1
|
Ucero-Lozano R, Donoso-Úbeda E, Cuesta-Barriuso R, Pérez-Llanes R. Immersive VR movement visualization in patients with hemophilic knee arthropathy: randomized, multicenter, single-blind clinical trial. Disabil Rehabil 2024:1-8. [PMID: 39244653 DOI: 10.1080/09638288.2024.2401138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 08/30/2024] [Accepted: 08/31/2024] [Indexed: 09/10/2024]
Abstract
PURPOSE To evaluate the efficacy of an immersive movement visualization intervention in patients with hemophilia and hemophilic knee arthropathy. MATERIALS AND METHODS Randomized, single-blind clinical study. Twenty-eight patients with hemophilia were recruited. Patients were randomized to an experimental group (four weeks of immersive movement visualization) and a control group (no intervention). The intensity of pain, pressure pain threshold in the knee, tibialis anterior muscle, lower back level, conditioned pain modulation, range of knee motion, and lower limb functionality were evaluated. RESULTS There were statistically significant differences in the intergroup effect on knee pain intensity (F = 23.71; p < 0.001) and lower limb functionality (F = 7.11; p = 0.003). 42.86% of the patients in the experimental group exhibited changes greater than the minimum detectable change (MDC) in functionality. 39.29% of the patients subject to the intervention experienced changes greater than the MDC in the knee pressure pain threshold. CONCLUSIONS Immersive motion visualization can improve the intensity of joint pain and functionality in patients with hemophilic knee arthropathy. Functionality, pressure pain threshold, and pain intensity improved in those patients who conducted immersive movement visualization.Implications for rehabilitationImmersive visualization of movement significantly improves intensity of joint pain, functionality, pressure pain threshold, joint health, and conditioned pain modulation in patients with hemophilic knee arthropathy.The fact that it is a therapy without potential aversive stimuli makes it a possible access pathway for patients with high levels of kinesiophobia and/or catastrophism.This low-cost, home-based technology allows its use in patients far from hemophilia reference centers or with difficult access to physiotherapy treatments.The immersive visualization of movement influences the democratization of treatment, in accordance with the WHO's Sustainable Development Goal 3 (health and well-being for all).
Collapse
Affiliation(s)
- Roberto Ucero-Lozano
- Department of Physiotherapy, European University of Madrid, Madrid, Spain
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), Oviedo, Spain
| | - Elena Donoso-Úbeda
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), Oviedo, Spain
- Department of Physiotherapy, Catholic University San Antonio-UCAM Murcia, Murcia, Spain
| | - Rubén Cuesta-Barriuso
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), Oviedo, Spain
- Department of Surgery and Medical-Surgical Specialties, University of Oviedo, Oviedo, Spain
| | - Raúl Pérez-Llanes
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), Oviedo, Spain
- Department of Physiotherapy, University of Murcia, Murcia, Spain
| |
Collapse
|
2
|
Al Shrbaji T, Bou-Assaf M, Andias R, Silva AG. A single session of action observation therapy versus observing a natural landscape in adults with chronic neck pain - a randomized controlled trial. BMC Musculoskelet Disord 2023; 24:983. [PMID: 38114952 PMCID: PMC10729350 DOI: 10.1186/s12891-023-07070-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Action observation (AO) has emerged as a potential neurorehabilitation therapy for patients with neck pain (NP), but evidence of its effectiveness is scarce. This study aims to assess the effect of a single session of AO when compared to observing a natural landscape on NP intensity, fear of movement, fear-avoidance beliefs, neck muscles' strength, pressure pain threshold, and tactile acuity. METHODS Sixty participants with NP were randomly allocated to the AO group (n = 30) or control group (n = 30). Both groups watched an 11-minute video: the AO group watched a video of a person matched for age and sex performing neck exercises, while the control group watched a video of natural landscapes. Neck pain intensity, fear of movement, fear-avoidance beliefs, tactile acuity, pressure pain thresholds, and neck muscle strength were assessed both at baseline and post-intervention. General linear models of repeated measures (ANCOVA of two factors) were used to explore between-group differences at post-intervention. RESULTS There was a significant main effect of time for pain intensity (p = 0.02; η2p = 0.09; within-group mean change and 95% CI: AO=-1.44 (-2.28, -0.59); control=-1.90 (-2.74, -1.06), but no time versus group interaction (p = 0.46). A time versus group significant interaction was found for one out of the six measurement sites of two-point discrimination and the neck flexors strength (p < 0.05) favoring the control group. No other statistically significant differences were found for the remaining variables). CONCLUSIONS Results suggest a similar acute benefit for both a single session of AO and observing natural landscapes for promoting hypoalgesia, but no impact on kinesiophobia, fear-avoidance beliefs, or pressure pain thresholds. Also, AO had no positive effect on two-point discrimination and muscle strength. Further research is needed, with longer interventions. TRIAL REGISTRATION Clinialtrials.gov (NCT05078489).
