Spatial acuity of healthy subjects in locating two identical pressure stimuli using digital body chart

Federica, Moresi and Elena, Morosini and Barbero, Marco and Cescon, Corrado and Roberto, Gatti (2015) Spatial acuity of healthy subjects in locating two identical pressure stimuli using digital body chart. In: World Confederation for Physical Therapy Congress 2015, 1-4 May, Singapore.

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Background: Body charts are a useful tool to assess pain in clinical practice. Patients report their complaints by drawing on body chart the location and the extent of pain. Reporting pain or symptoms over a body chart is a complex task as it involves subjective body spatial cognition and also recognition over a standard two-dimensional template that does not take into account body structures variability. Several methods, paper-based or digital, for completing and analyzing pain drawings have been proposed, and their good test-retest or inter-examiner reliability were described. However, subjects’ spatial acuity in reporting two successive identical stimulus over a body chart has never been investigated. Purpose: The aim of the present study is to assess spatial acuity in reporting two successive identical stimulus over a digital body chart in a group of healthy subjects. Moreover, we investigated if spatial acuity is influenced by the size and the location of the stimulus. Methods: Fifty healthy subjects participated in the study. All subjects received in well defined body parts twenty pressure stimulations, randomly distributed all over the body. Pressure stimulations involved points (1cm2) or larger areas (60cm2) over the body and were applied respectively by an algometer of 1,5 Kg and a flat weight of 2 kg. Each stimulus was performed twice, in a randomized sequence and exactly in the same body location. After each of the forty stimulations, participants were requested to represent the perceived stimulation on a digital body chart. To investigate spatial acuity in reporting perceived stimulus, an appropriate software compared each couple of drawings (D1 and D2) representing the identical stimulations. For the point-like drawings, the distance in pixel between D1 and D2 whereas for drawings of larger areas, the not overlapping area between D1 and D2 were calculated. Results: The median of distance between point-like drawings was 8.8 pixel (IQR: 12.06), the median of not-overlapping area was 48.67% (IQR: 36.34) of the total area (D1+D2). Friedman Test showed a significant change in accuracy of point-like drawings in different body regions: the lower distance (5.9 pixels) between D1 and D2 has been found in the anterior part of the arm, the larger distance (16.1 pixels) in the anterior part of the thigh. Overlapping of reported areas was not significantly different in different body regions. Conclusion The results of the present study showed that the two identical pressure stimuli were reported over a digital body chart in non-identical locations. Moreover, this phenomena has resulted different among different body parts. Implications: It will be interesting to analyze if the same spatial acuity could be observed in patients with pain, in order to evaluate if pain is responsible of an alteration of this variable. Consequently, it will be also possible to assess more precisely pain drawings reliability.

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