Muscle test and Psychomotor therapy

Projektdetaljer

Beskrivelse

Forskning i muskeltest og psykomotorisk behandling

Dette projekt er udviklet på baggrund af et mindre forprojekt i 2013 med titlen ”Forskningssamarbejde vedr. psykomotorisk terapi". I projektets formål er beskrevet to mulige forskningsprojekter i samarbejde med Aalborg Universitet. Heraf er det ene - Muskeltest ift. psykomotorisk behandling -nu klar til at blive sat i gang.

Projektbeskrivelse

Titel: Muscle test and Psychomotor therapy
Purpose
This project intends to (1) create new knowledge within the psychomotor therapy as it relates to standard and recognized objective assessments, and (2) to evaluate the efficacy of the psychomotor therapy in a properly controlled RCT. In order to accomplish these goals, four subprojects are proposed: The first subproject aims to validate a diagnosis schema used within psychomotor therapy and the second will evaluate the interrater reliability of the muscletest across trained therapist. The third subproject will investigate the acute effects of psychomotor therapy and knowledge gained from the third project will be tested in a larger RCT study aimed to evaluate the efficacy of psychomotor therapy with respect .

Justification for this research proposal is driven by two factors. Firstly, there is a need for greater understanding of the validity and efficacy of psychomotor therapy. Therapies aiming to treat the whole person (mind and body) may facilitate recovery in patient populations overcoming pain (chronic pain patients, trauma patients, abused individuals), or even more common, stress. The proposed project may lead to benefits for the general population including younger or elderly adults who are seeking alternative approaches to enhance their quality of life and well-being.
The expected results are considered to have an impact on future research regarding psychomotor therapy and other similar country-specific therapies or techniques related therapies in rehabilitation and clinical settings. Furthermore, such approaches are receiving attention from health and wellness governing bodies as a potential method to offset accumulated work-related stresses, and thus may be a therapy which can be applied as a preventative intervention. Further studies aiming at long-term benefits may be a subsequent follow-up project.

Purpose of Sub-project 1: Validation of diagnosis schema for muscle tonus in relation to objective assessments of pressure pain threshold and muscle stiffness
Purpose of Sub-project 2: Inter-rater reliability of the Muscletest

Purpose of Sub-project 3: Acute effects of psychomotor therapy on muscle function and psychological state
Purpose of Sub-project 4: A comprehensive psychomotor therapy program on psychological and physiological state in individuals with chronic low back pain (CLBP). : A ran-domized control trial
Theory
Background research of the project was found among publically available and Aalborg University’s access to peer-reviewed articles. A systematic and structured literature search of relevant databases within Pubmed, for example, gives only 17500 research articles for ‘Psychomotor Therapy’ of which only a handful of these articles (<50) focus on specific aspects related to psychomotor therapy. When considering the overlap of the cornerstones of psychomotor ther-apy and other similar treatment methods, as listed in Table 1, an example of searching for ‘body awareness therapy’ gives 2051 and holistic therapy gives 12 307. Alltogether, only a fraction of these research articles have used appropriate evidence-based research methods such as a randomized control design (RCT) to evaluate the efficacy of these therapies.

Table 1: Psychomotor therapy and similar country-specific therapies or techniques related therapies (Probst et al., 2010)

The method is described by Ivanouw (1974): About different methods to registration of muscle tone. Lisbeth Marcher´s muscle test is described in details, and a method to plan and do psychomotor treatment after a muscle test assessment is explained. It is build on research about muscle tone and psychological matters and a theory about relation between muscle tone and psyche is formed.
The theory originated in 1974 and is further developed in 1978 in: Betragtninger over muskel-tonus under handleforløb, by Ivanouw. Here the theory is combined with Torsten Ingemann Nielsens theory of action. In an article from 2010: Kroppen og det ubevidste , Ivanouw describes experiments which relates EMG and assessment of muscle tone by the palpation techniques used in the muscle test. Lisbeth Marcher´s muscletest has been developed further by the The Bodynamic System as a psychomotor developmental psychotherapy and a scientific validation has been made in 2001 by Lisbeth Marcher, Lennart Ollars and Erik Jarlnaes in 2001

Methods
Subproject Specifics: Cognitive Tests, Muscle Function and Outcome Measures
For the purpose of clarity, this section lists the cognitive tests, muscle function tests and out-come measures used in each subproject.

