title: Are tactile acuity and clinical symptoms related to differences in perceived body image in patients with chronic nonspecific lower back pain?
abstract: Clinically, perceived image of the lower back and the two-point discrimination (TPD) test are used as markers for evaluating alterations of cortical reorganization. The purpose of the present study was to examine whether TPD and selected clinical findings are different in subgroups of individuals with chronic nonspecific lower back pain (CNLBP) based on body image drawings. Forty-two patients with CNLBP and seventeen healthy individuals were recruited. Perceived body image, TPD and clinical profiles was measured. Of the patients with CNLBP, 42.8% had a normal perceived body image, 28.5% an expanded image, and 28.5% a shrunken image. The TPD distance threshold was significantly larger for the expanded subgroup (13.3 ± 6.8 mm) compared with the control (5.5 ± 3.8 mm; Difference, 7.8; 95%CI, 1.83 to 13.66; p < 0.05) and normal subgroups (4.5 ± 5.5 mm; Difference, 8.8; 95%CI, 2.90 to 14.59; p < 0.05). No significant differences in pain intensity, duration of pain, Roland Morris Disability Questionnaire (RDQ), and Pain Catastrophizing Scale (PCS) scores were found between three body image subgroups. Our results suggest that TPD is increased in patients who report an expanded perceived image of the lower back compared with healthy individuals and patients who report a normal image. The effectiveness of new rehabilitation techniques may be evaluated by assessing perceived image of the lower back and TPD values for patients with CNLBP before and after treatment.
authors: Department of Nursing and Physical Therapy, Konan Woman's University, 6-2-23, Morikita-machi, Higashinada-ku, Kobe, 658-0001, Japan. Electronic address: t-nishi@konan-wu.ac.jp.
authors: Tomohiko
authors: T
authors: Nishigami
authors: Department of Rehabilitation, Tanabe Orthopaedics Clinic, 5-52, Tennouji-ku, Osaka, Japan.
authors: Akira
authors: A
authors: Mibu
authors: Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, 4-2-2, Kitakatsuragi-gun, Kouryou-tyou, Japan.
authors: Michihiro
authors: M
authors: Osumi
authors: Department of Rehabilitation, Tanabe Orthopaedics Clinic, 5-52, Tennouji-ku, Osaka, Japan.
authors: Kouki
authors: K
authors: Son
authors: Department of Rehabilitation, Tanabe Orthopaedics Clinic, 5-52, Tennouji-ku, Osaka, Japan.
authors: Shyogo
authors: S
authors: Yamamoto
authors: Department of Rehabilitation, Tanabe Orthopaedics Clinic, 5-52, Tennouji-ku, Osaka, Japan.
authors: Saori
authors: S
authors: Kajiwara
authors: Department of Rehabilitation, Tanabe Orthopaedics Clinic, 5-52, Tennouji-ku, Osaka, Japan.
authors: Katsuyoshi
authors: K
authors: Tanaka
authors: Department of Nursing and Physical Therapy, Konan Woman's University, 6-2-23, Morikita-machi, Higashinada-ku, Kobe, 658-0001, Japan.
authors: Ayako
authors: A
authors: Matsuya
authors: Department of Rehabilitation, Tanabe Orthopaedics Clinic, 5-52, Tennouji-ku, Osaka, Japan.
authors: Akihito
authors: A
authors: Tanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001828:Body Image / Q000523:psychology*; D016022:Case-Control Studies; D058443:Catastrophization / Q000523:psychology; D059350:Chronic Pain / Q000503:physiopathology* / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D014110:Touch / Q000502:physiology*
keywords: Body image; Cortical reorganization; Low back pain; Tactile acuity