Chronic Knee Pain, Chronic Musculoskeletal Pain, Chronic Shoulder Pain
Conditions
Keywords
Chronic musculoskeletal pain, Shoulder pain, Knee pain, Laterality training, Left/right discrimination, Graded motor imagery, Pain neuroscience, Pain drawings
Brief summary
The goal of this clinical trial is to learn if laterality training (a type of brain-based therapy) can help reduce pain and change how people with chronic musculoskeletal pain experience and describe their pain. The study will focus on adults with shoulder or knee pain lasting longer than 6 months. The main questions it aims to answer are: Does laterality training lead to a reduction in self-reported pain levels? Does laterality training reduce the area of the body that participants indicate as painful in their pain drawings? Does laterality training improve accuracy and speed in left/right judgment tasks? Researchers will compare participants who complete laterality training to those who complete a non-therapeutic cognitive task (a word puzzle) to see if laterality training changes pain drawings and improves pain outcomes. Participants will: Complete a pre-intervention assessment including pain ratings, pain drawings, and a left/right judgment test Be randomly assigned to one of two groups: Intervention group: Complete 5 one-minute sessions of laterality training using a tablet-based app called Recognise™, identifying left or right hand/foot images depending on the location of their pain Control group: Complete a 10-minute crossword puzzle activity (non-therapeutic) Complete the same assessments after the activity (pain ratings, pain drawings, left/right judgment test) The study will take place at two outpatient physical therapy clinics. Participation involves a single session lasting approximately 30-45 minutes. There is no cost to participate, and no compensation is provided. Participation is voluntary, and all personal data will be kept confidential. This research will help determine whether laterality training, a non-invasive brain-based technique, can reduce pain and improve quality of life in people with long-standing musculoskeletal pain.
Interventions
BEHAVIORALLaterality Training
Participants complete a structured laterality training session using a tablet-based application that presents images of hands or feet. Depending on their pain location (shoulder or knee), participants identify whether each image shows a left or right body part. The session consists of 5 one-minute training bouts with 60-second rest intervals between each. The task is designed to engage and retrain cortical body maps associated with the painful region, based on principles of graded motor imagery. Participants are instructed to prioritize accuracy over speed.
OTHERSham (No Treatment)
Participants in this arm will complete a non-therapeutic cognitive activity by working independently on a standard word-based crossword puzzle for 10 minutes. This task is designed to match the duration and engagement level of the laterality training without influencing sensorimotor processing or cortical body maps. It serves as a sham comparator to help isolate the specific effects of the laterality training intervention.
Sponsors
Therapeutic Neuroscience Research Group
Hawaii Pacific University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
This study uses a parallel assignment model in which participants are randomly assigned to one of two groups: an intervention group receiving laterality training or a control group completing a non-therapeutic cognitive task. Each participant completes only one condition (no crossover), and pre- and post-intervention outcomes are compared between groups. This design allows researchers to evaluate the specific effects of laterality training on pain and pain-related body mapping.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 years or older * Diagnosis of chronic shoulder or knee pain lasting more than 6 months * Able to read and understand English * Willing to provide written informed consent
Exclusion criteria
* Visual impairments that would interfere with laterality training (e.g., blindness or significant difficulty with vision) * Previous participation in laterality (left/right discrimination) training * Unwilling or unable to participate in the study procedures
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pain Drawing Area | Baseline and post-intervention (approximately 15 minutes after Baseline) | Measured using a standardized body chart with a grid overlay. Participants mark areas of perceived pain, and the total number of grid squares marked is quantified to assess changes in spatial pain representation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Left/Right Judgment Accuracy and Reaction Time | Baseline and post-intervention (approximately 15 minutes after Baseline) | Assessed using the Recognise™ app. Participants complete two 60-second tests identifying left/right images of hands (shoulder pain) or feet (knee pain). Accuracy (%) and average response time (seconds per image) are recorded. |
| Change in Numeric Pain Rating Scale (NPRS) | Baseline and post-intervention (approximately 15 minutes after Baseline) | Self-reported pain intensity measured using an 11-point numeric scale (0 = no pain, 10 = worst imaginable pain). This outcome assesses the immediate change in pain before and after the intervention. |
Countries
United States
Contacts
Primary ContactAdriaan P Louw, PhD
Backup ContactBrett D Neilson, DSc
Outcome results
None listed