Changing the visual body appearance by use of as virtual reality system, funny mirror, or binocular glasses has been reported to be helpful in rehabilitation of pain. However, there are interindividual differences in the analgesic effect of changing the visual body image. We hypothesized that a negative body image associated with changing the visual body appearance causes interindividual differences in the analgesic effect although the relationship between the visual body appearance and analgesic effect has not been clarified. We investigated whether a negative body image associated with changes in the visual body appearance increased pain. Twenty-five healthy individuals participated in this study. To evoke a negative body image, we applied the method of rubber hand illusion. We created an “injured rubber hand” to evoke unpleasantness associated with pain, a “hairy rubber hand” to evoke unpleasantness associated with embarrassment, and a “twisted rubber hand” to evoke unpleasantness associated with deviation from the concept of normality. We also created a “normal rubber hand” as a control. The pain threshold was measured while the participant observed the rubber hand using a device that measured pain caused by thermal stimuli. Body ownership experiences were elicited by observation of the injured rubber hand and hairy rubber hand as well as the normal rubber hand. Participants felt more unpleasantness by observing the injured rubber hand and hairy rubber hand than the normal rubber hand and twisted rubber hand (p<0.001). The pain threshold was lower under the injured rubber hand condition than with the other conditions (p<0.001). We conclude that a negative body appearance associated with pain can increase pain sensitivity.
In human postural control, touching a fingertip to a stable object with a slight force (<1 N) reduces postural sway independent of mechanical support, which is referred to as the effect of light touch (LT effect). The LT effect is achieved by the spatial orientation according to haptic feedback acquired from an external spatial reference. However, the neural mechanism of the LT effect is incompletely understood. Therefore, the purpose of this study was to employ EEG frequency analysis to investigate the cortical brain activity associated with the LT effect when attentional focus was strictly controlled with the eyes closed during standing (i.e., control, fixed-point touch, sway-referenced touch, and only fingertip attention). We used EEG to measure low-alpha (about 8-10 Hz) and high-alpha rhythm (about 10-12 Hz) task-related power decrease/increase (TRPD/TRPI). The LT effect was apparent only when the subject acquired the stable external spatial reference (i.e., fixed-point touch). Furthermore, the LT-specific effect increased the high-alpha TRPD of two electrodes (C3, P3), which were mainly projected from cortical brain activities of the left primary sensorimotor cortex area and left posterior parietal cortex area. Furthermore, there was a negative correlation between the LT effect and increased TRPD of C3. In contrast, the LT effect correlated positively with increased TRPD of P3. These results suggest that central and parietal high-alpha TRPD of the contralateral hemisphere reflects the sensorimotor information processing and sensory integration for the LT effect. These novel findings reveal a partial contribution of a cortical neural mechanism for the LT effect.
The effects of vestibular rehabilitation on poststroke patients are unknown. This study aimed to investigate whether or not vestibular rehabilitation would improve both the vestibulo-ocular reflex and gait performance of patients with poststroke hemiparesis. Twenty-eight patients with stroke were assigned randomly to either an experimental group (N=14) or a control group (N=14). The experimental group performed the conventional physical therapy for 40 min and vestibular rehabilitation for 20 min, as a 60 min session, during the first 3 weeks and then completed only the conventional intervention for 60 min for the following 3 weeks. The control group performed only the 60 min conventional physical therapy for 6 weeks. Both groups were measured using the gaze stabilization test, the 10 m walking test, the timed up and go test, and the dynamic gait index. Patients were assessed at baseline, and at 3 and 6 weeks. Although the control group showed no significant difference in any outcome measures, the experimental group showed an improvement in gaze stabilization test scoring, which increased significantly after 3 weeks compared with the baseline (P=0.030). The dynamic gait index was also significantly increased after 3 and 6 weeks compared with the baseline (P=0.049 and 0.024, respectively). This study indicated that vestibular rehabilitation might improve poststroke patients' vestibulo-ocular reflex. Moreover, patients might show improved gait performance at least up to 3 weeks after the vestibular intervention by the sensory reweight to coordinate vestibular input.
Modulation of pain using visual distortion of body size (VDBS) has been the subject of various reports. However, the mechanism underlying the effect of VDBS on pain has been less often studied. In the present study, factors associated with modulation of pain threshold by VDBS were investigated. Visual feedback in the form of a magnified image of the hand was provided to 44 healthy adults to examine changes in pain. In participants with a higher pain threshold when visual feedback of a magnified image of the hand was provided, the two-point discrimination threshold decreased. In contrast, participants with a lower pain threshold with visual feedback of a magnified image of the hand experienced unpleasant emotions toward the magnified image of the hand. Interestingly, this emotional reaction was strongly associated with negative body consciousness in several subjects. These data suggested an analgesic effect of visual feedback in the form of a magnified image of the hand is only when tactile perception is vivid and the emotional reaction toward the magnified image is moderate. The results also suggested that negative body consciousness is important for the modulation of pain using VDBS.
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