Do People With Chronic Musculoskeletal Pain Have Impaired Motor Imagery? A Meta-analytical Systematic Review of the Left/Right Judgment Task

Breckenridge, John D.; Ginn, Karen A.; Wallwork, Sarah B.; McAuley, James H.

doi:10.1016/j.jpain.2018.07.004

Cited by 53 publications

(60 citation statements)

References 49 publications

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“…Reduced accuracy in the neck left/right judgement task, but not in the hand task, supports the somatotopically specific nature of impairments in proprioceptive representation. This specificity of impairment is largely consistent with past research in several chronic pain conditions, including back pain (Bowering et al, 2014) and arm pain (Schwoebel et al, 2001;Moseley, 2004b) (see also systematic review findings: (Breckenridge et al, 2018)), and also in experimentally induced pain (Moseley et al, 2005) and even the expectation of experimentally induced pain (Hudson et al, 2006). It is important to consider the wider body of evidence when interpreting the current results because different problems might underpin impairment of accuracy as distinct from response time.…”

Section: Effect Of Pain Duration On Task Performancesupporting

confidence: 85%

“…There is accumulating evidence that people with chronic pain are less accurate at left/right judgement tasks that use images that correspond to the painful body-part (Breckenridge et al, 2018), suggesting disruptions to neural proprioceptive representations that are associated with movement. Our findings are consistent with this body of literature and specifically support previous work in people with recurrent, idiopathic neck pain that showed lower accuracy at a left/right neck judgement task than that observed in people without neck pain (Elsig et al, 2014).…”

Section: Effect Of Pain Duration On Task Performancementioning

confidence: 99%

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Implicit motor imagery performance is impaired in people with chronic, but not acute, neck pain

Wallwork

Leake

Peek

et al. 2020

PeerJ

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Background People with chronic neck pain have impaired proprioception (i.e., sense of neck position). It is unclear whether this impairment involves disruptions to the proprioceptive representation in the brain, peripheral factors, or both. Implicit motor imagery tasks, namely left/right judgements of body parts, assess the integrity of the proprioceptive represention. Previous studies evaluating left/right neck judgements in people with neck pain are conflicting. We conducted a large online study to comprehensively address whether people with neck pain have altered implicit motor imagery performance. Methods People with and without neck pain completed online left/right neck judgement tasks followed by a left/right hand judgement task (control). Participants judged whether the person in the image had their head rotated to their left or right side (neck task) or whether the image was of a left hand or a right hand (hand task). Participants were grouped on neck pain status (no pain; <3 months—acute; ≥3 months—chronic) and pain location (none, left-sided, right-sided, bilateral). Outcomes included accuracy (primary) and response time (RT; secondary). Our hypotheses—that (i) chronic neck pain is associated with disrupted performance for neck images and (ii) the disruption is dependent on the side of usual pain, were tested with separate ANOVAs. Results A total of 1,404 participants were recruited: 105 reported acute neck pain and 161 reported chronic neck pain. When grouped on neck pain status, people with chronic neck pain were less accurate than people without neck pain (p = 0.001) for left/right neck judgements, but those with acute neck pain did not differ from those without neck pain (p = 0.14) or with chronic neck pain (p = 0.28). Accuracy of left/right hand judgements did not differ between groups (p = 0.58). RTs did not differ between groups for any comparison. When grouped on neck pain location, people were faster and more accurate at identifying right-turning neck images than left-turning neck images, regardless of history or location of pain (p < 0.001 for both); people with no pain were more accurate and faster than people with bilateral neck pain (p = 0.001, p = 0.015) and were faster than those with left-sided neck pain (p = 0.021); people with right-sided neck pain were more accurate than people with bilateral neck pain (p = 0.018). Lastly, there was a significant interaction between neck image and side of neck pain: people with right-sided neck pain were more accurate at identifying right-sided neck turning images than people with left-sided neck pain (p = 0.008), but no different for left-sided neck turning images (p = 0.62). Conclusions There is evidence of impaired implicit motor imagery performance in people with chronic neck pain, which may suggest disruptions to proprioceptive representation of the neck. These disruptions seem specific to the neck (performance on hand images intact) but non-specific to the exact location of neck pain.

