thinking about movement hurts

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Thinking about Movement Hurts Lorimer Moseley NHMRC Senior Research Fellow Prince of Wales Medical Research Institute, Sydney, Australia Senior Fellow The GAMFI project University of Oxford, UK © GL Moseley www.BodyInMind.com.au

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Slides to accompany paper Thinking about movement hurts. Evidence that motor imagery increases pain and swelling in people with chronic upper limb pain. Arthritis Care & Research 59,5 623-31

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Page 1: Thinking about Movement Hurts

Thinking about Movement Hurts

Lorimer MoseleyNHMRC Senior Research FellowPrince of Wales Medical Research Institute, Sydney, Australia

Senior FellowThe GAMFI projectUniversity of Oxford, UK

© GL Moseley www.BodyInMind.com.au

Page 2: Thinking about Movement Hurts

© GL Moseley www.BodyInMind.com.au

Mean (circles) and 95% confidence intervals for the effect of pain before the task, the duration of symptoms and patient group (CRPS1 or non-CRPS1 pain) on pain (A) and swelling (B) immediately after the task. Units for pain are in mm on a 100 mm visual analogue scale (VAS) and for swelling are percent change in the ratio between measures taken on the affected side and those taken on the unaffected side.

Page 3: Thinking about Movement Hurts

© GL Moseley www.BodyInMind.com.au

All patients. Scatterplot for change in pain (x-axis) in mm on a 100 mm VAS and change in swelling, in percentage change in the ratio between affected and unaffected limb circumference (r2 =0.378, p <0.001).

Page 4: Thinking about Movement Hurts

© GL Moseley www.BodyInMind.com.au

Individual data for patients with CRPS1 (top panels) and non-CRPS1 pain (bottom panels) for swelling (left) and pain (right), before (pre) immediately after (post) and 60 minutes after (60 min) the imagined movements task. Solid lines represent patients who had symptoms for more than 8 months and dotted lines represent patients who had symptoms for less than 8 months.

Page 5: Thinking about Movement Hurts

© GL Moseley www.BodyInMind.com.au

Mean (circles) and 95% confidence intervals for the effect of symptoms on change in pain (left panel) and swelling (right panel) over the course of the task. Units for pain are in mm on a 100 mm visual analogue scale (VAS) and for swelling are percent change in the ratio between measures taken on the affected side and those taken on the unaffected side. Note that perceived size is associated with an increase in pain and swelling and the symptom of allodynia is associated with a decrease in swelling.

Page 6: Thinking about Movement Hurts

© GL Moseley www.BodyInMind.com.au

Mean (circles) and 95% confidence intervals for the effect of signs on change in pain (left panel) and swelling (right panel) over the course of the task. Units for pain are in mm on a 100 mm visual analogue scale (VAS) and for swelling are percent change in the ratio between measures taken on the affected side and those taken on the unaffected side. Note that RT to recognise limb laterality is associated with an increase in pain and swelling.

Page 7: Thinking about Movement Hurts

© GL Moseley www.BodyInMind.com.au

Mean (bold lines) and standard deviation (fine lines) for heart rate (HR) and galvanic skin response (GSR) as a proportion of control values, during and after the imagined movements task.. Note an initial increase in both measures in both groups and apparent extended elevated period for HR in the CRPS1 group only.