Cortical changes in chronic low back pain: Current state of the art and implications for clinical practice

Wand, Benedict M; Parkitny, Luke; O’Connell, Neil E; Luomajoki, Hannu; McAuley, James H.; Thacker, Michael; Moseley, G. Lorimer

doi:10.1016/j.math.2010.06.008

Cited by 298 publications

(200 citation statements)

References 74 publications

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“…As a consequence, the chronic LBP patient is left with disrupted feedback sense and altered body schema. This hypothesis fits with findings of impaired repositioning sense (O 'Sullivan et al, 2003), impaired two point discrimination (Moseley, 2008;Luomajoki and Moseley, 2009), and cortical changes in chronic LBP patients (Wand et al, 2011). Other factors such as stress, anxiety, patients beliefs and clinicians advise to hold erect postures and co-contract the spine stabilising muscles may also be reflective in these findings.…”

Section: Why Would Patients Develop Behaviours Of Self Provocation?supporting

confidence: 84%

The validity of O’Sullivan’s classification system (CS) for a sub-group of NS-CLBP with motor control impairment (MCI): Overview of a series of studies and review of the literature

Dankaerts

O’Sullivan

2011

Manual Therapy

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a b s t r a c tChronic Low Back Pain (LBP) remains a common, recalcitrant and costly problem for the individual sufferer and for society. Effective treatments that reduce the social and economic burden have yet to be established for the majority of chronic LBP cases. Lack of evidence for specific interventions has been blamed on the heterogeneity of the chronic LBP population as well as a lack of a patient centred biopsycho-social approach. This issue of heterogeneity has resulted in classification being considered the highest research priority in the area of chronic LBP. The potential for a 'wash-out effect' caused by the heterogeneity of the chronic LBP populations sampled for randomised controlled clinical trials (RCTs), has driven the need for classifying patients with nonspecific chronic LBP. A summary of a series of studies is outlined in this review paper. They represent a comprehensive investigation into the validity of O'Sullivan's proposed mechanism-based classification system (CS) for a sub-group of localized mechanically provoked nonspecific chronic LBP with motor control impairment (MCI). Further, the findings of these studies are discussed in relation to the relevant literature and the clinical implications arising are presented. Finally, the limitations of this research are outlined and recommendations for future research are made.

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Section: Why Would Patients Develop Behaviours Of Self Provocation?supporting

confidence: 84%

The validity of O’Sullivan’s classification system (CS) for a sub-group of NS-CLBP with motor control impairment (MCI): Overview of a series of studies and review of the literature

Dankaerts

O’Sullivan

2011

Manual Therapy

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“…Such models continue to be developed but fail to adequately recognise the integral role of the CNS in the pain experience. This omission neglects a whole body of pertinent literature, that might offer some further explanation as to why attempts to link symptoms to peripheral structural pathology continue to fall short (Moseley, 2007;Wand et al, 2011).…”

Section: Background To the Role Of The Cnsmentioning

confidence: 99%

The central nervous system – An additional consideration in ‘rotator cuff tendinopathy’ and a potential basis for understanding response to loaded therapeutic exercise

et al. 2013

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“…Rapid advances in our understanding of the role of the brain in chronic pain has seen the development of treatments for chronic pain that directly target cortical reorganisation 32,44 . The first of these treatments was developed in response to remarkable findings in amputees with phantom limb pain (PLP), which showed that pain was associated with reorganisation of the primary sensory cortex contralateral to the amputated limb.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Graded Motor Imagery and Its Components on Chronic Pain: A Systematic Review and Meta-Analysis

Bowering

O’Connell

Tabor

et al. 2013

The Journal of Pain

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Running title: Effect of graded motor imagery on chronic pain Indexing words:Graded motor imagery, GMI, mirror therapy, motor imagery left/right judgements, chronic pain, systematic review 2 AbstractGraded motor imagery (GMI) is becoming increasingly used in the treatment of chronic pain conditions. The objective of this systematic review was to synthesise all evidence concerning the effects of GMI and its constituent components on chronic pain. Systematic searches were conducted in 10 electronic databases. All randomised controlled trials (RCTs) of GMI, left/right judgement training, motor imagery, and mirror therapy used as a treatment for chronic pain were included.Methodological quality was assessed using the Cochrane risk of bias tool. Six RCTs met our inclusion criteria and the methodological quality was generally low. No effect was seen for left/right judgement training and conflicting results were found for motor imagery used as stand-alone techniques, but positive effects were observed for both mirror therapy and GMI. A meta-analysis of GMI versus usual physiotherapy care favoured GMI in reducing pain (2 studies, n = 63; effect size 1.06 (0.41, 1.71); heterogeneity, I 2 = 15%). Our results suggest that GMI and mirror therapy alone may be effective although this conclusion is based on limited evidence. Further rigorous studies are needed to investigate the effects of GMI and its components on a wider chronic pain population.Perspective: This systematic review synthesises the evidence for GMI and its constituent components on chronic pain. This review may assist clinicians in making evidence-based decisions on managing patients with chronic pain conditions.

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Cortical changes in chronic low back pain: Current state of the art and implications for clinical practice

Cited by 298 publications

References 74 publications

The validity of O’Sullivan’s classification system (CS) for a sub-group of NS-CLBP with motor control impairment (MCI): Overview of a series of studies and review of the literature

The validity of O’Sullivan’s classification system (CS) for a sub-group of NS-CLBP with motor control impairment (MCI): Overview of a series of studies and review of the literature

The central nervous system – An additional consideration in ‘rotator cuff tendinopathy’ and a potential basis for understanding response to loaded therapeutic exercise

The Effects of Graded Motor Imagery and Its Components on Chronic Pain: A Systematic Review and Meta-Analysis

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