Collapse
Affiliation(s)
- Tala Al Shrbaji
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Aveiro, 3800-193, Portugal
| | - Mário Bou-Assaf
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Aveiro, 3800-193, Portugal
| | - Rosa Andias
- CINTESIS.RISE@UA, University of Aveiro, Campus Universitário de Santiago, Aveiro, 3810-193, Portugal
| | - Anabela G Silva
- CINTESIS.RISE@UA, School of Health Sciences, University of Aveiro, Edifício 30, Agras do Crasto - Campus Universitário de Santiago, Aveiro, 3810-193, Portugal.
| |
Collapse
|
3
|
Matesanz-García L, Fernández-Chamorro L, Rubio-Vallejo A, Cecilia-López D, Cuenca-Martínez F, Di-Bonaventura S, Fernández-Carnero J. Motor Imagery and Pain Processing in Patients With Entrapment Neuropathies: A Cross-sectional Study. Clin J Pain 2023; 39:620-627. [PMID: 37712289 DOI: 10.1097/ajp.0000000000001158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/01/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVES (1) To assess the ability to generate both kinesthetic and visual motor imagery in participants with carpal tunnel syndrome (CTS), compared with asymptomatic participants. (2) To assess the influence of psychophysiological and functional variables in the motor imagery process. METHODS Twenty patients with unilateral CTS and 18 pain-free individuals were recruited. An observational case-control study with a nonprobability sample was conducted to assess visual and kinesthetic movement imagery ability and psychophysiological variables in patients with CTS compared with asymptomatic participants in a control group. The trial was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology statement. RESULTS CTS patients have more difficulties in generating visual motor images compared with asymptomatic individuals ( t =-2.099; P <0.05; d=0.70). They need more time to complete the mental tasks (visual t =-2.424; P <0.05 and kinesthetic t =-2.200; P <0.05). A negative correlation was found between the ability to imagine and functional deficits ( r =-0.569; P =0.021) for the kinesthetic subscale and temporal summation ( r =-0.515; P <0.5). A positive correlation was found between pain pressure threshold homolateral (homolateral) and time to generate the visual mental images ( r =0.537; P <0.05). DISCUSSION CTS patients have greater difficulty generating motor images than asymptomatic individuals. Patients also spend more time during mental tasks. CTS patients present a relationship between temporal summation and the capacity to generate kinesthetic images. In addition, the CST patients presented a correlation between chronometry mental tasking and mechanical hyperalgesia.
Collapse
Affiliation(s)
- Luis Matesanz-García
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle
- Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Universidad Rey Juan Carlos
| | | | - Alberto Rubio-Vallejo
- Department of Physiotherapy, Centro superior de Estudios Universitarios (CSEU) La Salle, Universidad Autónoma de Madrid
| | - David Cecilia-López
- Unit of Elbow-Hand, Service de Traumatología, Hospital 12 de Octubre
- Complutense University of Madrid
- Department of Surgery, Hospital Vithas La Milagrosa
- Hospital Viamed Santa Elena
| | | | - Silvia Di-Bonaventura
- Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Universidad Rey Juan Carlos
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University
| | - Josué Fernández-Carnero
- Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Universidad Rey Juan Carlos
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University
- La Paz Hospital Institute for Health Research, IdiPAZ
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| |
Collapse
|
4
|
Takasaki H, Yamasaki C. Immediate neck hypoalgesic effects of craniocervical flexion exercises and cervical retraction exercises among individuals with non-acute neck pain and a directional preference for retraction or extension: preliminary pretest-posttest randomized experimental design. J Man Manip Ther 2023; 31:368-375. [PMID: 37052492 PMCID: PMC10566415 DOI: 10.1080/10669817.2023.2201918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 04/05/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Selective deep neck flexor muscle activation through craniocervical flexion exercises has been considered to be different from cervical retraction exercises. OBJECTIVE To compare the immediate analgesic effect of craniocervical flexion versus cervical retraction exercises in individuals with nonacute, directional preference (DP) for cervical retraction or extension. METHODS A two-arm, assessor-blinded, pretest-posttest randomized experiment was conducted. Participants were randomly assigned to either craniocervical flexion or cervical retraction exercises and those who were confirmed at the post-intervention examination to have a DP for cervical retraction or extension were analyzed. The primary outcome measure was pressure pain thresholds at the C2 and C5-C6 levels. RESULTS A total of 10 (mean age = 20.6 years) and nine participants (mean age = 19.4 years) undertook craniocervical flexion and retraction exercises, respectively. One-way analysis of variance demonstrated no statistically significant (p > 0.05) interaction effect regardless of the neck level. In the pre-post change percentages, retraction exercises provided greater analgesic effects compared to craniocervical flexion exercises at the C2 (Hedges' g = 0.679) and C5-C6 levels (g = 0.637). CONCLUSION This study showed a comparable or greater immediate neck analgesic effect from cervical retraction exercises compared to craniocervical flexion exercises in individuals with a DP for cervical retraction or extension.
