Explicit and Implicit Own's Body and Space Perception in Painful Musculoskeletal Disorders and Rheumatic Diseases: A Systematic Scoping Review

Abstract

Background: Pain and body perception are essentially two subjective mutually influencing experiences. However, in the field of musculoskeletal disorders and rheumatic diseases we lack of a comprehensive knowledge about the relationship between body perception dysfunctions and pain or disability. We systematically mapped the literature published about the topics of: (a) somatoperception; (b) body ownership; and (c) perception of space, analysing the relationship with pain and disability. The results were organized around the two main topics of the assessment and treatment of perceptual dysfunctions.Methods: This scoping review followed the six-stage methodology suggested by Arksey and O'Malley. Ten electronic databases and grey literature were systematically searched. The PRISMA Extension for Scoping Reviews was used for reporting results. Two reviewers with different background, independently performed study screening and selection, and one author performed data extraction, that was checked by a second reviewer.Results: Thirty-seven studies fulfilled the eligibility criteria. The majority of studies (68%) concerned the assessment methodology, and the remaining 32% investigated the effects of therapeutic interventions. Research designs, methodologies adopted, and settings varied considerably across studies. Evidence of distorted body experience were found mainly for explicit somatoperception, especially in studies adopting self-administered questionnaire and subjective measures, highlighting in some cases the presence of sub-groups with different perceptual features. Almost half of the intervention studies (42%) provided therapeutic approaches combining more than one perceptual task, or sensory-motor tasks together with perceptual strategies, thus it was difficult to estimate the relative effectiveness of each single therapeutic component.Viceconti et al. Body Perception in Musculoskeletal DisordersConclusions: To our knowledge, this is the first attempt to systematically map and summarize this research area in the field of musculoskeletal disorders and rheumatic diseases. Although methodological limitations limit the validity of the evidence obtained, some strategies of assessment tested and therapeutic strategies proposed represent useful starting points for future research. This review highlights preliminary evidence, strengths, and limitations of the literature published about the research questions, identifying key points that remain opened to be addressed, and make suggestions for future research studies. Body representation, as well as pain perception and treatment, can be better understood if an enlarged perspective including body and space perception is considered.

Development and validation of a shoulder-specific body-perception questionnaire in people with persistent shoulder pain

“…Lastly, distinction is made about functional role, particularly whether the representation is action orientated or perception orientated [ 62 ]. A recent scoping review sought to map and examine the range of literature on functional representations of the body in people with musculoskeletal pain disorders [ 63 ]. This group considered the three key domains of body representation pertinent to musculoskeletal pain, the perception of the body (how the body feels to the person), the perception of the space around the body and the sense of ownership of the body, and reviewed both implicit and explicit ways of assessing these domains [ 63 ].…”

“…A recent scoping review sought to map and examine the range of literature on functional representations of the body in people with musculoskeletal pain disorders [ 63 ]. This group considered the three key domains of body representation pertinent to musculoskeletal pain, the perception of the body (how the body feels to the person), the perception of the space around the body and the sense of ownership of the body, and reviewed both implicit and explicit ways of assessing these domains [ 63 ]. Under this taxonomy the FreSHAQ-J would be regarded as measure of explicit body perception, with reasonable face validity as it employs a subjective self-reported scale to measure a subjective consciously felt construct.…”

Body perception disturbances in women with pregnancy-related lumbopelvic pain and their role in the persistence of pain postpartum

“…Body perception refers to the way we consciously perceive our own body and is considered a dynamic construct that depends on ongoing visual, tactile, and proprioceptive input, and is influenced by psychosocial factors, memory, and beliefs [15]. Body perception disturbances have been observed in patients with chronic low back pain [14]. Studies reported that they perceive their back as expanded, shrunken, vulnerable, or fragile [17][18][19][20], and that they exhibit impairments in the mechanisms that support body perception, such as poorer tactile and proprioceptive acuity [21][22][23], problems with localizing and recognizing tactile stimuli [24,25], and impaired trunk motor imagery [26,27].…”

“…Studies reported that they perceive their back as expanded, shrunken, vulnerable, or fragile [17][18][19][20], and that they exhibit impairments in the mechanisms that support body perception, such as poorer tactile and proprioceptive acuity [21][22][23], problems with localizing and recognizing tactile stimuli [24,25], and impaired trunk motor imagery [26,27]. Patients with low back pain also reported a more altered perceptual awareness of the lower back compared to pain-free controls, which correlated with clinical features, such as pain intensity, pain duration, and disability [14,[28][29][30][31][32].…”

“…Instead, multiple biological, psychosocial, and lifestyle factors influence the pain and disability experienced [ 2 ], similar to other musculoskeletal conditions such as low back pain [ 13 ]. Recent studies identified a disturbed body perception as a potential contributor to the pain experience in musculoskeletal conditions [ 14 – 16 ]. Body perception refers to the way we consciously perceive our own body and is considered a dynamic construct that depends on ongoing visual, tactile, and proprioceptive input, and is influenced by psychosocial factors, memory, and beliefs [ 15 ].…”