Changes in Motor Cortex Following Exercises for Chronic Low Back Pain
Changes in Motor Cortex Following Exercises for Chronic Low Back Pain
The motor cortex of the brain changes following chronic pain and injury, and this is linked
 to pain-associated changes in motor behaviour. This study aimed to investigate whether
 therapeutic exercises in patients with chronic pain can induce reorganisation of the motor
 cortex and restore normal motor behaviour. The investigators hypothesised that motor training
 can induce reorganisation of the motor cortex and that these changes are related to improved
 motor behaviour.
The sensory and motor systems can reorganize following injury and learning of new motor
 skills. Recently we observed adaptive changes in motor cortical organization in patients with
 chronic back pain, which are closely linked to changes in motor behavior. Although
 pain-related alterations in behavior can be trained and are associated with improved
 symptoms, it remains unclear whether these meaningful functional outcomes are related to
 motor cortical reorganization. Here we investigate the effects of two interventions in people
 with chronic back pain: skilled motor training and a control intervention of self-paced
 walking exercise. We measured motor cortical excitability (motor threshold (MT)) and
 organization (center of gravity (CoG) and map volume) of the deep abdominal muscle,
 transversus abdominis (TrA), using transcranial magnetic stimulation (TMS). In addition,
 motor behavior of TrA was assessed during single rapid arm movements. The study helps to
 elucidate the mechanisms of specific motor exercises in chronic back pain management.
Inclusion Criteria:

 -  Sustained or episodic non-specific low back pain lasting longer than 3 months

 Exclusion Criteria:

 -  Orthopaedic, neurological, circulatory or respiratory conditions

 -  History or family history of epilepsy

 -  Recent or current pregnancies

 -  Previous surgery to the abdomen or back

 -  Abdominal or back exercises in the preceding 12 months