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Measuring Pain for Patients Seeking Physical Therapy: Can Functional Magnetic Resonance Imaging (fMRI) Help?

James M. Elliott, Meriel Owen, Mark D. Bishop, Cheryl Sparks, Henry Tsao, David M. Walton, Kenneth A. Weber, Timothy H. Wideman
DOI: 10.2522/ptj.20160089 Published 28 September 2016
James M. Elliott
J.M. Elliott, PT, PhD, Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL (USA); School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; and Centre for Health Sciences, Zürich University of Applied Sciences, Winterthur, Switzerland.
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  • For correspondence: j-elliott@northwestern.edu
Meriel Owen
M. Owen, MSc, Department of Physical Therapy and Human Movement Sciences, Interdepartmental Neuroscience, Northwestern University.
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Mark D. Bishop
M.D. Bishop, PT, PhD, Department of Physical Therapy, University of Florida, Gainesville, Florida.
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Cheryl Sparks
C. Sparks, PT, PhD, Physical Therapy and Health Science, Bradley University, Peoria, Illinois.
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Henry Tsao
H. Tsao, PT, PhD, The Royal Brisbane and Women's Hospital, Brisbane, Australia.
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David M. Walton
D.M. Walton, PT, PhD, School of Physical Therapy, The University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; and Pain and Quality of Life Integrative Research Lab, The University of Western Ontario.
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Kenneth A. Weber
K.A. Weber Jr, DC, PhD, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California.
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Timothy H. Wideman
T.H. Wideman, PT, PhD, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
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Abstract

In the multidisciplinary fields of pain medicine and rehabilitation, advancing techniques such as functional magnetic resonance imaging (fMRI) are used to enhance our understanding of the pain experience. Given that such measures, in some circles, are expected to help us understand the brain in pain, future research in pain measurement is undeniably rich with possibility. However, pain remains intensely personal and represents a multifaceted experience, unique to each individual; no single measure in isolation, fMRI included, can prove or quantify its magnitude beyond the patient self-report. Physical therapists should be aware of cutting-edge advances in measuring the patient's pain experience, and they should work closely with professionals in other disciplines (eg, magnetic resonance physicists, biomedical engineers, radiologists, psychologists) to guide the exploration and development of multimodal pain measurement and management on a patient-by-patient basis. The primary purpose of this perspective article is to provide a brief overview of fMRI and inform physical therapist clinicians of the pros and cons when utilized as a measure of the patient's perception of pain. A secondary purpose is to describe current known factors that influence the quality of fMRI data and its analyses, as well as the potential for future clinical applications relevant to physical therapist practice. Lastly, the interested reader is introduced and referred to existing guidelines and recommendations for reporting fMRI research.

  • Received March 3, 2016.
  • Accepted July 19, 2016.
  • © 2016 American Physical Therapy Association
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Vol 96 Issue 12 Table of Contents
Physical Therapy: 96 (12)

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Measuring Pain for Patients Seeking Physical Therapy: Can Functional Magnetic Resonance Imaging (fMRI) Help?
James M. Elliott, Meriel Owen, Mark D. Bishop, Cheryl Sparks, Henry Tsao, David M. Walton, Kenneth A. Weber, Timothy H. Wideman
Physical Therapy Sep 2016, DOI: 10.2522/ptj.20160089

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Measuring Pain for Patients Seeking Physical Therapy: Can Functional Magnetic Resonance Imaging (fMRI) Help?
James M. Elliott, Meriel Owen, Mark D. Bishop, Cheryl Sparks, Henry Tsao, David M. Walton, Kenneth A. Weber, Timothy H. Wideman
Physical Therapy Sep 2016, DOI: 10.2522/ptj.20160089
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Subjects

  • Examination/Evaluation
    • Tests and Measurements
  • Perspectives
  • Pain

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