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Pratt S, Wand BM, Hince DA, Travers MJ, Schneider L, Kelly S, Gibson W. Tactile localization accuracy at the low back. Atten Percept Psychophys 2024; 86:1008-1021. [PMID: 38332382 PMCID: PMC11062953 DOI: 10.3758/s13414-024-02843-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/10/2024]
Abstract
Localizing tactile stimulation is an important capability for everyday function and may be impaired in people with persistent pain. This study sought to provide a detailed description of lumbar spine tactile localization accuracy in healthy individuals. Sixty-nine healthy participants estimated where they were touched at nine different points, labelled in a 3 × 3 grid over the lumbar spine. Mislocalization between the perceived and actual stimulus was calculated in horizontal (x) and vertical (y) directions, and a derived hypotenuse (c) mislocalization was calculated to represent the direct distance between perceived and actual points. In the horizontal direction, midline sites had the smallest mislocalization. Participants exhibited greater mislocalization for left- and right-sided sites, perceiving sites more laterally than they actually were. For all vertical values, stimulated sites were perceived lower than reality. A greater inaccuracy was observed in the vertical direction. This study measured tactile localization for the low back utilizing a novel testing method. The large inaccuracies point to a possible distortion in the underlying perceptual maps informing the superficial schema; however, further testing comparing this novel method with an established tactile localization task, such as the point-to-point method, is suggested to confirm these findings.
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Affiliation(s)
- Simon Pratt
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Benedict M Wand
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Dana A Hince
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Mervyn J Travers
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Lee Schneider
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Sara Kelly
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - William Gibson
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia.
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2
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Meier R, Emch C, Gross-Wolf C, Pfeiffer F, Meichtry A, Schmid A, Luomajoki H. Sensorimotor and body perception assessments of nonspecific chronic low back pain: a cross-sectional study. BMC Musculoskelet Disord 2021; 22:391. [PMID: 33902545 PMCID: PMC8077718 DOI: 10.1186/s12891-021-04269-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is one of the most common musculoskeletal disorders, causing significant personal and social burden. Current research is focused on the processes of the central nervous system (particularly the sensorimotor system) and body perception, with a view to developing new and more efficient ways to treat chronic low back pain (CLBP). Several clinical tests have been suggested that might have the ability to detect alterations in the sensorimotor system. These include back-photo assessment (BPA), two-point discrimination (TPD), and the movement control tests (MCT). The aim of this study was to determine whether the simple clinical tests of BPA, TPD or MCT are able to discriminate between nonspecific CLBP subjects with altered body perception and healthy controls. METHODS A cross-sectional study was conducted. At one point in time, 30 subjects with CLBP and 30 healthy controls were investigated through using BPA, TPD and MCT on the lower back. Correlations among the main covariates and odds ratios for group differences were calculated. RESULTS MCT showed an odds ratio for the presence of CLBP of 1.92, with a statistically significant p-value (0.049) and 95%CI. The TPD and BPA tests were unable to determine significant differences between the groups. CONCLUSIONS Of the three tests investigated, MCT was found to be the only suitable assessment to discriminate between nonspecific CLBP subjects and healthy controls. The MCT can be recommended as a simple clinical tool to detect alterations in the sensorimotor system of nonspecific CLBP subjects. This could facilitate the development of tailored management strategies for this challenging LBP subgroup. However, further research is necessary to elucidate the potential of all the tests to detect alterations in the sensorimotor system of CLBP subjects. TRIAL REGISTRATION No trial registration was needed as the study contains no intervention. The study was approved by the Swiss Ethics Commission of Northwest and Central Switzerland (EKNZ) reference number 2015-243.
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Affiliation(s)
- R Meier
- Prodorso, Walchestrasse 15, CH-8006, Zurich, Switzerland
- Zurich University of Applied Sciences (ZHAW), School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland
| | - C Emch
- Physiotherapie im Schutzengel AG, Allmendstrasse 1, CH-6300, Zug, Switzerland
| | - C Gross-Wolf
- Physiotherapie im Sonnenheim, Sonnenheim 8, CH-6344, Meierskappel, Switzerland
| | - F Pfeiffer
- Zurich University of Applied Sciences (ZHAW), School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland
| | - A Meichtry
- Zurich University of Applied Sciences (ZHAW), School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland
| | - A Schmid
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
| | - H Luomajoki
- Zurich University of Applied Sciences (ZHAW), School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland.
