pt who suffered a stroke- hold affected limb in a certain position and ask pt to
replicate the position with good limb with eyes closed (removing visual input)
Single joint position sense
Change position of limb and ask pt to state whether limb is straight or bent
Start with gross, large movement and progress to finer, smaller movements
“So now we will look at how well you are able to interpret whether your joint is bent
or straight”
“Just for clarity, so you know this is (up/bent) and this is (down/straight)” explain
positions to pt
Precautions and contraindications
Recent fractures
Unable to consent
Severe balance issues
Any skin conditions
Knowledge
What is the purpose of the technique e.g what is being measured and why?
Testing patients awareness of joint position in space and awareness of direction of
movement.
Sense of proprioception relies on other sensory sources e.g. visual system,
somatosensory system and vestibular system
Information for proprioception is detected by sensory receptors (some in the skin,
some in muscle tissue)
Mechanoreceptors and sensory nerve endings in skin, vision, muscle spindles, Golgi
tendon organs, Ruffini receptor (joint)
Proprioceptor (in the skin) - Pacinian and Ruffini corpuscle
o They are activated by an adequate stimulus, then there’s local depolarisation
and the nerve impulses travel along afferent fibres to the CNS
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