Collapse
Affiliation(s)
- Hiroshi Takasaki
- CONTACT Hiroshi Takasaki Department of Physical Therapy, Saitama343-8540, Japan
| | - Chisato Yamasaki
- Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Saitama, Japan
| |
Collapse
|
5
|
Cuenca-Martínez F, Suso-Martí L, Peréz-Domínguez B, Calatayud J, López-Bueno R, Gargallo P, Blanco-Díaz M, Casaña J. Movement Representation Strategies as a Tool for Educational Innovation in Physiotherapy Students: A Randomized Single-Blind Controlled-Pilot Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4473. [PMID: 36901484 PMCID: PMC10001722 DOI: 10.3390/ijerph20054473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/18/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Physiotherapy has a strictly theoretical body of knowledge, but for the most part, the physiotherapist's learning is practical. The practical part is fundamental to acquire clinical skills that the physiotherapist will later use in professional practice. The main aim of this study was to assess the effectiveness of movement representation strategies (MRS) in the improvement of manual skills of physiotherapy students as an educational innovation strategy. We randomly assigned 30 participants to an action observation practice (AOP), motor imagery practice (MIP), or sham observation (SO) group. A high velocity, low amplitude lumbar manipulation technique that is widely used in clinical physiotherapy practice was taught in one session. The primary outcomes were required time and test score. The secondary outcomes were perceived mental fatigue and perceived difficulty for learning. The outcomes were assessed preintervention and immediately after the intervention (postintervention). The main results showed that both AOP and MIP improved the total time required and the test score, as well as entailed less perceived difficulty for learning. However, both strategies showed a higher level of mental fatigue after the intervention, which was higher in the MIP group. Based on the results obtained, it seems that the application of MRS promotes greater learning of manual motor tasks in physiotherapy students and could be used as educational innovation strategies.
Collapse
Affiliation(s)
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Borja Peréz-Domínguez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Pedro Gargallo
- Department of Physiotherapy, Faculty of Medicine and Health Science, Catholic University of Valencia, 46001 Valencia, Spain
| | - María Blanco-Díaz
- Surgery and Medical Surgical Specialties Department, Faculty of Medicine and Health Sciences, University of Oviedo, 33003 Oviedo, Spain
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| |
Collapse
|
6
|
Samadi M, Malmir K. Effects of mental practice on pain, functionality, and quality of life in individuals with chronic neck pain: A systematic review. Complement Ther Clin Pract 2023; 50:101690. [PMID: 36375324 DOI: 10.1016/j.ctcp.2022.101690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/20/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE There are conflicting reports in the literature regarding the effectiveness of motor imagery (MI) and action observation (AO) in individuals with chronic non-specific neck pain (CNSNP). This study sought to systematically investigate whether mental practice has any impact on pain, functionality and quality-of-life in individuals with CNSNP. METHODS This is a systematic review. Randomized controlled trials (RCTs) that explored the effects of mental practice on pain, functionality and quality-of-life in individuals with CNSNP were searched using databases PubMed, Cochrane library, Medline via Ovid, Scopus, and PEDro from inception to July 2022. Two reviewers independently extracted data and evaluated the quality of the studies utilizing the PEDro scale. RESULTS Six high-quality RCTs with 128 participants with CNSNP in the MI and AO groups, and 93 participants with CNSNP in the control group, were included in this review. Both AO and MI were effective in improving pain response and cervical joint position sense. However, AO was more efficient than MI and its effects were retained longer. Improvements in the visual analogue scale and neck disability index were retained when MI training lasted for 6 weeks. The pain and general health sub-parameters of the short form-36 health survey improved after MI training. CONCLUSION Mental practice, particularly AO, can improve neck pain intensity, joint position sense, functional disability, and some aspects of quality-of-life in individuals with CNSNP. These improvements dissipated over time. Although mental practice can be an alternative to exercise when pain exists, it can be more efficient when prescribed with simple movements and exercises. REGISTRATION The protocol of this review was registered with PROSPERO (CRD42022330240) Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022330240.
Collapse
Affiliation(s)
- Mansoureh Samadi
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kazem Malmir
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
7
|
Cetin H, Kose N, Oge HK. Virtual reality and motor control exercises to treat chronic neck pain: A randomized controlled trial. Musculoskelet Sci Pract 2022; 62:102636. [PMID: 35952621 DOI: 10.1016/j.msksp.2022.102636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 12/14/2022]
Abstract
AIM To compare the effects of virtual reality (VR) and motor control (MC) exercises. METHODS Forty-one participants with chronic neck pain (CNP) were randomized into the VR or MC group. Both groups performed 18 sessions over 6 weeks. The primary outcomes were pain intensity (visual analogue scale), pain pressure thresholds (PPTs), joint position sense error (JPSE), and muscle performance. The secondary outcomes were the Profile Fitness Mapping Questionnaire (ProFitMap-Neck), Hospital Anxiety-Depression Scale (HADS), and quality of life (SF-36). Data were analysed using T-Tests, and Fisher's Exact Test. Mean (standard deviation), median (interquartile range), effect size and %95 confidence interval (CI) were reported. RESULTS The results of Independent T-Tests showed that VR was advantageous in terms of PPTs of the C1/C2 and C5/C6 articular pillar bilaterally and large effect size (Cohen's d > 0.8, p < 0.05). Moreover, VR was more effective in decreasing JPSE (Cohen's d > 0.08; mean difference changes between -2.91 and -1.24, %95 CI -4.47 to 0.80) and functional limitation (ProFitMap-Neck) (Cohen's d = 0.7, mean difference 8.27, %95 CI 0.20 to 16.35). The results of T-Tests demonstrated that neither intervention was superior in terms of pain intensity, muscle performance, symptoms (ProFitMap-Neck), HADS, or SF-36 (Cohen's d < 0.5). CONCLUSIONS VR can be applied for improving proprioception and for decreasing cervical articular pain in CNP patients. In addition, VR may be more effective for decreasing functional limitations in patients. Clinicians can choose MC exercises with or without VR for improving pain, muscle performance, symptoms, anxiety/depression, and quality of life.
