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Beinert K1, Wedel A1, Trojan J2, Diers M3
1Hochschule fuer Gesundheitsorientierte Wissenschaften, Mannheim, Germany, 2Universität Koblenz-Landau, Psychology, Landau, Germany, 3Ruhr University Bochum, Psychosomatic Medicine and Psychotherapy, Bochum, Germany
Background: Chronic neck pain is the fourth most common disabling musculoskeletal disorder worldwide. In the last years, memory processes by means of pain conditioned movement behavior are thought to play more and more an important role in maintaining chronic pain. Although widely recognized, few diagnostic tools are available to identify pain conditioned movement behavior. Recent studies have demonstrated that observation and imagination of movements elicits comparable brain activity related to really executed movement. Moreover, observation and imagination of pain provoking movements activates pain associated brain centers. Therefore, observation and imagination of pain provoking movements are used to activate pain conditioned memory traces.
Purpose: The purpose of this study was to evaluate the effects of motor imagination and observation of pain provoking movements on pain and sensorimotor performance of the cervical spine.
Methods: 17 chronic neck pain patients were assessed for eligibility. Inclusion criteria were chronic nonspecific movement induced neck pain and neck pain, which sensitized when a pain provoking movement was watched in a video. Exclusion criteria were radicular pain and rheumatic, neurological or vestibular disorders. All participants were instructed to imagine and observe movements presented in two separate videos in a randomized order on two different days: One video with neck movement as experimental and one with knee extension movement as control condition. Prior to watching the videos, the pain provoking movement was assessed in neck pain patients to present a similar neck movement video to the patient. Pain provoking videos consisted of extension or rotation movements. Healthy controls were randomly allocated to one of the neck movement videos. One session consisted of 45 sec imagination and observation with 15 seconds break and was repeated five times. Effects on pain, cervical joint position sense and pressure pain thresholds were measured by a blinded assessor before and immediately after watching the videos. To identify the influence of the videos on both groups, repeated measures ANOVA were conducted for cervical joint position sense and pressure pain threshold with the between factor group and the within factor condition (neck video vs. knee video).
Results: Out of 17 neck pain patients, 59% sensitized and 31% did not meet the inclusion criteria of sensitization. 10 remaining neck pain patients and 10 healthy controls were finally assessed. A significant condition x group interaction effect (F 1,18 = 4.961, p = 0.039) was observed for cervical joint position sense acuity, resulting in decreased acuity in neck pain patients and increased acuity in healthy controls. No main effect for group or condition was found. Pressure pain threshold yielded no significant effects.
Conclusion(s): Five minutes of motor imagination and observation of pain provoking movements were able to profile patients in sensitizing versus not sensitizing. Further, sensitization may be a result of activated memory traces with respect to pain conditioned movement behavior and account for decreased acuity in cervical joint position sense.
Implications: Preliminary evidence suggests motor imagination and observation of pain provoking movements as a valuable tool to activate pain related memory traces in patients with symptoms of pain conditioned movement behavior.
Keywords: Chronic neck pain, pain conditioned movement behavior, sensorimotor performance
Funding acknowledgements: No funding was received
Purpose: The purpose of this study was to evaluate the effects of motor imagination and observation of pain provoking movements on pain and sensorimotor performance of the cervical spine.
Methods: 17 chronic neck pain patients were assessed for eligibility. Inclusion criteria were chronic nonspecific movement induced neck pain and neck pain, which sensitized when a pain provoking movement was watched in a video. Exclusion criteria were radicular pain and rheumatic, neurological or vestibular disorders. All participants were instructed to imagine and observe movements presented in two separate videos in a randomized order on two different days: One video with neck movement as experimental and one with knee extension movement as control condition. Prior to watching the videos, the pain provoking movement was assessed in neck pain patients to present a similar neck movement video to the patient. Pain provoking videos consisted of extension or rotation movements. Healthy controls were randomly allocated to one of the neck movement videos. One session consisted of 45 sec imagination and observation with 15 seconds break and was repeated five times. Effects on pain, cervical joint position sense and pressure pain thresholds were measured by a blinded assessor before and immediately after watching the videos. To identify the influence of the videos on both groups, repeated measures ANOVA were conducted for cervical joint position sense and pressure pain threshold with the between factor group and the within factor condition (neck video vs. knee video).
Results: Out of 17 neck pain patients, 59% sensitized and 31% did not meet the inclusion criteria of sensitization. 10 remaining neck pain patients and 10 healthy controls were finally assessed. A significant condition x group interaction effect (F 1,18 = 4.961, p = 0.039) was observed for cervical joint position sense acuity, resulting in decreased acuity in neck pain patients and increased acuity in healthy controls. No main effect for group or condition was found. Pressure pain threshold yielded no significant effects.
Conclusion(s): Five minutes of motor imagination and observation of pain provoking movements were able to profile patients in sensitizing versus not sensitizing. Further, sensitization may be a result of activated memory traces with respect to pain conditioned movement behavior and account for decreased acuity in cervical joint position sense.
Implications: Preliminary evidence suggests motor imagination and observation of pain provoking movements as a valuable tool to activate pain related memory traces in patients with symptoms of pain conditioned movement behavior.
Keywords: Chronic neck pain, pain conditioned movement behavior, sensorimotor performance
Funding acknowledgements: No funding was received
Topic: Pain & pain management; Musculoskeletal: spine
Ethics approval required: Yes
Institution: Hochschule für Gesundheitsorientierte Wissenschaften Rhein-Neckar
Ethics committee: Ethik Kommission HGWR
Ethics number: 20180101
All authors, affiliations and abstracts have been published as submitted.
