Tactile acuity at the back and motor control
  of the trunk are decreased in people with
                                 ...
TPD
ver(cal




                   TPD
horizontal




    TPD
=
two
point
discrimina(on
threshold
–
a

    measure
of
tac(...
This
shows
that
tac(le
acuity
is
less
in

                 people
with
back
pain
than
it
is
in

                 those
wit...
This
shows
voluntary

         lumbopelvic
control
and

         tac(le
acuity
are
related.




                          ...
Can
we
train
tac(le
acuity?





                                         © GL Moseley
                               www....
A. Stimulation                                              B. Condition                         NO ATTENTION
   Probes


...
This
shows
that
while
there
was
no
effect
of
the
s(mula(on
alone,
there
was
significant
improvement
in
pain,
tac(le

       ...
6
                         Change                                              7
                         in pain
        ...
Can we use vision and gaze
direction to make it better?

Taylor-Clarke et al (2002) Curr Biol 12, 233-6




These (and oth...
In
this
experiment
we
used
the

                                                   same
method
as
the
clinical
trial

    ...
This
shows
that,
a]er
a
single
30

                                                   minute
discrimina(on
training

     ...
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...
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Tactile acuity at the back

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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)

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Tactile acuity at the back

  1. 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. 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. 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. 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
  5. 5. Can
we
train
tac(le
acuity?
 © GL Moseley www.BodyInMind.com.au
  6. 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
  7. 7. This
shows
that
while
there
was
no
effect
of
the
s(mula(on
alone,
there
was
significant
improvement
in
pain,
tac(le
 acuity
and
func(on.
Improvements
were
maintained
at
3
month
follow‐up. NO ATTENTION 8 Pain NRS 4 Screen 5 0 1 2 34 60 TPD mm ATTENTION 30 10 Task-specific NRS 5 5 5 5 1 2 34 1 2 34 0 Wait No Attention Review attention © GL Moseley Moseley,
Zalucki
&
Wiech
(2008)
Pain
137,3
600‐8 www.BodyInMind.com.au
  8. 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. 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. 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. 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. 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
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