Movements, Lumbar and Temporomandibular Pain and Psychopathology

Abstract

157 males and females divided into four psychodiagnostic groups have been examined according to a specially defined physiotherapeutic method (ad modum Sundsvold). In this paper, results from the evaluation of passive and active movements in five body regions in both males and females are presented (36 variables). In all five body regions, significant differences concerning inhibited movements between the four groups were found, the psychotic group being most inhibited followed by the ego-weak neurotic group, the substance-abusing group and the healthy control group. With regard to the slack movements, significant differences were found in the two extremity regions. The substance-abusing group had the most slack movements, next came the ego-weak neurotic group, the psychotic group and lastly the control group. Men were more inhibited than women in three regions, mostly in the lumbosacral region. This finding is discussed in relationship to the high frequency of lumbar disc herniation in men. Women were more significantly inhibited in the temporomandibular region, a finding which may explain why mostly women are suffering from the myofacial pain syndrome.

Maintenance of induced muscle tension, stimulus generalization performance, and schizophrenia

“…Clinical examinations have demonstrated that psychotic patients deviate from neurotics and normals in the degree of adequate postural muscle tension, muscular elasticity, and muscular resistance to passive movements (Sundsvold, 1975;Sundsvold, Vaglum, & Ostberg, 1981). Furthermore, Meltzer (1976) has described evidence of biochemical abnormalities, morphological changes in the muscle fibers and motor nerves, and neurophysiological abnormalities in the nerve condition velocity and Hoffman-reflect of schizophrenic subjects relative to normal controls (Goode, Meltzer, Crayton, & Mazura, 1977).…”

Examination of movement in patients with long‐lasting musculoskeletal pain: reliability and validity

“…* During an introductory course (two to three days) it is stressed how to standardize, and how to transform the observations or measures to the scoring scale. Items included in the GPM have been selected based on two main criteria: variables should represent the whole body, and have the greatest possible capacity for discriminating between groups of patients with different degrees of psychopathology (Sundsvold, 1975;Sundsvold et al, 1981;Sundsvold and Vaglum, 1985). Tests in standing and in stooping are performed first, then passive tests, followed by active movements in a supine position.…”

“…Earlier studies have indicated acceptable inter-tester reliability within the movement domain, measured with mean, standard deviation (SD) and Pearson's r (r >0.80) (Sundsvold and Vaglum, 1985;Kvåle and Sundsvold, 1991;Sundsvold et al, 1991). Validity studies have shown signif icant differences in scores between patients with substance abuse, psychosomatic and/or psychiatric problems, and healthy subjects recruited from students and health personnel (Sundsvold et al, 1981).…”

“…As the GPM method was originally developed from psychosomatic physiotherapy, test variables have been selected that seemed most sensitive in patients with psychosomatic and psychiatric disorders (Sundsvold, 1969;Sundsvold, 1975;Sundsvold et al, 1980;Sundsvold et al, 1981;Sundsvold and Vaglum, 1985). Whether the same items should be included in the examination of pain patients, has not yet been examined.…”

Amalgam og psykosomatiske tilstander

“…Psykosomatisk orienterte psykiatere har pekt p i at mange av disse pasientene har vanskelig for uttrykke f~lelser (alexithymi) og derfor kommer frem med konflikter og spenninger i form av kroppslige symptomer (5,7). Psykofysiologer p i sin side har fremsatt teorier om tonisk aktivering over tid pga psykologisk konflikt som f~r e r ti1 muskelforandringer og somatiske symptomer (8,9,10). Alle synes i vrere enige om at somatiseringstilstander er en heterogen gruppe lidelser med sannsynlig tildela ulike patogenetiske faktorer fra pasient ti1 pasient.…”