Collapse
Affiliation(s)
- Hatice Cetin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Nezire Kose
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Halil Kamil Oge
- Department of Neurosurgery, Medical Faculty, Hacettepe University, Ankara, Turkey
| |
Collapse
|
8
|
Ucero-Lozano R, Pérez-Llanes R, López-Pina JA, Cuesta-Barriuso R. Approach to Knee Arthropathy through 180-Degree Immersive VR Movement Visualization in Adult Patients with Severe Hemophilia: A Pilot Study. J Clin Med 2022; 11:jcm11206216. [PMID: 36294536 PMCID: PMC9605271 DOI: 10.3390/jcm11206216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/07/2022] Open
Abstract
(1) Background: Hemarthrosis is a typical clinical manifestation in patients with hemophilia. Its recurrence causes hemophilic arthropathy, characterized by chronic joint pain. Watching movement recorded from a first-person perspective and immersively can be effective in the management of chronic pain. The objective of this study was to evaluate the effectiveness of an immersive virtual reality intervention in improving the pain intensity, joint condition, muscle strength and range of motion in patients with hemophilic knee arthropathy. (2) Methods: Thirteen patients with hemophilic knee arthropathy were recruited. The patients wore virtual reality glasses and watched a flexion-extension movement of the knee on an immersive 180° video, recorded from a first-person perspective over a 28-day period. The primary variable was the pain intensity (visual analog scale). The secondary variables were the joint status (Hemophilia Joint Health Score), quadriceps and hamstring strength (dynamometry), and range of motion (goniometry). (3) Results: After the intervention period, statistically significant differences were observed in the intensity of the joint pain (Standard error [SE] = 19.31; 95% interval confidence [95%CI] = -1.05; -0.26), joint condition (SE = 18.68; 95%CI = -1.16; -0.52) and quadriceps strength (SE = 35.00; 95%CI = 2.53; 17.47). We found that 38.46% and 23.07% of the patients exhibited an improvement in their quadriceps muscle strength and joint condition above the minimum detectable change for both variables (8.21% and 1.79%, respectively). (4) Conclusions: One hundred and eighty degree immersive VR motion visualization can improve the intensity of joint pain in patients with hemophilic knee arthropathy. An intervention using immersive virtual reality can be an effective complementary approach to improve the joint condition and quadriceps strength in these patients.
Collapse
Affiliation(s)
| | - Raúl Pérez-Llanes
- Department of Physiotherapy, Catholic University San Antonio-UCAM, 30107 Murcia, Spain
| | | | - Rubén Cuesta-Barriuso
- Department of Surgery and Medical-Surgical Specialties, University of Oviedo, 33006 Oviedo, Spain
- Correspondence: ; Tel.: +34-985103386
| |
Collapse
|
9
|
Cuenca-Martínez F, Bocos-Corredor E, Espinosa-Giménez Á, Barrero-Santiago L, Nefa-Díaz N, Canchal-Crespo D, Varangot-Reille C, Herranz-Gómez A, Suso-Martí L, Sempere-Rubio N, La Touche R. Effects of Self-Efficacy and Outcome Expectations on Motor Imagery-Induced Thermal and Mechanical Hypoalgesia: A Single-Blind Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11878. [PMID: 36231179 PMCID: PMC9565608 DOI: 10.3390/ijerph191911878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
The main aim of this study was to assess whether self-efficacy (SE) and outcome expectations (OEs) modulate the hypoalgesic effect induced by motor imagery (MI). A total of 75 asymptomatic participants were randomly assigned to the positive (SE+, OE+), negative (SE-, OE-) or non-expectation (CG) groups. Heat pain threshold (HPT) and pain pressure threshold (PPT) were the main variables. Cold detection threshold (CDT), warm detection threshold (WDT), heart rate (HR) and perceived fatigue were the secondary variables. The variables were assessed preintervention, immediately postintervention and 10 min postintervention, except for HR, which was measured continuously during the intervention. Regarding HPT, significant within-group pre-post differences were found in the OE+ group, with a low effect size (p = 0.01, d = -0.39). With regard to ΔPPT, significant intergroup differences were found in Δpost-pre between the SE+ and CG groups (p = 0.012, d = 1.04) and also between SE+ and OE- (p = 0.006, d = 1.08), both with a large effect size. CG, SE-, and OE- groups had poorer CDT and WDT. Regarding HR, significant intergroup differences were found in the postintervention measurement between OE+ and SE-, with a large effect size (p = 0.016, d = 1.34). Lastly, no between-group differences were found regarding perceived fatigue (p > 0.05). The results obtained showed that positive expectations have a slight influence on the increase in heat and mechanical pain detection thresholds. Positive and non-expectancy groups showed an autonomic activation. The results also showed that negative expectations led to poorer perceptual processes.