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Adamczyk WM, Szikszay TM, Kung T, Carvalho GF, Luedtke K. Not as "blurred" as expected? Acuity and spatial summation in the pain system. Pain 2021; 162:794-802. [PMID: 32925592 PMCID: PMC7920491 DOI: 10.1097/j.pain.0000000000002069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 11/27/2022]
Abstract
ABSTRACT Spatial acuity measured by 2-point discrimination (2PD) threshold and spatial summation of pain (SSp) are useful paradigms to probe the pain system in humans. Whether the results of these paradigms are influenced by different stimulus modalities and intensities is unclear. The aim of this study was to test 2PD controlling the stimulus modality and the intensity and to investigate the effect of modality on SSp. Thirty-seven healthy volunteers were tested for 2PDs with 2 stimulus modalities (electrocutaneous and mechanical) and intensity (noxious and innocuous). For each condition, participants received stimuli to either 1 or 2 points on their lower back with different distances (2-14 cm, steps of 2 cm). It was found that 2PDs were significantly smaller for noxious stimuli for both modalities. By contrast, between-modality comparison reproduced previous reports of impaired acuity for noxious stimulation. Higher pain intensities were reported when a larger area was stimulated (SSp), independent of the modality. Furthermore, reported pain intensities were higher when the distance between 2 stimulated areas was increased from 2 to 6 cm (P < 0.001), 8 cm (P < 0.01), and 14 cm (P < 0.01). 2PDs determined by mechanical and electrocutaneous stimuli were significantly correlated within both stimulus intensities, ie, innocuous (r = 0.34, P < 0.05) and noxious (r = 0.35, P < 0.05). The current results show 3 novel findings: (1) the precision of the pain system might be higher than in the innocuous (tactile) system when mechanical and electrocutaneous modalities are used, (2) the pattern of distance-based and area-based SSp seems to be comparable irrespective of the modality applied (mechanical and electrocutaneous), and (3) both modalities are moderately correlated.
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Affiliation(s)
- Wacław M. Adamczyk
- Department of Health Sciences, Academic Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), University of Luebeck, Luebeck, Germany
- Center of Brain, Behavior and Metabolism (CBBM), University of Luebeck, Luebeck, Germany
- Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Tibor M. Szikszay
- Department of Health Sciences, Academic Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), University of Luebeck, Luebeck, Germany
- Center of Brain, Behavior and Metabolism (CBBM), University of Luebeck, Luebeck, Germany
| | - Tiffany Kung
- BSc Study Program, University of Alberta, Edmonton, AB, Canada
| | | | - Kerstin Luedtke
- Department of Health Sciences, Academic Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), University of Luebeck, Luebeck, Germany
- Center of Brain, Behavior and Metabolism (CBBM), University of Luebeck, Luebeck, Germany
- Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
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Yokota H, Otsuru N, Saito K, Kojima S, Miyaguchi S, Inukai Y, Nagasaka K, Onishi H. Region-Specific Effects of 10-Hz Transcranial Alternate Current Stimulation Over the Left Posterior Parietal Cortex and Primary Somatosensory Area on Tactile Two-Point Discrimination Threshold. Front Neurosci 2021; 15:576526. [PMID: 33679291 PMCID: PMC7930224 DOI: 10.3389/fnins.2021.576526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/20/2021] [Indexed: 11/13/2022] Open
Abstract
Changes in α-band cortical oscillatory activity (8-13 Hz) affect perception; however, how these changes in the left posterior parietal cortex (PPC) and primary somatosensory cortex (S1), which play different roles in determining the two-point discrimination (TPD) threshold, affect TPD threshold remains unelucidated. Therefore, to determine TPD threshold, we aimed to investigate the function of the left PPC and S1 by applying α-band transcranial alternating current stimulation (α-tACS; 10 Hz). TPD threshold was examined at the pad of the right index finger, contralateral to the stimulation site, in 17 healthy adults using a custom-made, computer-controlled, two-point tactile stimulation device, with random application of either active or sham α-tACS over the left PPC (Experiment 1) and left S1 (Experiment 2). Then, 50% TPD threshold was obtained in the active and sham conditions via logistic regression analysis. Afterward, we compared the difference between the active and sham conditions at 50% TPD threshold in each region and found that α-tACS reduced TPD threshold when applied over the left PPC (P = 0.010); however, its effect was insignificant when applied over the left S1 (P = 0.74). Moreover, a comparison of the change in 50% TPD threshold among the regions revealed that α-tACS applied over the left PPC significantly reduced TPD threshold compared with that applied over the left S1 (P = 0.003). Although we did not reveal the actual changes in cortical activity induced by α-tACS, this is the first empirical evidence that α-tACS applied over the left PPC and left S1 exerts region-specific effects on determining TPD threshold assessed in the contralateral index finger pad by stimulation.
