ISSN: 2640-2734
Authors: Louw A*, Moyer H, Bernier C, Blaske H, Hazer K, Knobloch KF, Nolting M, McEachern L, McEachern J, Gardner C, Bruzzone H, Louw C and Farrell K
Background: Altered cortical maps can initiate and maintain a pain experience and older adults who move less may be at increased risk for pain, balance and fall risk issues. Purpose: To determine if a brief graded motor imagery (GMI) session to the plantar surface of the foot in older adults can influence self-reported pain, sensitivity of the nervous system and fall risk. Methods: Forty-one older adults (mean age 76.8) received pain neuroscience education, and GMI to the plantar surface of their feet. Measurements pre- and immediately post- intervention included self-reported pain (Numeric pain rating scale), laterality, fall risk (Brief-BESTest), gait speed (40-meter self-paced walk test - SPWT), and nerve sensitivity (Pressure Pain Thresholds - PPT) to the dorsum of the foot and web space dominant hand. Results: Immediately following treatment, mean self-reported pain improved by 1.24 points (p < 0.001), with a large sub-group meeting the minimal clinically important difference (MCID) for self-reported pain (1.7). Gait speed improved significantly (p < 0.001) meeting MCID (0.1 m/s). Left-right judgement task speed (p < 0.001) and accuracy (p = 0.04) improved. None of the PPT measurements improved. While mean composite Briefest test scores did not reach MCID values (9 points), statistically significant improvements were noted in the biomechanical constraints (p = 0.007) and sensory orientation (p = 0.009) subcomponent scores. Conclusion: A brief, one-time GMI session in older adults can decrease pain and improve scores on tests associated with fall risk but fail to decrease sensitivity of the nervous system. More research is needed to validate the results of this exploratory study.
Keywords: Graded Motor Imagery; Fall Risk; Older Adults; Pain; Gait Speed
