training the brain 1 cognitive

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Lorimer Moseley NHMRC Senior Research Fellow Prince of Wales Medical Research Institute & Faculty of Medicine, University of NSW, Sydney, Australia CRPS Rehabilitation (or training the brain) www.bodyinmind.com.au Copyright GL Moseley 2009 Complex Regional Pain Syndrome

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Part of training the brain series focused on Complex Regional Pain Syndrome (CRPS) but relevant to all types of pain.

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Page 2: Training The Brain 1 Cognitive

Why train the brain?

CRPS as an extreme protective response.

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 3: Training The Brain 1 Cognitive

Why train the brain?

Our approach to treating CRPS

Cognitive

Understanding the problem

Other threatening cues are relevant

Educate & explain

Behavioural

Function & movement hierarchy

‘training the brain part 1’

Brain changes

S1 reorganisation

Reorganisation elsewhere?

‘training the brain part 2’

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 5: Training The Brain 1 Cognitive

DAVID

BUTLER | LO

RIMER M

OSELEY | ART SU

NYATA

www.noigroup.comwww.OPTP.comwww.physiouk.co.uk

www.noigroup.comwww.physiouk.co.uk

www.OPTP.com

resources

www.amazon.comCA$35 & post.

Page 6: Training The Brain 1 Cognitive

1. Nociception is neither sufficient nor necessary for pain.

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 7: Training The Brain 1 Cognitive

The same thing applies to pain

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 8: Training The Brain 1 Cognitive

The same thing applies to painComplex reasoning

mechanisms based on experience, context,

environment…MEANING

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 9: Training The Brain 1 Cognitive

The same thing applies to painComplex reasoning

mechanisms based on experience, context,

environment…MEANING

pain

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 10: Training The Brain 1 Cognitive

The same thing applies to painComplex reasoning

mechanisms based on experience, context,

environment…MEANING

“How dangerous is this really?”

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 11: Training The Brain 1 Cognitive

Noxious inputNon-noxious input

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 12: Training The Brain 1 Cognitive

Noxious inputNon-noxious input

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 13: Training The Brain 1 Cognitive

Noxious inputNon-noxious input

Neurons that represent our physical self

Neural networks that evoke ‘basic’ protective

responses

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 14: Training The Brain 1 Cognitive

Neural networks that evoke feelings to assist

protection (ie pain)

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 15: Training The Brain 1 Cognitive

Neural networks that evoke ‘basic’ protective

responses

Motor systemImmune system

Autonomic system

Neural networks that evoke feelings to assist

protection (ie pain)

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 16: Training The Brain 1 Cognitive

“How dangerous is this really?”

multi-system outputs

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 17: Training The Brain 1 Cognitive

‘Basic’ protective responses

Motor systemImmune system

Autonomic system

Pain

Every represented byte can modulate

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 18: Training The Brain 1 Cognitive

‘Basic’ protective responses

Motor systemImmune system

Autonomic system

Pain

Every represented byte can modulate

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 19: Training The Brain 1 Cognitive

‘Basic’ protective responses

Motor systemImmune system

Autonomic system

Pain

Every represented byte can modulate

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 20: Training The Brain 1 Cognitive

‘Basic’ protective responses

Motor systemImmune system

Autonomic system

Pain

Every represented byte can modulate

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 21: Training The Brain 1 Cognitive

‘Basic’ protective responses

Motor systemImmune system

Autonomic system

Pain

Every represented byte can modulate

www.bodyinmind.com.au Copyright GL Moseley 2009

Page 22: Training The Brain 1 Cognitive

‘Basic’ protective responses

Motor systemImmune system

Autonomic system

Pain

Every represented byte can modulate

Sum evaluative inputs = Need to protect

www.bodyinmind.com.au Copyright GL Moseley 2009