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Affiliation(s)
- Hirotake Yokota
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Kei Saito
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Shota Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Yasuto Inukai
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Kazuaki Nagasaka
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
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Leo F, Nataletti S, Brayda L. Non-informative vision improves spatial tactile discrimination on the shoulder but does not influence detection sensitivity. Exp Brain Res 2020; 238:2865-2875. [PMID: 33051694 PMCID: PMC7644450 DOI: 10.1007/s00221-020-05944-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 10/06/2020] [Indexed: 12/20/2022]
Abstract
Vision of the body has been reported to improve tactile acuity even when vision is not informative about the actual tactile stimulation. However, it is currently unclear whether this effect is limited to body parts such as hand, forearm or foot that can be normally viewed, or it also generalizes to body locations, such as the shoulder, that are rarely before our own eyes. In this study, subjects consecutively performed a detection threshold task and a numerosity judgment task of tactile stimuli on the shoulder. Meanwhile, they watched either a real-time video showing their shoulder or simply a fixation cross as control condition. We show that non-informative vision improves tactile numerosity judgment which might involve tactile acuity, but not tactile sensitivity. Furthermore, the improvement in tactile accuracy modulated by vision seems to be due to an enhanced ability in discriminating the number of adjacent active electrodes. These results are consistent with the view that bimodal visuotactile neurons sharp tactile receptive fields in an early somatosensory map, probably via top-down modulation of lateral inhibition.
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Affiliation(s)
- Fabrizio Leo
- Robotics, Brain, and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy.
| | - Sara Nataletti
- Robotics, Brain, and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy.,DIBRIS, University of Genoa, Genoa, Italy
| | - Luca Brayda
- Robotics, Brain, and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy.,Acoesis s.r.l, Genoa, Italy
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6
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Zimney K, Dendinger G, Engel M, Mitzel J. Comparison of reliability and efficiency of two modified two-point discrimination tests and two-point estimation tactile acuity test. Physiother Theory Pract 2020; 38:235-244. [PMID: 31994431 DOI: 10.1080/09593985.2020.1719563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: Determine reliability and minimal detectible difference of two modified two-point discrimination (TPD) testing methods and explore reliability of newer tactile acuity test, two-point estimation (TPE) method.Design: Non-experimental observational reliability study.Setting: Community.Participants: Thirty-five (female = 25) healthy individuals average age 27.7 years (SD = 9.7).Intervention: Two modified methods (i.e., descending-ascending and descending with randomization) of TPD testing utilizing decreased runs of descending and ascending measurements were tested for inter-rater reliability and efficiency between two testers at three locations (neck, hand, and foot). The newer tactile acuity test of TPE was also performed between both examiners at the three location sites.Results: Inter-rater reliability (ICC 2, k) for the descending-ascending method was 0.75, 0.79, and 0.67 for the neck, hand, and foot, respectively. For the descending with randomization method, ICC values were 0.74, 0.50, and 0.69 for the three body regions respectively. The minimal detectable difference for the neck was 28.8 and 32.7 mm, hand 5.3 and 10.8 mm, and foot 12.3 and 12.4 mm for the descending-ascending and randomization methods. TPE showed poor reliability for neck and hand (0.27 and 0.15), but moderate reliability for the foot (0.67). Time to perform the TPD test were between 54 and 108 seconds, while TPE was 12 seconds.Conclusion: The modified TPD testing methods demonstrated similar reliability to previous research, even with reduced runs allowing for increased efficiency in performing the test. The TPE method showed poor reliability, so caution should be applied when using this method.
