Wherever is my arm? impaired upper limb position accuracy in Complex Regional Pain Syndrome

J S Lewis, P Kersten, K M McPherson, Gordon J Taylor, Nigel Harris, C S McCabe, David Blake

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Knowledge of the position of one's limbs is an essential component of daily function and relies on complex interactions of sensorimotor body schema-related information. Those with Complex Regional Pain Syndrome (CRPS) express difficulty in knowing where their affected limb is positioned. The aim of this study was to determine the degree to which experimental data supported the reported difficulty in limb position sense. A controlled experimental design was used to measure upper limb position accuracy amongst those with CRPS of one arm. Position accuracy was individually measured in both arms and compared to a known target position. Video captured each of 36 trials (half with arm in full view and half with vision obscured). The error in degrees between actual and known targets was determined using video analysis software. The Brief Pain Inventory measured pain. A subjective mental image representation of both upper limbs was documented. The CRPS group had moderate pain intensity and were significantly less accurate in positioning both the affected and unaffected limbs compared to controls (p < 0.001). Position accuracy of the CRPS affected limb significantly improved with vision (8.3 degrees in view, 10.7 degrees not in view). Subjective mental representations of the affected limb were visualised as distorted. Evidence of bilateral arm positioning impairments in unilateral arm CRPS suggests that central mechanisms are involved. Cortical reorganisation in regions associated with the body schema (i.e. primary somatosensory and parietal cortices) is proposed as an explanation. The exact relationship between pain and limb position deficits requires further exploration.
Original languageEnglish
Pages (from-to)463-469
Number of pages7
JournalPain
Volume149
Issue number3
Early online date11 Apr 2010
DOIs
Publication statusPublished - Jun 2010

Fingerprint

Complex Regional Pain Syndromes
Upper Extremity
Arm
Extremities
Pain
Body Image
Proprioception
Parietal Lobe
Somatosensory Cortex
Research Design
Software
Equipment and Supplies

Cite this

Lewis, J. S., Kersten, P., McPherson, K. M., Taylor, G. J., Harris, N., McCabe, C. S., & Blake, D. (2010). Wherever is my arm? impaired upper limb position accuracy in Complex Regional Pain Syndrome. Pain, 149(3), 463-469. https://doi.org/10.1016/j.pain.2010.02.007

Wherever is my arm? impaired upper limb position accuracy in Complex Regional Pain Syndrome. / Lewis, J S; Kersten, P; McPherson, K M; Taylor, Gordon J; Harris, Nigel; McCabe, C S; Blake, David.

In: Pain, Vol. 149, No. 3, 06.2010, p. 463-469.

Research output: Contribution to journalArticle

Lewis, JS, Kersten, P, McPherson, KM, Taylor, GJ, Harris, N, McCabe, CS & Blake, D 2010, 'Wherever is my arm? impaired upper limb position accuracy in Complex Regional Pain Syndrome', Pain, vol. 149, no. 3, pp. 463-469. https://doi.org/10.1016/j.pain.2010.02.007
Lewis JS, Kersten P, McPherson KM, Taylor GJ, Harris N, McCabe CS et al. Wherever is my arm? impaired upper limb position accuracy in Complex Regional Pain Syndrome. Pain. 2010 Jun;149(3):463-469. https://doi.org/10.1016/j.pain.2010.02.007
Lewis, J S ; Kersten, P ; McPherson, K M ; Taylor, Gordon J ; Harris, Nigel ; McCabe, C S ; Blake, David. / Wherever is my arm? impaired upper limb position accuracy in Complex Regional Pain Syndrome. In: Pain. 2010 ; Vol. 149, No. 3. pp. 463-469.
@article{a20badbeaf3e42cfbf0e33f252bbd599,
title = "Wherever is my arm? impaired upper limb position accuracy in Complex Regional Pain Syndrome",
abstract = "Knowledge of the position of one's limbs is an essential component of daily function and relies on complex interactions of sensorimotor body schema-related information. Those with Complex Regional Pain Syndrome (CRPS) express difficulty in knowing where their affected limb is positioned. The aim of this study was to determine the degree to which experimental data supported the reported difficulty in limb position sense. A controlled experimental design was used to measure upper limb position accuracy amongst those with CRPS of one arm. Position accuracy was individually measured in both arms and compared to a known target position. Video captured each of 36 trials (half with arm in full view and half with vision obscured). The error in degrees between actual and known targets was determined using video analysis software. The Brief Pain Inventory measured pain. A subjective mental image representation of both upper limbs was documented. The CRPS group had moderate pain intensity and were significantly less accurate in positioning both the affected and unaffected limbs compared to controls (p < 0.001). Position accuracy of the CRPS affected limb significantly improved with vision (8.3 degrees in view, 10.7 degrees not in view). Subjective mental representations of the affected limb were visualised as distorted. Evidence of bilateral arm positioning impairments in unilateral arm CRPS suggests that central mechanisms are involved. Cortical reorganisation in regions associated with the body schema (i.e. primary somatosensory and parietal cortices) is proposed as an explanation. The exact relationship between pain and limb position deficits requires further exploration.",
author = "Lewis, {J S} and P Kersten and McPherson, {K M} and Taylor, {Gordon J} and Nigel Harris and McCabe, {C S} and David Blake",
year = "2010",
month = "6",
doi = "10.1016/j.pain.2010.02.007",
language = "English",
volume = "149",
pages = "463--469",
journal = "Pain",
issn = "0304-3959",
publisher = "Elsevier",
number = "3",

