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Tactile acuity and lumbopelvic motor control in patients with back pain and healthy controls

PainSci » bibliography » Luomajoki et al 2011
updated
Tags: etiology, back pain, mind, exercise, massage, pro, pain problems, spine, self-treatment, treatment, manual therapy

One page on PainSci cites Luomajoki 2011: The Complete Guide to Low Back Pain

PainSci notes on Luomajoki 2011:

This study showed that patients with back pain have decreased tactile acuity and coordination — that is, their sense of touch goes on the blink, and their movement precision is a bit wonky. Touch accuracy is determined by the minimum distance apart that two points of contact can be distinguished: 10mm for a healthy person, but 13mm for those with low back pain. The worse the touch accuracy in a patient, the worse the coordination as well. The authors speculated that “training tactile acuity may aid recovery and assist in achieving normal motor performance after back injury.” That’s quite a leap, but it’s not an unreasonable question to ask (and it could be an example of the potential value of touch therapy for assisting with normalizing a patient’s sense of self).

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: Voluntary lumbopelvic control is compromised in patients with back pain. Loss of proprioceptive acuity is one contributor to decreased control. Several reasons for decreased proprioceptive acuity have been proposed, but the integrity of cortical body maps has been overlooked. We investigated whether tactile acuity, a clear clinical signature of primary sensory cortex organisation, relates to lumbopelvic control in people with back pain.

METHODS: Forty-five patients with back pain and 45 age- and sex-matched healthy controls participated in this cross-sectional study. Tactile acuity at the back was assessed using two-point discrimination (TPD) threshold in vertical and horizontal directions. Voluntary motor control was assessed using an established battery of clinical tests.

RESULTS: Patients performed worse on the voluntary lumbopelvic tasks than healthy controls did (p<0.001). TPD threshold was larger in patients (mean (SD)=61 (13) mm) than in healthy controls (44 (10) mm). Moreover, larger TPD threshold was positively related to worse performance on the voluntary lumbopelvic tasks (Pearson's r=0.49; p<0.001).

DISCUSSION: Tactile acuity, a clear clinical signature of primary sensory cortex organisation, relates to voluntary lumbopelvic control. This relationship raises the possibility that the former contributes to the latter, in which case training tactile acuity may aid recovery and assist in achieving normal motor performance after back injury.

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