통증 재활운동에 대한 마지막 결론은 sensorimotor integration
감각과 운동의 통합
읽고 이해하면 PNF 테크닉을 아주 깊이 이해할 수 있을거 같다.
The Sensorimotor System. 관절안정성의 physiologic 기.pdf
The purpose of this first paper is to introduce the sensorimotor motor system, the biological system that controls the
contributions of the dynamic restraints for functional joint stability. A secondary purpose is to define the nomenclature pertaining to the mechanisms responsible for both the sensory and motor components of proprioception and neuromuscular control for the maintenance of functional joint stability.
Figure 1. The sensorimotor system incorporates all the afferent, efferent, and central integration and processing components involved in maintaining functional joint stability. Although visual and vestibular input contributes, the peripheral mechanoreceptors are the most important from a clinical orthopaedic perspective. The peripheral mechanoreceptors (pictured on the lower left) reside in the cutaneous, muscular, joint, and ligamentous tissues. Afferent pathways (dotted lines) convey input to the 3 levels of motor control and associated areas such as the cerebellum. Activation of motor neurons may occur in direct response to peripheral sensory input (reflexes) or from descending motor commands, both of
which may be modulated or regulated by the associate areas (gray lines). Efferent pathways from each of the motor control levels (solid lines) converge upon the alpha and gamma motor neurons located in the ventral aspects of the spinal cord. The contractions by the extrafusal and intrafusal muscle fibers cause new stimuli to be presented to the peripheral mechanoreceptors.
Figure 3. The final common input hypothesis.24 Peripheral receptors from cutaneous, muscle (Golgi tendon organs and muscle spindle afferents), and articular tissues, as well as descending commands from supraspinal areas, converge onto the static and dynamic gamma motor neurons. Collectively, all of these influences alter the sensitivity of muscle spindles; thus, the final afferent signals arising from the muscle spindles can be considered a function of both the preceding influential activity and muscle length.