Driving Plasticity in the Motor Brain in Chronic Back Pain
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Chronic Low Back Pain
- Sponsor
- The University of Queensland
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Motor cortical map and excitability from transcranial magnetic stimulation
- Status
- Completed
- Last Updated
- 17 years ago
Overview
Brief Summary
The motor cortex of the brain changes following chronic pain and injury, and this is linked to pain-associated changes in motor behaviour. This study aimed to investigate whether therapeutic exercises in patients with chronic pain can induce reorganisation of the motor cortex and restore normal motor behaviour. The investigators hypothesised that motor training can induce reorganisation of the motor cortex and that these changes are related to improved motor behaviour.
Detailed Description
The sensory and motor systems can reorganize following injury and learning of new motor skills. Recently we observed adaptive changes in motor cortical organization in patients with chronic back pain, which are closely linked to changes in motor behavior. Although pain-related alterations in behavior can be trained and are associated with improved symptoms, it remains unclear whether these meaningful functional outcomes are related to motor cortical reorganization. Here we investigate the effects of two interventions in people with chronic back pain: skilled motor training and a control intervention of self-paced walking exercise. We measured motor cortical excitability (motor threshold (MT)) and organization (center of gravity (CoG) and map volume) of the deep abdominal muscle, transversus abdominis (TrA), using transcranial magnetic stimulation (TMS). In addition, motor behavior of TrA was assessed during single rapid arm movements. The study helps to elucidate the mechanisms of specific motor exercises in chronic back pain management.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Sustained or episodic non-specific low back pain lasting longer than 3 months
Exclusion Criteria
- •Orthopaedic, neurological, circulatory or respiratory conditions
- •History or family history of epilepsy
- •Recent or current pregnancies
- •Previous surgery to the abdomen or back
- •Abdominal or back exercises in the preceding 12 months
Outcomes
Primary Outcomes
Motor cortical map and excitability from transcranial magnetic stimulation
Time Frame: Pre and 2 weeks post-intervention
Secondary Outcomes
- Motor activation of the abdominal muscles during functional arm movement task(Pre and 2 weeks post-intervention)
- Self-reported pain (VAS scale) and functional scale (patient-specific functional scale)(Pre and 2 weeks post-intervention)