Driving plasticity in the motor cortex in recurrent low back pain

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Motor Control

Background:

• Recurrent low back pain (LBP) is associated with altered motor coordination and motor cortical reorganisation.
• It is unclear if training-induced improvements in motor coordination in LBP patients involve changes in motor cortex structure.

Purpose of the Study:

• To investigate if motor skill training can reverse motor cortical reorganisation in individuals with recurrent LBP.
• To examine the relationship between changes in motor cortex organisation and motor coordination following training.

Main Methods:

• 20 individuals with recurrent LBP underwent 2 weeks of either isolated transversus abdominis (TrA) motor skill training or walking exercise.
• Electromyography (EMG) recorded TrA activity; transcranial magnetic stimulation (TMS) assessed motor cortical organisation.
• Postural activation timing of TrA during arm movements was measured before and after interventions.

Main Results:

• Motor skill training induced a shift in the motor cortical representation of TrA towards that of healthy individuals.
• This cortical reorganisation correlated with earlier postural activation of TrA.
• No significant changes were observed in the control group.

Conclusions:

• Motor skill training can reverse aberrant motor cortical reorganisation in recurrent LBP.
• This study provides the first evidence that motor training can modify neuronal networks in the motor cortex in pain patients.
• Findings highlight the link between cortical plasticity and motor coordination improvements in LBP recovery.