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Affiliation(s)
- Kory Zimney
- Department of Physical Therapy, University of South Dakota, Vermillion, SD, USA
| | - Gina Dendinger
- Department of Physical Therapy, University of South Dakota, Vermillion, SD, USA
| | - Macey Engel
- Department of Physical Therapy, University of South Dakota, Vermillion, SD, USA
| | - Jordan Mitzel
- Department of Physical Therapy, University of South Dakota, Vermillion, SD, USA
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7
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Santiesteban CS, Cárdenas S J, Low H K, Barría RM. Tactile acuity and predominance of central sensitization in subjects with non-specific persistent low back pain. Somatosens Mot Res 2019; 36:270-274. [PMID: 31718378 DOI: 10.1080/08990220.2019.1684889] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aim: This study aimed to evaluate differences in tactile acuity (TA) in people with non-specific persistent low back pain (NSPLBP) with and without predominant central sensitisation (CS).Method: An analytical cross-sectional study was conducted with 45 participants divided into three groups: (i) subjects with NSPLBP with predominant CS (n = 14), (ii) subjects with NSPLBP without predominant CS (n = 16) and (iii) subjects without low back pain (n = 15). Using an analogue calliper, TA was measured using the two-point discrimination threshold (TPD) in the three groups, both horizontally and vertically in the painful region. The analysis was based on the comparison of median discrimination thresholds between groups using the Kruskal-Wallis test.Result: A higher median TPD value was observed in the group with NSPLBP with predominant CS (vertical measurement 37.5 mm; horizontal measurement 52.5 mm) compared to the group with NSPLBP without predominant CS (vertical measurement 32.5 mm; horizontal measurement 33.8 mm) and the group without low back pain (vertical measurement 30 mm; horizontal measurement 27.5 mm) (p < 0.0001), both in vertical and horizontal measurement.Conclusion: The findings found in this study highlight the need to differentiate patients with NSPLBP with predominant CS when considering therapeutic evaluation as an indirect mechanism for assessing the perceptual function of the primary somatosensory cortex.
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Affiliation(s)
| | | | | | - R Mauricio Barría
- Kinesiology Unit, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
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Yokota H, Otsuru N, Kikuchi R, Suzuki R, Kojima S, Saito K, Miyaguchi S, Inukai Y, Onishi H. Establishment of optimal two-point discrimination test method and consideration of reproducibility. Neurosci Lett 2019; 714:134525. [PMID: 31580886 DOI: 10.1016/j.neulet.2019.134525] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/26/2019] [Accepted: 09/28/2019] [Indexed: 10/25/2022]
Abstract
Two-point discrimination (TPD) has been widely used as a parameter for the examination of higher-order perceptual functions in the field of rehabilitation. Previous research has shown that the threshold of TPD increases with aging or pathological conditions such as stroke or chronic pain. It has also been reported that the threshold can be decreased by continuous tactile or electrical stimulation. The cognitive process in the cortex has been shown to be involved in the determination of the TPD threshold. However, the reliability of TPD has been questioned, because differences in the firing rate of the responding receptors and afferent fibers occur, depending on how the measuring instrument is applied. To investigate the influence of the stimulus condition on the TPD threshold, we utilized a computer-controlled two-point tactile stimulator and measured the TPD threshold by alternating stimulus speed and stimulus penetration depths. We found that a stimulus speed of 5.0 mm/s or 10.0 mm/s and a stimulus penetration depth of 1.0 mm were the optimum condition for measurement, at which the TPD threshold becomes lowest. We also found that no influence is exerted on the threshold by repeated measurement under the stimulus conditions utilized in this experiment. Our findings suggest that TPD measurement should be performed under certain stimulus conditions, as identified in this present study, to obtain reliable results that reflect the highest ability of the subject for spatial discrimination.
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Affiliation(s)
- Hirotake Yokota
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan.
