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SMARTERehab Group - Body Image, Midline & Central Pain Presentations


  • Davidson Physiotherapy 520 Pinewood Road Riverview, NB, E1B 5J9 Canada (map)

Course Description

The brain needs to know what is happening in the body. It gets this information from sensory feedback. When this information is deficient the brain will change its behaviour to get this information. When it is absent, significantly inaccurate or cannot be processed, musculoskeletal symptoms can result. It is now clear that our virtual brain and body image are involved in pain states. In some cases they can be a primary cause of the pain state We will cover how to assess for a disrupted body image using original screening tools developed by SMARTERehab for the diagnosis of central body image pain and a physical assessment of a battery of midline testing. Evidence based treatments will be covered in detail. These involve specific sensory training and the neurodevelopmental process whereby we learn how our midline and body image. This is through the primitive and postural reflexes that guide our movement and the sensory systems that are used during this process. We have researched a clinical prediction rule for widespread central sensitization and developed rehabilitation strategies based on the underlying mechanisms. You will leave with a clear understanding of when to apply the clinical prediction rule, and assessment strategies for altered body image, along with the appropriate subjective history, physical examination and outcome measures to use. You will be able to develop a rehabilitation program for clients with altered body image or central sensitization and have appropriate progressions and problem solving strategies.

Course Objectives

The participant will be able to:

  • Understand midline, altered body image, central sensitization and their role in pain states
  • Use a clinical prediction rule of self report and physical examination items to diagnose central sensitization
  • Be able to assess for midline, altered body image & Musculoskeletal Body Image Pain
  • Appreciate the role of the sensory system and the developmental process in midline, body image and pain
  • Develop a rehabilitation program for body image disorders and central sensitization with appropriate starting points and progressions

Facilitator Sean Gibbons graduated from Manchester University in 1995. He has been rehabilitating movement patterns for over 20 years. He researched and developed the concept of Midline as a sensory system which is involved in coordination and Body Image Pain - a new type of Central Pain. His PhD was on the development of a prescriptive clinical prediction rule for specific motor control exercises in low back pain. Key new sub-classifications were identified: neurocognitive, sensory motor function which is related to extremely poor movement and the ability to learn to coordination exercises; central body image pain and neuro-immune-endocrine dys-regulation. His current work follows this and aims to further subclassify pain mechanisms and understand the mechanisms of non mechanical pain. His dissection and research into psoas major, gluteus maximus and other muscles has led to the development of new rehabilitation options. He has presented his research at national and international conferences and has several journal publications and book chapters on related topics. He is an associate researcher at MUN and is part of the teaching faculty at McMaster's Advanced Orthopaedic Musculoskeletal / Manipulative Physiotherapy specialization. 

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