Collapse
Affiliation(s)
- Ferran Cuenca-Martínez
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, 08018 Barcelona, Spain
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Elena Bocos-Corredor
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - África Espinosa-Giménez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Laura Barrero-Santiago
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Naira Nefa-Díaz
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - David Canchal-Crespo
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Clovis Varangot-Reille
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Aida Herranz-Gómez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Luis Suso-Martí
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, 08018 Barcelona, Spain
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Núria Sempere-Rubio
- UBIC, Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, 46010 Valencia, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28003 Madrid, Spain
| |
Collapse
|
10
|
Cuenca-Martínez F, Reina-Varona Á, Castillo-García J, La Touche R, Angulo-Díaz-Parreño S, Suso-Martí L. Pain relief by movement representation strategies: An umbrella and mapping review with meta-meta-analysis of motor imagery, action observation and mirror therapy. Eur J Pain 2021; 26:284-309. [PMID: 34592050 DOI: 10.1002/ejp.1870] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 08/23/2021] [Accepted: 09/25/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To develop a mapping and umbrella review with a meta-meta-analysis (MMA) to critically evaluate the current evidence of motor imagery (MI), action observation and mirror therapy (MT) on pain intensity. METHODS The study involved a systematic search of PubMed, PEDro, Scielo, EBSCO and Google Scholar. RESULTS Ten systematic reviews were included in the qualitative synthesis, 70% of which showed high methodological quality. Three reviews found a significant reduction in chronic musculoskeletal pain as the result of applying movement representation methods (MRM) plus usual-care (UC), with a large clinical effect (standardized mean difference [SMD] of -1.47; 95% CI -2.05 to -0.88; heterogeneity Q = 1.66; p = 0.44; I2 = 0%). However, two reviews showed no statistically significant reduction in acute and postsurgical pain as a result of applying MI plus UC. Four reviews showed no significant reduction in phantom limb pain (PLP) as a result of applying MT plus UC interventions. In four reviews, the MMA showed a significant reduction in complex regional pain syndrome (CRPS) as a result of applying MT plus UC, with a large clinical effect (SMD -1.27; 95% CI -1.87 to -0.67; heterogeneity Q = 3.95; p = 0.27; I2 = 24%). In two reviews, the MMA showed no significant differences in poststroke pain as a result of applying MT plus UC. CONCLUSION Results show that MRM could be effective for chronic musculoskeletal pain, with low to moderate-quality evidence. The results also show a reduction in pain intensity through MT interventions in patients with CRPS, although these results were not found in patients with PLP or poststroke pain. SIGNIFICANCE This umbrella review analysed systematic reviews evaluating movement representation techniques, with the aim of synthesizing the available evidence regarding motor imagery, action observation and mirror therapy on pain. The results provide relevant information about the potential clinical use of movement representation techniques in different types of patients with painful conditions.
Collapse
Affiliation(s)
- Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Álvaro Reina-Varona
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan Castillo-García
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain
| | - Santiago Angulo-Díaz-Parreño
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Facultad de Medicina, Universidad CEU San Pablo, Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
| |
Collapse
|
11
|
Matesanz-García L, Cáceres-Pajuelo JE, Cuenca-Martínez F, La Touche R, Goicoechea-García C, Fernández-Carnero J. Effects of neural mobilizations through movement representation techniques for the improvement of neural mechanosensitivity of the median nerve region: a randomized controlled trial. Somatosens Mot Res 2021; 38:267-276. [PMID: 34404324 DOI: 10.1080/08990220.2021.1964463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The main objective was to compare the effects of neural mobilization (NM), NM performed through mirror therapy (MT), NM performed through action observation (AO) training and finally classic rehabilitation program (mobility and strength) exercises on neural mechanosensitivity, widespread of proximal and distal pain and pressure pain thresholds (PPT). The second objective was to assess the effects of these interventions on handgrip strength, conditioned pain modulation, motor imagery ability and temporal summation. MATERIALS AND METHODS Single-blinded randomized controlled trial. Fifty-four healthy subjects were randomly assigned to each group. Neural mechanosensitivity, widespread pain and PPT were the main variables. The secondary variables included handgrip strength, conditioned pain modulation, motor imagery ability and temporal summation. RESULTS All groups showed significant differences in time*factor for neural mechanosensitivity (p = 0.001), PPT in the dermatome of the median nerve (p = 0.007), PPT at carpal tunnel (p < 0.05) and proximal widespread (p = 0.01). No differences were found for distal widespread, conditioned pain modulation, handgrip strength motor imagery ability or temporal summation (p > 0.05). There is an absence of statistically significant differences between groups. CONCLUSIONS NM through movement representation techniques can reduce mechanosensitivity and mechanical hyperalgesia in the median nerve dermatome and forearm, although no differences were found between groups.