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan
| | - Rie Kikuchi
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan
| | - Rinako Suzuki
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan
| | - Kei Saito
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan
| | - Shota Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan
| | - Yasuto Inukai
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan
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Nishigami T, Wand BM, Newport R, Ratcliffe N, Themelis K, Moen D, Jones C, Moseley GL, Stanton TR. Embodying the illusion of a strong, fit back in people with chronic low back pain. A pilot proof-of-concept study. Musculoskelet Sci Pract 2019; 39:178-183. [PMID: 30049618 DOI: 10.1016/j.msksp.2018.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/17/2018] [Accepted: 07/12/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This proof-of-concept pilot study aimed to investigate if a visual illusion that altered the size and muscularity of the back could be embodied and alter perception of the back. METHODS The back visual illusions were created using the MIRAGE multisensory illusion system. Participants watched real-time footage of a modified version of their own back from behind. Participants undertook one experimental condition, in which the image portrayed a muscled, fit-looking back (Strong), and two control conditions (Reshaped and Normal) during a lifting task. Embodiment, back perception as well as pain intensity and beliefs about the back during lifting were assessed. RESULTS Two participants with low back pain were recruited for this study: one with altered body perception and negative back beliefs (Participant A) and one with normal perception and beliefs (Participant B). Participant A embodied the Strong condition and pain and fear were less and both perceived strength and confidence were more than for the Normal or the Reshaped condition. Participant B did not embody the Strong condition and reported similar levels of pain, fear strength and confidence across all three conditions. DISCUSSION An illusion that makes the back look strong successfully induced embodiment of a visually modified back during a lifting task in a low back pain patient with altered body perception. Both participants tolerated the illusion, there were no adverse effects, and we gained preliminary evidence that the approach may have therapeutic potential.
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Affiliation(s)
- Tomohiko Nishigami
- Department of Nursing and Physical Therapy, Konan Woman's University, Kobe, Hyogo, Japan; Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, SA, Australia.
| | - Benedict Martin Wand
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Roger Newport
- School of Psychology, University of Nottingham, Nottingham, UK; School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | | | - Kristy Themelis
- School of Psychology, University of Nottingham, Nottingham, UK; Brighton and Sussex Medical School, University of Sussex, Sussex, UK
| | - David Moen
- Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Cat Jones
- Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - G Lorimer Moseley
- Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, SA, Australia; Neuroscience Research Australia, Sydney, NSW, Australia
| | - Tasha R Stanton
- Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, SA, Australia; Neuroscience Research Australia, Sydney, NSW, Australia
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11
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12
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Ehrenbrusthoff K, Ryan CG, Grüneberg C, Wolf U, Krenz D, Atkinson G, Martin DJ. The intra- and inter-observer reliability of a novel protocol for two-point discrimination in individuals with chronic low back pain. Physiol Meas 2016; 37:1074-88. [DOI: 10.1088/0967-3334/37/7/1074] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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13
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Kälin S, Rausch-Osthoff AK, Bauer CM. What is the effect of sensory discrimination training on chronic low back pain? A systematic review. BMC Musculoskelet Disord 2016; 17:143. [PMID: 27038609 PMCID: PMC4818915 DOI: 10.1186/s12891-016-0997-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/24/2016] [Indexed: 01/17/2023] Open
Abstract
Background Sensory discrimination training (SDT) for people with chronic low back pain (CLBP) is a novel approach based on theories of the cortical reorganization of the neural system. SDT aims to reverse cortical reorganization, which is observed in chronic pain patients. SDT is still a developing therapeutic approach and its effects have not been systematically reviewed. The aim of this systematic review was to evaluate if SDT decreases pain and improves function in people with CLBP. Methods A systematic review was performed on the available literature to evaluate the effects of SDT. Randomised controlled trials compared the effectiveness of SDT on pain and function in people with CLBP with the effectiveness of other physiotherapy interventions, no treatment, or sham therapy. The methodological quality of the included studies and the clinical relevance of reported treatment effects were investigated. Results The original search revealed 42 records of which 6 fulfilled the inclusion criteria. The majority of studies showed that SDT caused statistically significant improvements in pain and function, but only two studies reported clinically relevant improvements. The applied SDT varied considerably with regard to dosage and content. The methodological quality of the included studies also varied, which hampered the comparability of results. Conclusions Although SDT seems to improve pain and function in people with CLBP, study limitations render firm conclusions unsafe. Future studies should pay closer attention to power and sample selection as well as to the content and dosage of the SDT intervention. We recommend a large, well-powered, prospective randomized control study that uses a standardized SDT approach to address the hypothesis that SDT causes clinically relevant improvements in pain and function. Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-0997-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Samuel Kälin
- Institute of Physiotherapy, Department of Health, Zurich University of Applied Sciences, Technikumstrasse 71, 8400, Winterthur, Switzerland
| | - Anne-Kathrin Rausch-Osthoff
- Institute of Physiotherapy, Department of Health, Zurich University of Applied Sciences, Technikumstrasse 71, 8400, Winterthur, Switzerland
| | - Christoph Michael Bauer
- Institute of Physiotherapy, Department of Health, Zurich University of Applied Sciences, Technikumstrasse 71, 8400, Winterthur, Switzerland. .,University of Tampere, School of Medicine, Kalevantie 4, FI-33014, Tampere, Finland.
