Moving in an Environment of Induced Sensorimotor Incongruence Does Not Influence Pain Sensitivity in Healthy Volunteers: A Randomised Within-Subject Experiment

Abstract

ObjectivesIt has been proposed that in the same way that conflict between vestibular and visual inputs leads to motion sickness, conflict between motor commands and sensory information associated with these commands may contribute to some chronic pain states. Attempts to test this hypothesis by artificially inducing a state of sensorimotor incongruence and assessing self-reported pain have yielded equivocal results. To help clarify the effect sensorimotor incongruence has on pain we investigated the effect of moving in an environment of induced incongruence on pressure pain thresholds (PPT) and the pain experienced immediately on completion of PPT testing.MethodsThirty-five healthy subjects performed synchronous and asynchronous upper-limb movements with and without mirror visual feedback in random order. We measured PPT over the elbow and the pain evoked by testing. Generalised linear mixed-models were performed for each outcome. Condition (four levels) and baseline values for each outcome were within-subject factors.ResultsThere was no effect of condition on PPT (p = 0.887) or pressure-evoked pain (p = 0.771). A sensitivity analysis using only the first PPT measure after each condition confirmed the result (p = 0.867).DiscussionInducing a state of movement related sensorimotor incongruence in the upper-limb of healthy volunteers does not influence PPT, nor the pain evoked by testing. We found no evidence that sensorimotor incongruence upregulates the nociceptive system in healthy volunteers.

Sensorimotor Incongruence in People with Musculoskeletal Pain: A Systematic Review

“…The level of conclusion was judged as level 2. In most studies (87.5%), experimental conditions were randomized . Few studies (12.5%) reported allocation concealment and blinding of assessors .…”

“…In most studies (87.5%), experimental conditions were randomized . Few studies (12.5%) reported allocation concealment and blinding of assessors . All studies held participants naive to the purpose of the study, and 3 studies thereof (37.5%) described exactly how participants were given a different rationale of the study to prevent expectancy bias .…”

“…In 4 studies, the washout period was described as a rest period that lasted until sensations disappeared or returned to their baseline status . The study of Wand et al had the longest washout period (15 minutes). The study of Foell et al had the shortest washout period (1 second).…”

“…Evidence has shown that experimental SMI causes pain and additional symptoms in participants with fibromyalgia and whiplash‐associated disorders . Contradictory evidence comes from studies investigating healthy individuals . These studies show that experimental SMI does not cause pain, although most studies show that sensory disturbances are frequent.…”

Dysesthesia symptoms produced by sensorimotor incongruence in healthy volunteers: an electroencephalogram study

“…However, Foell et al3 reported that the perception of pain due to sensorimotor incongruence is less than in other dysesthesias. In addition, Wand et al30 reported that pain does not appear with sensorimotor incongruence and that the pressure pain threshold does not change. Clinical studies have reported that dysesthesia is more severe in patients who are already in pain and who are made to move in conditions of sensorimotor incongruence compared with healthy individuals.…”