Collapse
Affiliation(s)
- Luis Matesanz-García
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle. Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle. Universidad Autónoma de Madrid, Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle. Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle. Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, Spain
| | | | - Josué Fernández-Carnero
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle. Universidad Autónoma de Madrid, Madrid, Spain.,Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, Madrid, Spain.,La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| |
Collapse
|
12
|
Ito T, Kamiue M, Kihara T, Ishimaru Y, Kimura D, Tsubahara A. Visual Attention and Motion Visibility Modulate Motor Resonance during Observation of Human Walking in Different Manners. Brain Sci 2021; 11:brainsci11060679. [PMID: 34067268 PMCID: PMC8224780 DOI: 10.3390/brainsci11060679] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/15/2021] [Accepted: 05/20/2021] [Indexed: 11/25/2022] Open
Abstract
To advance our knowledge on the motor system during cyclic gait observation, we aimed to explore the effects of gaze fixation on corticospinal excitability evaluated by single-pulse transcranial magnetic stimulation (TMS). Fourteen healthy adult volunteers watched a video of a demonstrator walking on a treadmill under three different conditions: (1) observing the right lower limb, (2) observing the right ankle joint, and (3) observing the right lower limb on a video focused on the area below the knee. In each condition, motor-evoked potentials elicited by TMS in the tibialis anterior (TA) muscle were measured synchronously with the demonstrator’s initial contact and toe-off points. Directing visual attention to the ankle joint and focusing on its movements caused corticospinal facilitation in the TA muscle compared with watching the video without any visual fixation. In addition, phase-dependent differences in corticospinal excitability between the initial contact and toe-off points were only detected when the visibility range was restricted to below the knee. Our findings indicated that motor resonance during cyclic gait observation is modulated by visual attention and motion visibility in different activation manners.
Collapse
Affiliation(s)
- Tomotaka Ito
- Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki-City, Okayama 701-0193, Japan
| | - Masanori Kamiue
- Doctoral Program in Rehabilitation, Graduate School of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki-City, Okayama 701-0193, Japan
| | - Tomonori Kihara
- Department of Rehabilitation, Kasaoka Daiichi Hospital, Kasaoka-City, Okayama 714-0043, Japan
| | - Yuta Ishimaru
- Department of Rehabilitation, Kurashiki Sweet Hospital, Kurashiki-City, Okayama 710-0016, Japan
| | - Daisuke Kimura
- Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki-City, Okayama 701-0193, Japan
| | - Akio Tsubahara
- Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki-City, Okayama 701-0193, Japan
| |
Collapse
|
13
|
Öztürk Ö, Bombacı H, Keçeci T, Algun ZC. Effects of additional action observation to an exercise program in patients with chronic pain due to knee osteoarthritis: A randomized-controlled trial. Musculoskelet Sci Pract 2021; 52:102334. [PMID: 33582621 DOI: 10.1016/j.msksp.2021.102334] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/30/2020] [Accepted: 01/20/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Knee osteoarthritis (OA) leads to pain, stiffness, and functional impairment and eventually decreased level of the quality of life. Although several treatment methods have been used to achieve pain relief, patients still complain of pain. OBJECTIVE The aim of this study was to investigate the effects of the addition of action observation therapy to an exercise program on pain severity, pressure pain threshold, kinesiphobia functionality, and pain catastrophization in knee OA patients with chronic pain. METHODS This prospective, randomized-controlled, superiority trial included a total of 36 patients with knee OA. The patients were randomly divided into two groups as the treatment group (n = 18) receiving action observation therapy in addition to exercise and control group (n = 18) receiving exercise alone. The interventions were performed three times weekly for six weeks. The primary outcomes were pain and pressure pain threshold. Secondary outcomes were kinesiphobia, functionality, and pain catastrophization. All participants were assessed at baseline (pre-intervention) and after the six-week treatment (post-intervention). RESULTS There was no significant difference in the primary and secondary outcome measures before and after the intervention between the groups (p > 0.05). Both groups showed a significant improvement in all outcome measures after the intervention (p < 0.01). CONCLUSION Our study results suggest that action observation therapy in addition to an exercise program does not contribute any additional benefits to pain, pressure pain threshold, kinesiophobia, pain catastrophization, and functionality in knee OA patients with chronic pain. Nonetheless, further large-scale, long-term, prospective studies are needed to gain a better understanding on this subject.
Collapse
Affiliation(s)
- Özgül Öztürk
- Acibadem Mehmet Ali Aydinlar University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
| | - Hasan Bombacı
- University of Health Sciences, Haydarpaşa Numune Research and Training Hospital, Department of Orthopedics and Traumatology, Istanbul, Turkey
| | - Tolga Keçeci
- Ordu University, Faculty of Medicine, Department of Orthopedics and Traumatology, Ordu, Turkey
| | - Zeliha Candan Algun
- Istanbul Medipol University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| |
Collapse
|
14
|
Takasaki H, Kawazoe S. Investigation on the effectiveness of abdominal hollowing home-exercises using a portable ultrasound: Randomized controlled trial. J Electromyogr Kinesiol 2021; 58:102532. [PMID: 33667960 DOI: 10.1016/j.jelekin.2021.102532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/13/2021] [Accepted: 02/11/2021] [Indexed: 11/29/2022] Open
Abstract
We used a 3-arm randomized control trial to investigate whether abdominal hollowing (AH) home exercise using pocket-sized ultrasonography (US)-miruco (AH with miruco group)-was more effective than conventional AH home exercise using abdominal palpation and or also a wait-and-see approach (control group) to improve isolated control of the transversus abdominis (TrA) muscle during AH. We randomized 60 participants with low back pain into the three groups equally. Primary outcome measures for the US group were percentage of change in TrA thickness and excursion of the edge of the TrA fascia during AH when the thickness of the internal or external oblique muscles increased. Score on the Oswestry Disability Index (ODI) was a secondary outcome measure. The intervention period was 1 week, followed by 1 week without intervention. As a result, we found no statistically significant interaction effect (P > .05) in changes of the primary outcome measures from baseline for each follow-up period. The AH with miruco group had a statistically lower ODI (P = .036) than did the control group after the intervention. Results indicate a limited benefit for use of the miruco in AH home exercise to improve isolated control of the TrA muscle during AH.
