Proprioception and Geriatric Low Back Pain

Proprioception is a deep sensation that perceives the position of each part of the body, state of movement and muscle contraction, and resistance and mass applied to the body. Proprioceptive feedback influences movement and positional accu-racy, resulting in key somatosensory functions for human postural control. Proprioception encompasses signals received from proprioceptors located in the skin, subcutaneous tissue, muscles, tendons, and joint capsules, commonly known as mechanoreceptors. The muscle spindle, a crucial proprioceptor, is stretched during eccentric contraction of muscle, thus gen-erating an action potential on afferent fibers to convey a proprioceptive information to the sensorimotor cortex in the brain. For exercise therapy in patients with locomotor disease, proprioception serves an essential function for motor control; thus, this should be considered to obtain effective muscle output. As postural control is achieved by proprioceptive function ac-cording to the balance between the lower limb and trunk, relative proprioceptive weighting ratio can help clarify propriocep-tive control using muscle response to mechanical vibration. The absence of proprioceptive information congruent with mo-tor intention activates cortical center monitoring incongruence of sensation, leading to pathological pain. Therapeutic proce-dures may aim to restore the integrity of cortical information processing in musculoskeletal chronic pain. Poor propriocep-tion is one of the main causes of decreased postural balance control in elderly patients with low back pain (LBP). It has been hypothesized that proprioception of the lower limbs deteriorates with age-related muscle mass loss (sarcopenia), which increases the proprioceptive burden on the lumbar spine. Accurate diagnosis of the proprioceptive function is important for establishing a treatment procedure for proprioceptive recovery, and further prospective research is required to clarify the re-lationship between proprioception and LBP improvement.