Article

Representational body maps are dynamically maintained in the brain and negatively
influenced by neglect, decreased movement and pain. Graded motor imagery (GMI)
utilizing various tactile and cognitive processes has shown efficacy in
decreasing pain, disability and movement restrictions in musculoskeletal pain.
Limited information is known about the cortical changes patients undergo during
lumbar surgery (LS), let alone the therapeutic effect of GMI for LS. A 56-year-old patient underwent LS for low back pain, leg pain and progressive
neurological deficit. Twenty-four hours prior to and 48 h after LS various
psychometric, physical movement and tactile acuity measurements were recorded.
Apart from predictable postoperative increases in pain, fear-avoidance,
disability and movement-restrictions, pressure pain thresholds (PPT), two-point
discrimination (TPD) and tactile acuity was greatly reduced. The patient
underwent six physiotherapy (PT) treatments receiving a GMI program aimed at
restoring the PPT, TPD and tactile acuity. The results revealed that GMI
techniques applied to a patient immediately after LS caused marked improvements
in movement (flexion average improvement/session 3.3 cm; straight leg raise
average 8.3 degrees /session) and an immediate hypoalgesic effect. GMI may
provide PT with a non-threatening therapeutic treatment for the acute LS patient
and establish a new role for PT in acute LS patients.

Langue : ANGLAIS