Subproject 1: Validation of muscle tests schema for muscle tonus in relation to objective assessments of pressure pain thresholds and muscle stiffness
Cognitive Assessments: Det Nationale Forskningscenter for Arbejdsmiljø (NFA) Questionnaire of Psychological work environment, McGill Pain questionnaire and drawings of pain areas on a body chart
Muscle Function: Pressure Pain Thresholds, muscle stiffness, and muscle test schema level.
Cardiovascular assessments: Heart rate and blood pressure
Outcome Measures: Pressure pain thresholds, muscle stiffness, heart rate, blood pressure, subjective diagnosis schema level of muscle function, current pain, area of pain, and pain de-scriptors, stress index from the NFA Questionnaire of Psychological work environment, participant characteristics (age, weight and height).

Subproject 2: Inter-rater reliability of the muscle test
Cognitive Assessments: Det Nationale Forskningscenter for Arbejdsmiljø (NFA) Questionnaire of Psychological work environment, McGill Pain questionnaire and drawings of pain areas on a body chart
Muscle Function: Muscle test schema level
Outcome Measures: Pressure pain thresholds, muscle stiffness, heart rate, blood pressure, subjective muscle test schema level of muscle function, current pain, area of pain, and pain descriptors, stress index from the NFA Questionnaire of Psychological work environment, participant characteristics (age, weight and height).

Subproject 3: Acute effects of psychomotor therapy on muscle function and psychological state
Cognitive Assessments: Det Nationale Forskningscenter for Arbejdsmiljø (NFA) Questionnaire of Psychological work environment, McGill Pain questionnaire and drawings of pain areas on a body chart
Muscle Function: Pressure Pain Thresholds, muscle stiffness, and diagnosis schema level.
Cardiovascular assessments: Heart rate and blood pressure
Outcome Measures: Pressure pain thresholds, muscle stiffness, heart rate, blood pressure, subjective diagnosis schema level of muscle function, current pain, area of pain, and pain de-scriptors, stress index from the NFA Questionnaire of Psychological work environment, participant characteristics (age, weight and height).

Subproject 4: A comprehensive psychomotor therapy program on psychological and physiological state in individuals with chronic low back pain (CLBP). : A randomized control trial
Cognitive Assessments: Det Nationale Forskningscenter for Arbejdsmiljø (NFA) Questionnaire of Psychological work environment, McGill Pain questionnaire and drawings of pain areas on a body chart, and Mood Scale (PHQ).
Muscle Function: Pressure Pain Thresholds and muscle stiffness
Outcome Measures: Pressure pain thresholds, muscle stiffness, heart rate, blood pressure, subjective diagnosis schema level of muscle function, current pain, area of pain, and pain descriptors, stress index from the NFA Questionnaire of Psychological work environment, participant characteristics (age, weight and height).

Subjects

Number of Subjects: This project requires a larger number of individual participants as opposed to a larger number of experimental sessions. The entire project will include 240 – 260 test persons. Subproject 1 will require 65 tests persons to participate in a single session study in order to assess the validity of the diagnosis schema. A large sample of data will be required to cover the range of the levels found on the muscletest schema. Subproject 2 will also require 65 tests persons that will be assessed three times on three separate occasions, separated by one to two days. This will allow for inter-rater reliability testing occur across trained psychomotor therapist while minimizing the risk of a change in muscle tonus. Subproject 3 will require 20 test persons in each group. Subproject 4 will aim to recruit between 35 – 45 test persons in each group.
Statistics
Group × time interactions and between group differences will be analyzed using group parametric/non-parametric (depending on normality testing of data) one and two-way RM ANOVA. As well, student t-tests, and paired t-tests and will be used for demographic data and all outcome measures where appropriate. The Student-Newman Keul’s post hoc test will be used to correct for multiple comparisons. Significance will be accepted as P
StatusAfsluttet
Effektiv start/slut dato01/01/1431/12/14