EMBODYING THE ILLUSION OF A STRONG, FIT BACK IN PEOPLE WITH CHRONIC LOW BACK PAIN. A PILOT PROOF-OF -CONCEPT STUDY

Review written by Robin Kerr info

BACKGROUND & OBJECTIVE

People experiencing persistent low back pain may exhibit alterations in cortical structure and function, including the areas involved in self-perception of the low back. Perceptions of fragility, weakness or vulnerability of the lumbar spine are common maladaptive beliefs potentially reinforcing factors for ongoing pain and disability.

This pilot study was an investigation into the possibility that real-time manipulated visual input, aimed at altering the size and muscularity of a participant’s back to make it look stronger whilst performing a functional task, could provide input to the brain that may be embodied and modify maladaptive self-perceptions.

METHODS

Subjects (n=2) with persistent low back pain and pain experienced during lifting were recruited. An extensive raft of baseline measures relating to low back self-perception were taken. Test Procedure: A head mounted video display was worn which manipulated the size and muscularity of the back. Participants watched live video feed of their own back from the rear. They underwent a standardized procedure to promote embodiment, including tactile stimulation during which they watched their back be touched and move whilst they shrugged and altered position.

A lifting task was then performed (weighted basket @ 80% of back pain causing weight - held in a semi-stooped position for 60 seconds) x 3 for each of the 3 randomized video conditions:

Strong: Overlay of heavy back musculature, shoulders at 125% of normal and waste narrowed to 75% of normal width Reshaped: Widened shoulders and narrowed waist only Normal: Unmodified view of the back Embodiment and back self-perception were assessed after each condition.

RESULTS

Baseline findings: Subject A (72yrs): Distorted back perception, maladaptive beliefs about his back, high pain intensity and severe disability. Subject B (34yrs): Non-distorted back perception, minimal maladaptive belief about his back, mild pain and disability. Outcomes: Subject A:

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