Abstract
The Left Right Judgement Task (LRJT) involves determining if an image of the body part is of the left or right side. The LRJT has been utilized as part of rehabilitation treatment programs for persons with pain associated with musculoskeletal injuries and conditions. Although studies often attribute changes and improvement in LRJT performance to an altered body schema, imaging studies suggest that the LRJT implicates other cortical regions. We hypothesized that cognitive factors would be related to LRJT performance of hands and feet and that sensory, motor, and pain related factors would be related to LRJT in the affected hand of participants with wrist/hand pain. In an observational cross-sectional study, sixty-one participants with wrist/hand pain participated in a study assessing motor imagery ability, cognitive (Stroop test), sensory (Two-Point Orientation Discrimination, pressure pain thresholds), motor (grip strength, Purdue Pegboard Test), and pain related measures (West Haven Yale Multidimensional Pain Inventory) as well as disability (Disability of the Arm, Shoulder and Hand). Multiple linear regression found Stroop test time and motor imagery ability to be related to LRJT performance. Tactile acuity, motor performance, participation in general activities, and the taking of pain medications were predictors of LRJT accuracy in the affected hand. Participants who took pain medications performed poorly in both LRJT accuracy (p=0.001) and reaction time of the affected hand (p=0.009). These participants had poorer cognitive (p=0.013) and motor function (p=0.002), and higher pain severity scores (p=0.010). The results suggest that the LRJT is a complex mental task that involves cognitive, sensory, motor, and behavioural processes. Differences between persons with and without pain and improvement in LRJT performance may be attributed to any of these factors and should be considered in rehabilitation research and practice utilizing this task.
Highlights
The Left Right Judgement Task (LRJT) involves determining, as accurately and as quickly as possible, if an image of a body part is of the left or right side
It has been suggested that the LRJT implicates the body schema as accuracy and reaction time (RT) are affected by both the position of the participant’s anatomical part in space and the number of movements necessary to position the participant’s body part to conform to that seen on the image [20,21,22,23]
Novel and unexpected findings are that participants who indicated that they had taken pain medication on the day of the evaluation performed more poorly in the LRJT and that activities and participation were positively associated with better LRJT performance in the affected hand only
Summary
The Left Right Judgement Task (LRJT) involves determining, as accurately and as quickly as possible, if an image of a body part is of the left or right side. Studies involving the LRJT have been performed with persons experiencing pain associated with musculoskeletal injuries and conditions with variable findings. These include no changes in LRJT performance [6], localised [7, 8], bilateral. It has been suggested that the LRJT implicates the body schema as accuracy and reaction time (RT) are affected by both the position of the participant’s anatomical part in space and the number of movements necessary to position the participant’s body part to conform to that seen on the image [20,21,22,23]
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