NOI Notes - "Pain off the Radar"

This is a useful posting from the NOI group. Particularly interesting for clinicians at GF Strong who work with clients with neurological conditions like SCI, stroke and MS.

http://noinotes.wordpress.com/2012/12/20/missing-out-at-christmas/

It really underlines how some of the patients we work with really aren't well represented in pain research. As a result, establishing useful pain treatments can be even more difficult.

From the NOI Posting:
"What can we do about it?
In our very own small way, we are planning to do something. We have had our first course in neurological disease and pain last month and introduced therapies such as graded motor imagery and therapeutic neuroscience education for these once untouched neuropathic pains. There are more courses planned in Australia and later for overseas. We are well on the way in planning for pelvic pain courses under neuroimmune refreshed biopsychosocial thinking. And we will fund imagery studies on face pain, pelvic pain and therapeutic neuroscience education for stroke pain, but I think we can all start by listing awareness on groups that are missing out on the very first stage of treatment – "an understanding of why I hurt".  Tell us who you think is missing out."

Understanding the biology of the pain states that exist for some of our patients, and how we successfully work with patients to reduce their pain will be very important information for us to share in order to move forward.

Another Course: Graded Motor Imagery - One Day Seminar with Sam Steinfeld, BSc, BMR (PT), Sunday February 10, 2013

This one is being offered through Vancouver Coastal Health.  Good for us!

Sam Steinfeld has been teaching NOI - Neuro Orthopedic Institute - courses in Canada since 1997.

Graded Motor Imagery (GMI) is an emerging new rehabilitation strategy for chronic pain states. GMI comprises a sequence of strategies including laterality restoration (being able to identify left and right limbs, or movement to the left or right), motor imagery and mirror therapy via use of a mirror box.

Evidence for the use of GMI comes from basic sciences (neuroscience) and clinical trials. It can offer substantial improvements in pain and disability in complex regional pain syndrome and phantom limb pain and anecdotally, the GMI programme, or parts of it may offer improvements in a range of chronic pain states such as brachial plexus lesions and osteoarthritis.

Course description

The GMI course provides the most up to date basic sciences, clinical trials, and clinical use of the programme. The course is a series of lectures, practical sessions and clinical applications.

Course objectives:

1. Knowledge of the basic sciences underpinning the use of GMI, including the neuromatrix paradigms, neuroplasticity and mirror neurones

2. Practical knowledge and skills on the use of laterality reconstruction, motor imagery and mirror therapy.

3. The skills to adapt the GMI programme to various patient groups

4. An awareness of the ongoing research programmes in GMI and the basic sciences validating its use 

5. Perhaps a desire to contribute to ongoing research programmes. 

Course Program – 8:00am to 4:00pm

• Registration 8:00 to 8:30am 
• Introduction and history of GMI 
• Neuroscience 1 The neuromatrix paradigm 
• Neuroscience 2 Mirror neurons
• Neuroscience 3 Plasticity and contextualization
• Graded exposure principles and application to GMI
• Neuroscience Education as GMI ally – what do you tell them?
• Laterality reconstruction: theory, principles and techniques
• Motor imagery: theory, principles and techniques 

This course is open to health professionals involved in pain and stress management. While there are no prerequisites for this course attendance at an Explain Pain course would certainly assist, as would study of the information and resources provided at www.gradedmotorimagery.com.

Logistical Information:

Vancouver, BC | 10 February 2013 
Venue Multipurpose room 1 + 2, Level 1, Jim Pattison Tower 
855 West 12th Ave, Vancouver BC Time 8:00 am – 4:00 pm 
Cost $250 per person 

Host Vancouver Coastal Health 
Morning coffee and lunch will be provided. Parking $15/day or with VCH ID staff rate $8.50/day. 

To register or for more information:

Direct your enquiry via e-mail to either: 

Dolores.Langford@vch.ca or, Catherine.LeCornuLevet@vch.ca  

Complete and forward the form below along with payment by cheque to: Catherine Le Cornu Levett, Rehab Services, Level 1 Jim Pattison Tower 855 West 12th Ave Vancouver BC V5Z 1M9

Upcoming Course: Pain Science and Innovative Physiotherapy for People in Pain with Neil Pearson, March 16 & 17, 2013

This one has just been posted on the PABC site. It will definitely be a good one and will likely fill up fast.

Outline:
The objectives of this two-day course are to bring physiotherapists up-to-date on pain neuroscience research and clinical practices, and to enhance physiotherapy practice by providing practical methods to integrate pain science into our daily physiotherapy practice.

Day 1 provides detailed current physiological understanding of pain, chronic pain and the lived experience of pain. This information is the biological foundation from which we can better understand the positive effects of our current physiotherapy treatments on outcomes of pain, function and quality of life. It is also the foundation from which we can analyze and develop new physiotherapy interventions for people in pain.

Day 1 also includes a review of neurophysiology of peripheral, central and autonomic systems, recent and ongoing research of neurophysiology and neuroplasticity, as well as treatments that will promote positive neurophysiological changes, and language with which to provide people in pain with an optimistic and realistic perspective of pain management.

Day 2 provides practical sessions combined with a deeper look into current interventions provided by physiotherapists for people with pain - specifically discussing situations in which the person does not respond as we would expect to our traditional biomechanical and exercise-based approaches. Given the recent academic disputes related to myofascial techniques and to acupuncture, the day will start with a discussion of these interventions, specifically related to pain biology.Exercise in the face of persistent pain will be considered in light of recent outcome studies. Specific movement practices, and their associated outcome studies will be analyzed, including yoga, Tai Chi and Qi Gong for people in pain. The NOI group’s graded motor imagery techniques will be reviewed, and participants will discuss how these innovation could be beneficial with in broader populations rather than only for those with complex regional pain syndrome.

Link for the course description is here:
http://www.bcphysio.org/content/pabc-education-pain-science-and-innovative-physiotherapy-people-pain-neil-pearson-march-16-1

Direct link for registration is here:
http://painscience.eventbrite.com/