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Section: Effect Of Pain Duration On Task Performancesupporting

confidence: 85%

Section: Effect Of Pain Duration On Task Performancementioning

confidence: 99%

Implicit motor imagery performance is impaired in people with chronic, but not acute, neck pain

Wallwork

Leake

Peek

et al. 2020

PeerJ

Self Cite

View full text Add to dashboard Cite

show abstract

“…Reduced accuracy in the neck left/right judgement task, but not in the hand task, supports the somatotopically specific nature of impairments in proprioceptive representation. This specificity of impairment is largely consistent with past research in several chronic pain conditions, including back pain (Bowering, Butler et al 2014) and arm pain (Schwoebel, Friedman et al 2001) (see also systematic review findings: (Breckenridge, Ginn et al 2018)), and also in experimentally induced pain (Moseley, Sim et al 2005) and even the expectation of experimentally induced pain (Hudson, McCormick et al 2006). It is important to consider the wider body of evidence when interpreting the current results because different problems might underpin impairment of accuracy as distinct from response time.…”

Section: Effect Of Pain Duration On Task Performancesupporting

confidence: 85%

“…There is accumulating evidence that people with chronic pain are less accurate at left/right judgement tasks that use images that correspond to the painful body-part (Breckenridge, Ginn et al 2018), indicating disruptions to neural proprioceptive representations that are associated with movement. Our findings are consistent with this body of literature and specifically support previous work in people with recurrent, idiopathic neck pain that showed lower accuracy at a left/right neck judgement task, than that observed in people without neck pain (Elsig, Luomajoki et al 2014).…”

Section: Effect Of Pain Duration On Task Performancementioning

confidence: 99%

Peer Review #1 of "Implicit motor imagery performance is impaired in people with chronic, but not acute, neck pain (v0.2)"

2020

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Background: People with chronic neck pain have impaired proprioception (i.e., sense of neck position). It is unclear whether this impairment involves disruptions to the proprioceptive representation in the brain, peripheral factors, or both. Implicit motor imagery tasks, namely left/right judgements of body parts, assess the integrity of the proprioceptive represention. Previous studies evaluating left/right neck judgements in people with neck pain are conflicting. We conducted a large online study to comprehensively address whether people with neck pain have altered proprioceptive representation.

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“…Pain related cortical changes can be explored indirectly by motor imagery, one method being the left/right judgement task (LRJT) [ 40 ] requiring activation of proprioceptive, somatosensory, premotor and related regions. Altered motor imagery performance seems to be a feature of a number of chronic pain conditions [ 41 ], but there is uncertainty whether motor imagery performance is altered in people with chronic shoulder pain [ 42 , 43 ]. A second method of exploring pain related somatosensory changes is through tactile acuity testing and the prevailing approach is the two-point discrimination threshold test [ 44 ].…”

Section: Introductionmentioning

confidence: 99%

Motor Imagery Performance and Tactile Spatial Acuity: Are They Altered in People with Frozen Shoulder?

Breckenridge

McAuley

Ginn

2020

IJERPH

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Frozen shoulder (adhesive capsulitis) is a severe chronic pain condition that is not well understood and current treatment is suboptimal. In several other chronic pain conditions motor imagery and tactile acuity deficits are present, which are thought to represent associated neuroplastic changes. The aims of this study were to determine if motor imagery performance assessed by the left/right judgement task, and tactile acuity assessed by two-point discrimination, are altered in people with unilateral frozen shoulder. In this cross-sectional, prospective study eighteen adults diagnosed with frozen shoulder in a physiotherapy clinic setting completed a left/right judgement task, response times (RT) and accuracy for the left/right judgement task were determined. Next, tactile acuity over both shoulders was assessed with a novel, force-standardised two-point discrimination test. Results corresponding to the affected side were compared to the pain free shoulder; Left/right judgement task: mean RT (SD) corresponding to the affected shoulder was significantly slower than RT for the healthy shoulder (p = 0.031). There was no side-to-side difference in accuracy (p > 0.05). Neither RT nor accuracy was related to pain/disability scores or duration of symptoms (p > 0.05). Two-point discrimination: mean two-point discrimination threshold of the affected shoulder was significantly larger than the contralateral healthy shoulder (p < 0.001). Two-point discrimination threshold was not related to pain/disability scores or pain duration (p > 0.05); One explanation for these findings is altered sensorimotor processing and/or disrupted sensorimotor cortex representations of the affected shoulder. A case then exists for the use of treatments aimed at reversing these changes, training the brain to reduce chronic shoulder pain.

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Do People With Chronic Musculoskeletal Pain Have Impaired Motor Imagery? A Meta-analytical Systematic Review of the Left/Right Judgment Task

Cited by 53 publications

References 49 publications

Implicit motor imagery performance is impaired in people with chronic, but not acute, neck pain

Implicit motor imagery performance is impaired in people with chronic, but not acute, neck pain

Peer Review #1 of "Implicit motor imagery performance is impaired in people with chronic, but not acute, neck pain (v0.2)"

Motor Imagery Performance and Tactile Spatial Acuity: Are They Altered in People with Frozen Shoulder?

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