Collapse
Affiliation(s)
- Hiroshi Takasaki
- Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan.
| | - Shota Kawazoe
- Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan
| |
Collapse
|
15
|
Javdaneh N, Molayei F, Kamranifraz N. Effect of adding motor imagery training to neck stabilization exercises on pain, disability and kinesiophobia in patients with chronic neck pain. Complement Ther Clin Pract 2020; 42:101263. [PMID: 33276225 DOI: 10.1016/j.ctcp.2020.101263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/26/2020] [Accepted: 11/13/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The investigation of this study was to compare the effect of adding motor imagery training to neck stabilization exercises on pain, disability, and kinesiophobia in patients with chronic neck pain. MATERIAL AND METHODS After screening, seventy-two volunteers with chronic neck pain were randomly allocated to 3 groups: neck stabilization exercises alone, n = 24, combined ( neck stabilization exercises + motor imagery training), n = 24, and a control group, n = 24. Pain intensity, disability, and kinesiophobia before and after the intervention exercises were measured by the Visual Analog Scale, Neck Disability Index, and the Tampa Scale of Kinesiophobia , respectively. RESULTS Statistically significant differences in pain intensity, the neck disability index, and kinesiophobia were found when a combined intervention group including neck stabilization and motor imagery training was compared with neck stabilization training alone at 6 weeks ) p ≤ 0.005). Also, there were significant between-group differences favoring experimental groups versus control for all outcomes (p ≤ 0.001). CONCLUSION neck stabilization exercises in combination with motor imagery training was superior to neck stabilization exercises alone in decreasing pain, disability, and kinesiophobia in patients with chronic neck pain.
Collapse
Affiliation(s)
- Norollah Javdaneh
- Department of Biomechanics and Sport Medicine, Kharazmi University, Tehran, Iran.
| | - Feridon Molayei
- Iran University of Medical Sciences & Physiotherapy Center of Ahangesalamati, Tehran, Iran
| | - Nazanin Kamranifraz
- Iran University of Medical Sciences & Physiotherapy Center of Ahangesalamati, Tehran, Iran
| |
Collapse
|
16
|
Moriuchi T, Nakashima A, Nakamura J, Anan K, Nishi K, Matsuo T, Hasegawa T, Mitsunaga W, Iso N, Higashi T. The Vividness of Motor Imagery Is Correlated With Corticospinal Excitability During Combined Motor Imagery and Action Observation. Front Hum Neurosci 2020; 14:581652. [PMID: 33088268 PMCID: PMC7500410 DOI: 10.3389/fnhum.2020.581652] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/18/2020] [Indexed: 12/26/2022] Open
Abstract
The present study aimed to investigate the relationship between motor imagery (MI) assessment (ability and quality) and neurophysiological assessment [transcranial magnetic stimulation (TMS)-induced motor-evoked potentials (MEPs)] during combined MI and action observation (AO; MI + AO). Sixteen subjects completed an MI task playing the piano with both hands, and neurophysiological assessment was performed during the MI task. The Movement Imagery Questionnaire-Revised was adopted to evaluate MI ability, while the visual analogue scale (VAS) was adopted to evaluate MI quality. A TMS pulse was delivered during the MI task, and MEPs were subsequently recorded in the abductor pollicis brevis (APB). We found a significant positive correlation between the VAS score and the TMS-induced MEPs (ρ = 0.497, p < 0.001). These findings suggest that the VAS score could potentially reflect the corticospinal excitability during MI + AO, particularly in complex MI tasks.
Collapse
Affiliation(s)
- Takefumi Moriuchi
- Department of Occupational Therapy, Nagasaki University Graduate School of Biomedical Sciences, Health Sciences, Nagasaki, Japan
| | - Akira Nakashima
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Jiro Nakamura
- Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Kimika Anan
- Department of Occupational Therapy, Nagasaki University Graduate School of Biomedical Sciences, Health Sciences, Nagasaki, Japan
| | - Keita Nishi
- Department of Oral Anatomy and Dental Anthropology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takashi Matsuo
- Department of Rehabilitation, Division of Occupational Therapy, Kumamoto Health Science University, Kumamoto, Japan
| | - Takashi Hasegawa
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Wataru Mitsunaga
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Iso
- Department of Occupational Therapy, Faculty of Health Sciences, Tokyo Kasei University, Saitama, Japan
| | - Toshio Higashi
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| |
Collapse
|
17
|
Morales Tejera D, Fernandez-Carnero J, Suso-Martí L, Cano-de-la-Cuerda R, Lerín-Calvo A, Remón-Ramiro L, La Touche R. Comparative study of observed actions, motor imagery and control therapeutic exercise on the conditioned pain modulation in the cervical spine: a randomized controlled trial. Somatosens Mot Res 2020; 37:138-148. [PMID: 32340585 DOI: 10.1080/08990220.2020.1756244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Aim: The aim of this study was to compare the effects of cervical exercise, motor imagery (MI) and action observation (AO) of cervical exercise actions on conditioned pain modulation and pressure pain thresholds. The second objective was to assess the effects of these interventions on cervical motor activity (ranges of motion and muscle endurance), attention, and the ability to generate motor images.Study design: Single-blinded randomized controlled trial.Materials and methods: Fifty-four healthy subjects were randomly assigned to each group. Response conditioned pain modulation, pressure pain threshold, were the main variables. The secondary outcome measures included, cervical range of motion, Neck flexor endurance test, mental movement representation associated and psychosocial variables.Results: All groups showed significant differences in time factor for all evaluated variables (p < .01) except pressure pain threshold over the tibial region. The post hoc analysis revealed significant within-group differences in the AE and AO groups in conditioned pain modulation (p < .05), with medium effect size in time [AE (d -0.61); AO (d -0.74)].Conclusion: The results showed that within-group changes in conditioned pain modulation, cervical muscle endurance, and attention where founded only in the AE and AO groups. Variations in pain thresholds at pressure in the trapezium area were also obtained in the three groups. Changes in the ranges of flexion-extension and rotation movement were presented exclusively in the exercise group, and in the capacity to generate motor images only in the AO group. However, there was no difference in the pressure pain threshold over the tibial region.