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The point-to-point test: A new diagnostic tool for measuring lumbar tactile acuity? Inter and intra-examiner reliability study of pain-free subjects. ACTA ACUST UNITED AC 2016; 22:220-6. [DOI: 10.1016/j.math.2015.12.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/21/2015] [Accepted: 12/26/2015] [Indexed: 01/12/2023]
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15
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Diers M, Löffler A, Zieglgänsberger W, Trojan J. Watching your pain site reduces pain intensity in chronic back pain patients. Eur J Pain 2015; 20:581-5. [DOI: 10.1002/ejp.765] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2015] [Indexed: 11/10/2022]
Affiliation(s)
- M. Diers
- Department of Cognitive and Clinical Neuroscience; Central Institute of Mental Health/Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
- Institute of Medical Psychology and Medical Sociology; Georg-August-University Göttingen; Göttingen Germany
| | - A. Löffler
- Department of Cognitive and Clinical Neuroscience; Central Institute of Mental Health/Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - W. Zieglgänsberger
- Department of Clinical Neuropharmacology; Max Planck Institute of Psychiatry; Munich Germany
| | - J. Trojan
- Department of Psychology; University of Koblenz-Landau; Germany
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16
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Eads J, Lorimer Moseley G, Hillier S. Non-informative vision enhances tactile acuity: A systematic review and meta-analysis. Neuropsychologia 2015; 75:179-85. [PMID: 26071257 DOI: 10.1016/j.neuropsychologia.2015.06.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Individual experimental data suggest that visual input during tactile stimulation enhances tactile appreciation - whether this finding is replicated across studies and across body sites is unknown. OBJECTIVE To determine the available evidence as to whether non-informative vision of the body has an effect on tactile acuity. METHODS Studies that assessed tactile acuity with vision of the body, compared to vision of a neutral object or vision occluded, were systematically identified and reviewed. Seven relevant electronic databases were searched from their inception to April 2014. Risk of bias was assessed using adapted criteria from the Cochrane Handbook. Effect sizes were calculated using mean differences in a random effects model. RESULTS Ten studies were included. All were randomized, within subject, controlled trials published in English (total n=232 participants), with low to moderate risk of bias. Despite the diversity of protocols and outcome measures used, eight of the studies reported improvements in tactile acuity when vision of the relevant body part (predominantly the hand) was available. Meta-analysis revealed statistically significant findings from grating orientation tests (p=0.002, SMD 3.31, 95% CI 1.24-5.39), demonstrating a positive effect of vision of the body. No significant effect was found for other sensory tests or for other body parts, such as the back, and statistical heterogeneity was high. CONCLUSIONS This review provides confirmatory evidence for a visual enhancement effect for tactile acuity for body parts where vision has a plausible functional linkage - further studies are required to elaborate on the mechanisms for multi-modal processing of sensory stimuli.
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Affiliation(s)
- Jacki Eads
- International Centre for Allied Health Evidence, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide 5001, South Australia, Australia
| | - G Lorimer Moseley
- Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide 5001, South Australia, Australia
| | - Susan Hillier
- International Centre for Allied Health Evidence, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide 5001, South Australia, Australia.
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