Is ankle proprioception targeted by exercises on an unstable surface?

Everyone who has ever experienced an ankle sprain knows the exercises done on unstable surfaces, such as wobble boards. This is aiming to improve proprioception.

Proprioception is defined according to Physiopedia  as:

Proprioception is the sense of the relative position of body segments in relation to other body segments. Unlike the six exteroceptive senses (sight, taste, smell, touch, hearing and Balance) by which we perceive the outside world, and interoceptive senses, by which we perceive the pain and the stretching of internal organs, proprioception is a third distinct sensory modality that provides feedback solely on the status of the body internally. It is the sense that indicates whether the body is moving with the appropriate effort and  where the various segments of the body are located in relation to each other.

However, a study done by Kiers et al. (2011) concluded that these exercises do not target ankle proprioception as thought by most people. It was even found that on foam, the effect of triceps surae vibration on mean center of pressure (CoP) velocity was significantly smaller than on a solid surface, while for paraspinal musculature vibration the effect was bigger on foam than on solid surface. Similar effects were seen for mean CoP displacement as outcome. They rather challenge the capacity of the central nervous system to shift the weighting of sources of proprioceptive signals on balance. The study does however not mention what exercises can be done instead to target ankle proprioception. Hence, further research needs to be done in this field.

Therefore, in the daily practice, the therapist should take in mind that improvement may result from improvement of paraspinal musculature and the capacity of the central nervous system rather than the ankle proprioception. This does not mean that proprioception exercises do not benefit ankle sprains but that the benefit might have a different cause for balance improvements.

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