Collapse
Affiliation(s)
- David Morales Tejera
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Josue Fernandez-Carnero
- La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain.,Grupo Multidisciplinar de Investigación y Tratamiento del Dolor. Grupo de Excelencia Investigadora, URJC-Banco de Santander, Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Departament of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Alfredo Lerín-Calvo
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España
| | - Lorena Remón-Ramiro
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España
| | - Roy La Touche
- La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, España
| |
Collapse
|
18
|
Action observation as a treatment option for fear avoidance behavior in chronic spinal pain. Med Hypotheses 2020; 137:109535. [PMID: 31901606 DOI: 10.1016/j.mehy.2019.109535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 11/22/2022]
Abstract
Psychological factors play an essential role in the maintenance of various chronic pain states, with fear avoidance beliefs contributing to significant functional limitation and disability in chronic spinal pain. Fear avoidance behaviors are typically managed with cognitive-behavioral interventions such as graded exposure to feared movements and graded activity programs. However, attempts to make patients with high pain-related fear perform painful actions using graded exposure therapy can be very challenging. These fear avoidance beliefs in individuals with pain are usually acquired through previous pain experiences, observation, and threating verbal input from others that movement is harmful to the spinal structures. Observational learning of fear has been recently demonstrated in several experimental studies, where participants acquired fear of pain after observing the distressed painful expressions of the volunteers performing a painful cold pressor task. The primary purpose of this paper is to propose action observation, a cognitive rehabilitation technique, as one of the treatment options for reducing fear avoidance behavior in chronic spinal pain. Action observation involves the visualization of others performing a movement or an action to influence motor behavior positively and is mainly used in stroke rehabilitation. The paper hypothesizes that the pain-related fear of movement may be reduced through observation of others performing threatening movements successfully without displaying pain or discomfort. Action observation of others successfully executing a strenuous task may break the preexisting cognitive association between movement and pain among patients with high pain-related fear. Other possible mechanisms through which observation may influence pain-related fear could be the activation of mirror neuron systems and subsequent modulation of nociceptive information through the interconnections between the amygdala (one of the brain centers for fear), descending pain modulatory system and higher cortical centers. Few initial studies that investigated the effects of action observation on other outcomes of pain, such as pain severity are described to review the hypothesis. Considering the influence of observational learning on pain-related fear, action observation may be explored as potential adjunctive treatment to reduce fear avoidance behavior in chronic spinal pain.
Collapse
|
19
|
Cuenca-Martínez F, La Touche R, León-Hernández JV, Suso-Martí L. Mental practice in isolation improves cervical joint position sense in patients with chronic neck pain: a randomized single-blind placebo trial. PeerJ 2019; 7:e7681. [PMID: 31565582 PMCID: PMC6745187 DOI: 10.7717/peerj.7681] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 08/16/2019] [Indexed: 12/12/2022] Open
Abstract
Objective The main objective of this trial was to assess whether action observation (AO) training and motor imagery (MI) produced changes in the cervical joint position sense (CJPS) both at the end of the intervention and 10 min postintervention compared with a placebo intervention in patients with nonspecific chronic neck pain (NSCNP). Methods A single-blind placebo clinical trial was designed. A total of 30 patients with NSCNP were randomly assigned to the AO group, MI group or placebo observation (PO) group. CJPS in flexion, extension and rotation movements in both planes were the main variables. Results The results obtained in the vertical plane showed that the AO group obtained greater improvements than the PO group in the CJPS in terms of cervical extension movement both at the end of the intervention and 10 min postintervention (p = .001, d = 1.81 and p = .004, d = 1.74, respectively), and also in cervical flexion movement, although only at 10 min after the intervention (p = .035, d = 0.72). In addition, the AO group obtained greater improvements than the MI group in the CJPS only at the end of the intervention in cervical extension movement (p = .041, d = 1.17). Regarding the left rotation cervical movement, both the MI and AO groups were superior to the PO group in both planes at the end of the intervention (p < .05, d > 0.80). Conclusions Although both AO and MI could be a useful strategy for CJPS improvement, the AO group showed the strongest results. The therapeutic potential of the application of mental practice in a clinical context in the early stages of rehabilitation of NSCNP should be considered.
Collapse
Affiliation(s)
- Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Jose Vicente León-Hernández
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| |
Collapse
|