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Description of research into the relationship between sensory acuity at the back and motor control of the back in people with back pain, Luomajoki & Moseley Br J Sport Med 2009 and Moseley, Zalucki & Wiech Pain, 137 (2008)
Citation preview
Tactile acuity at the back and motor control of the trunk are decreased in people with
back pain
Lorimer MoseleyNHMRC Senior Research FellowPrince of Wales Medical Research Institute & School of Medical Sciences, University of New South Wales, Sydney, Australia
Team leaderThe GAMFI projectUniversity of Oxford, UK
© GL Moseley http://www.bodyinmind.com.au
TPDver(cal
TPDhorizontal
© GL Moseley www.BodyInMind.com.au
TPD=twopointdiscrimina(onthreshold–ameasureoftac(leacuity.
Luomajoki&Moseley2009BrJSportMed
Luomajoki&Moseley2009BrJSportMed© GL Moseley
www.BodyInMind.com.au
Thisshowsthattac(leacuityislessinpeoplewithbackpainthanitisinthosewithout.
Thisshowsvoluntarylumbopelviccontrolisworseinpeoplewithbackpainthaninthosewithout.
© GL Moseley www.BodyInMind.com.au
Thisshowsvoluntarylumbopelviccontrolandtac(leacuityarerelated.
Luomajoki&Moseley2009BrJSportMed
Canwetraintac(leacuity?
© GL Moseley www.BodyInMind.com.au
1 2 34
5
Probes
Stimulation sites
A. Stimulation
2 mm 11 mm
B. Condition
Photograph of affected part, with stimulation sites marked.
Affected part ATTENTION
5
1 2 345 1 2 345
1 2 345Screen
NO ATTENTION
Moseley,Zalucki&Wiech(2008)Pain137,3600‐8© GL Moseley
www.BodyInMind.com.au
Inonecondi(on,wejusttouchedtheaffectedhandatthesepointswhilethepa(entreadabook.Intheothercondi(on,wedididen(caltouchesbutnowtheyhadtodiscriminatebetweenthem–whichpointandwhichprobe.
0
5
10
Wait No attention
Attention Review
Task-specificNRS
0
4
8Pain NRS
30
60
TPDmm
ATTENTION
5
1 2 3451 2 345
1 2 345Screen
NO ATTENTION
© GL Moseley www.BodyInMind.com.au
Thisshowsthatwhiletherewasnoeffectofthes(mula(onalone,therewassignificantimprovementinpain,tac(leacuityandfunc(on.Improvementsweremaintainedat3monthfollow‐up.
Moseley,Zalucki&Wiech(2008)Pain137,3600‐8
0
3
6
-0.5 0 1 2
Change in pain NRS
Change in TPD
12
34
513
6
10
712
8 11
9
r2 = 0.34P = 0.04
123
4
513
6
10
7
12
8
11
9
0
3
-0.5 0 1
Change in pain NRS
ATTENTION
Change in TPD
NO ATTENTION
© GL Moseley www.BodyInMind.com.au
Thisshowsthatduringdiscrimina(on,thechangeintac(leacuityandthechangeinpainwererelated.
Moseley,Zalucki&Wiech(2008)Pain137,3600‐8
Can we use vision and gaze direction to make it better?
Taylor-Clarke et al (2002) Curr Biol 12, 233-6
These (and other) studies show that if you can see skin and look in the direction of a stimulus, our tactile acuity is better and sensory cortex response is bigger. © GL Moseley
www.BodyInMind.com.au
Inthisexperimentweusedthesamemethodastheclinicaltrial(condi(onE)andthenacondi(onthatalsocapturedvisualinputofskin(C),acondi(onthatcapturedgazedirec(onbutnotvisualinputofskin(D)andacondi(onthatcapturedboth(B).Eachsessioninvolved72s(mulirandomlytofivepointswitheitherafatoraskinnyprobe(A).
© GL Moseley www.BodyInMind.com.au
Moseley,Zalucki&Wiech(2008)Pain137,3600‐8
© GL Moseley www.BodyInMind.com.au
Thisshowsthat,a]erasingle30minutediscrimina(ontrainingsession,theincreaseintac(leacuitywasgreatestinthecondi(onthatcapturedbothvisualinputofskinandgazedirec(on.
Thisshowsthattherewasalsoasignificantdecreaseinpain.
Moseley,Zalucki&Wiech(2008)Pain137,3600‐8
Weshouldusevision&spa(ala^en(ontoenhanceTPDtraining
InCRPS,TPDtrainingcanreducepain
Doesthesameapplyfortheback?Howdoweusevisionthere?
© GL Moseley www.BodyInMind.com.au