Weitere ähnliche Inhalte Kürzlich hochgeladen (20) Tactile acuity at the back 1. Tactile acuity at the back and motor control
of the trunk are decreased in people with
back pain
Lorimer Moseley
NHMRC Senior Research Fellow
Prince of Wales Medical Research Institute & School of Medical Sciences,
University of New South Wales, Sydney, Australia
Team leader
The GAMFI project
University of Oxford, UK
© GL Moseley http://
www.bodyinmind.com.au
2. TPD
ver(cal
TPD
horizontal
TPD
=
two
point
discrimina(on
threshold
–
a
measure
of
tac(le
acuity.
© GL Moseley
Luomajoki
&
Moseley
2009
Br
J
Sport
Med www.BodyInMind.com.au
3. This
shows
that
tac(le
acuity
is
less
in
people
with
back
pain
than
it
is
in
those
without.
This
shows
voluntary
lumbopelvic
control
is
worse
in
people
with
back
pain
than
in
those
without.
© GL Moseley
Luomajoki
&
Moseley
2009
Br
J
Sport
Med www.BodyInMind.com.au
4. This
shows
voluntary
lumbopelvic
control
and
tac(le
acuity
are
related.
© GL Moseley
Luomajoki
&
Moseley
2009
Br
J
Sport
Med www.BodyInMind.com.au
6. A. Stimulation B. Condition NO ATTENTION
Probes
Screen
5
1 2 34
2 mm 11 mm
In
one
condi(on,
we
just
touched
the
affected
hand
at
these
points
while
the
pa(ent
read
a
book.
In
the
other
condi(on,
we
did
iden(cal
touches
but
now
they
had
to
discriminate
between
them
–
which
point
and
which
probe.
Affected part ATTENTION
Stimulation
sites
5
1 2 4
3 5
5 5
1 2 34 1 2 34
Photograph of affected part,
with stimulation sites marked. © GL Moseley
Moseley,
Zalucki
&
Wiech
(2008)
Pain
137,3
600‐8 www.BodyInMind.com.au
8. 6
Change 7
in pain
12 9
NRS
3 24 8 11
ATTENTION
3 5 10 1
13
r2 = 0.34
This
shows
that
during
0 P = 0.04
discrimina(on,
the
change
in
tac(le
acuity
and
the
change
-0.5 6
0 1 2
in
pain
were
related. Change in TPD
3
Change
in pain 4
NRS
7 6 9 8
NO ATTENTION
12 3
0 2 1 13 10
11 5
-0.5 0 1 © GL Moseley
Moseley,
Zalucki
&
Wiech
(2008)
Pain
137,3
600‐8 Change in TPD www.BodyInMind.com.au
9. 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
10. In
this
experiment
we
used
the
same
method
as
the
clinical
trial
(condi(on
E)
and
then
a
condi(on
that
also
captured
visual
input
of
skin
(C),
a
condi(on
that
captured
gaze
direc(on
but
not
visual
input
of
skin
(D)
and
a
condi(on
that
captured
both
(B).
Each
session
involved
72
s(muli
randomly
to
five
points
with
either
a
fat
or
a
skinny
probe
(A).
© GL Moseley
Moseley,
Zalucki
&
Wiech
(2008)
Pain
137,3
600‐8 www.BodyInMind.com.au
11. This
shows
that,
a]er
a
single
30
minute
discrimina(on
training
session,
the
increase
in
tac(le
acuity
was
greatest
in
the
condi(on
that
captured
both
visual
input
of
skin
and
gaze
direc(on.
This
shows
that
there
was
also
a
significant
decrease
in
pain.
© GL Moseley
Moseley,
Zalucki
&
Wiech
(2008)
Pain
137,3
600‐8 www.BodyInMind.com.au
12. Does
the
same
apply
for
the
back?
How
do
we
use
vision
there?
We
should
use
vision
&
spa(al
a^en(on
to
enhance
TPD
training
In
CRPS,
TPD
training
can
reduce
pain
© GL Moseley
www.BodyInMind.com.au