Abstract
Neuroscientific studies have shown that human's mental body representations are not fixed but are constantly updated through sensory feedback, including sound feedback. This suggests potential new therapeutic sensory approaches for patients experiencing body-perception disturbances (BPD). BPD can occur in association with chronic pain, for example in Complex Regional Pain Syndrome (CRPS). BPD often impacts on emotional, social, and motor functioning. Here we present the results from a proof-of-principle pilot study investigating the potential value of using sound feedback for altering BPD and its related emotional state and motor behavior in those with CRPS. We build on previous findings that real-time alteration of the sounds produced by walking can alter healthy people's perception of their own body size, while also resulting in more active gait patterns and a more positive emotional state. In the present study we quantified the emotional state, BPD, pain levels and gait of twelve people with CRPS Type 1, who were exposed to real-time alteration of their walking sounds. Results confirm previous reports of the complexity of the BPD linked to CRPS, as participants could be classified into four BPD subgroups according to how they mentally visualize their body. Further, results suggest that sound feedback may affect the perceived size of the CRPS affected limb and the pain experienced, but that the effects may differ according to the type of BPD. Sound feedback affected CRPS descriptors and other bodily feelings and emotions including feelings of emotional dominance, limb detachment, position awareness, attention and negative feelings toward the limb. Gait also varied with sound feedback, affecting the foot contact time with the ground in a way consistent with experienced changes in body weight. Although, findings from this small pilot study should be interpreted with caution, they suggest potential applications for regenerating BDP and its related bodily feelings in a clinical setting for patients with chronic pain and BPD.
Highlights
Anomalous bodily experiences accompany a number of chronic pain conditions, such as in the case of complex regional pain syndrome (CRPS), known as Reflex Sympathetic Dystrophy Syndrome (RSD)
We did not use statistical tests for comparison within the four body-perception disturbances (BPD) subgroups we identified based on the pre-test bodyrepresentation drawings (“Big,” “Small,” “Mixed,” and “Nothing” groups, as described in the Results Section) but we discuss the observed trends for each subgroup as displayed in figures and tables as these trends may provide some insight and inform the design of a larger study conducted in order to establish whether the type of BPD modulates the effect of sound feedback in CRPS
Pre-test body-representation drawings were produced based on participants verbal descriptions of their body perception when asked to visualize it with eyes closed as part of the CRPS BPD scale
Summary
Anomalous bodily experiences accompany a number of chronic pain conditions, such as in the case of complex regional pain syndrome (CRPS), known as Reflex Sympathetic Dystrophy Syndrome (RSD). CRPS may initially affect a single limb, but rarely may spread throughout the body. It may occur following injury and major nerve damage (Type 2), or after minor trauma with no apparent nerve injury, or spontaneously (Type 1). Sufferers of CRPS describe a severe, continuous, and debilitating pain in their affected limb, and 55–85% of these sufferers experience some sort of body perception disturbances (Lewis and McCabe, 2010)
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