}

TY - JOUR

T1 - Wherever is my arm? impaired upper limb position accuracy in Complex Regional Pain Syndrome

AU - Lewis, J S

AU - Kersten, P

AU - McPherson, K M

AU - Taylor, Gordon J

AU - Harris, Nigel

AU - McCabe, C S

AU - Blake, David

PY - 2010/6

Y1 - 2010/6

N2 - Knowledge of the position of one's limbs is an essential component of daily function and relies on complex interactions of sensorimotor body schema-related information. Those with Complex Regional Pain Syndrome (CRPS) express difficulty in knowing where their affected limb is positioned. The aim of this study was to determine the degree to which experimental data supported the reported difficulty in limb position sense. A controlled experimental design was used to measure upper limb position accuracy amongst those with CRPS of one arm. Position accuracy was individually measured in both arms and compared to a known target position. Video captured each of 36 trials (half with arm in full view and half with vision obscured). The error in degrees between actual and known targets was determined using video analysis software. The Brief Pain Inventory measured pain. A subjective mental image representation of both upper limbs was documented. The CRPS group had moderate pain intensity and were significantly less accurate in positioning both the affected and unaffected limbs compared to controls (p < 0.001). Position accuracy of the CRPS affected limb significantly improved with vision (8.3 degrees in view, 10.7 degrees not in view). Subjective mental representations of the affected limb were visualised as distorted. Evidence of bilateral arm positioning impairments in unilateral arm CRPS suggests that central mechanisms are involved. Cortical reorganisation in regions associated with the body schema (i.e. primary somatosensory and parietal cortices) is proposed as an explanation. The exact relationship between pain and limb position deficits requires further exploration.

AB - Knowledge of the position of one's limbs is an essential component of daily function and relies on complex interactions of sensorimotor body schema-related information. Those with Complex Regional Pain Syndrome (CRPS) express difficulty in knowing where their affected limb is positioned. The aim of this study was to determine the degree to which experimental data supported the reported difficulty in limb position sense. A controlled experimental design was used to measure upper limb position accuracy amongst those with CRPS of one arm. Position accuracy was individually measured in both arms and compared to a known target position. Video captured each of 36 trials (half with arm in full view and half with vision obscured). The error in degrees between actual and known targets was determined using video analysis software. The Brief Pain Inventory measured pain. A subjective mental image representation of both upper limbs was documented. The CRPS group had moderate pain intensity and were significantly less accurate in positioning both the affected and unaffected limbs compared to controls (p < 0.001). Position accuracy of the CRPS affected limb significantly improved with vision (8.3 degrees in view, 10.7 degrees not in view). Subjective mental representations of the affected limb were visualised as distorted. Evidence of bilateral arm positioning impairments in unilateral arm CRPS suggests that central mechanisms are involved. Cortical reorganisation in regions associated with the body schema (i.e. primary somatosensory and parietal cortices) is proposed as an explanation. The exact relationship between pain and limb position deficits requires further exploration.

UR - http://www.scopus.com/inward/record.url?scp=77952111730&partnerID=8YFLogxK

UR - http://dx.doi.org/10.1016/j.pain.2010.02.007

U2 - 10.1016/j.pain.2010.02.007

DO - 10.1016/j.pain.2010.02.007

M3 - Article

VL - 149

SP - 463

EP - 469

JO - Pain

JF - Pain

SN - 0304-3959

IS - 3

ER -