A Systematic Review of the Learning Dynamics of Proprioception Training: Specificity, Acquisition, Retention, and Transfer.
Han Gil Seo, Seo Jung Yun, Andria J Farrens and 2 others
PMID 37864458WHAT IT FOUND
Training that specifically challenges proprioception improves proprioception more than general strength or routine training, and gains were largely still present at follow-up.
Most of the 106 studies were small, and the review pooled before-and-after change within groups rather than comparing training with a control.
Key findings
01Training designed to challenge proprioception produced larger improvements in proprioception than training not aimed at it, which in turn did better than no training: mean changes of 28.8% to 42.6%, 12.3% to 22.0% and 5.0% to 8.8% respectively.
02Gains outlasted the training. When studies reassessed participants at least a week after training ended, the average change was still 31.2% (g 0.88), while groups that had no training changed by −8.4%.
03Most of the improvement arrived early: groups measured midway through training had already reached about 70% of their final change, with a large effect over the first half of training and a small one over the second (g 1.02 and 0.35).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Most of the evidence is from small studies. The median number of participants per study group was 15, and training methods and outcome measures varied so much between studies that results had to be averaged rather than compared directly. The main analysis was the change within each group from before to after training, not a comparison against a control group. Improvements could reflect repeated testing, natural recovery or expectation as well as the training. Untrained groups did improve slightly (5.0% to 8.8%), and the authors attribute part of that to familiarity with the tests. Most study groups were people with musculoskeletal problems. Neurological conditions were far less studied, and the authors suggest that when the central nervous system is damaged, training may struggle to change proprioceptive acuity. In musculoskeletal conditions, better proprioception scores may be an indirect result of pain relief or improved joint stability rather than a change in proprioception itself. Only four studies measured partway through training, so the description of a fast phase followed by a slow one rests on very little data. The authors say they could not conclude which form of proprioceptive training is most effective, which patients benefit most, how long gains last beyond the follow-up periods studied, or how transfer works. Many outcomes used active joint position reproduction, which also depends on motor command, working memory and communication between the two sides of the brain, so improvement on that test may not mean proprioception itself improved. Only English-language studies in adults were included.
Declared interests
The authors declared no potential conflicts of interest with respect to the research, authorship or publication of the article. No funding statement appears in the article text supplied; the article is indexed as receiving NIH extramural research support.
The easy way to misread this
Do not read the large improvements as proof that proprioceptive training caused them. The review pooled each group's own before-and-after change rather than comparing training against a control group, and groups that received no training also improved slightly (5.0% to 8.8%), which could reflect repeated testing or natural recovery.
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