Perceived body distortion rather than actual body distortion is associated with chronic low back pain in adults with cerebral palsy: A preliminary investigation

OBJECTIVES: The aim of the present study was to investigate whether distorted body perception is a feature of the low back pain (LBP) experience in people with cerebral palsy (CP) and whether any distortions noted are confounded by the presence of motor and postural impairments commonly seen in CP. METHODS: Forty-five individuals participated in this study: 15 adults with CP with LBP (CP_Pain group), 15 adults with CP without LBP (CP_noPain group), and 15 age-matched adults with LBP but no CP (Pain group). Body perception was evaluated using the Fremantle Back Awareness Questionnaire (FreBAQ) and by assessing 2-point discrimination thresholds over the low back. A comprehensive assessment of motor function was also undertaken in the CP population, and postural function was assessed in all 3 groups. RESULTS: Significant differences between the 3 groups were found for FreBAQ scores (P < 0.0001). The TPD threshold in the low back of the CP_Pain group was significantly larger than that of the CP_noPain group (P = 0.01), though we found no difference between the CP_noPain group and the Pain group (P = 0.21). We found no difference in motor or postural function between the 2 CP groups. DISCUSSION: The present results suggest that body image is disrupted in people with CP who experience LBP. The disruptions in perception were similar to those seen in people with LBP and no CP, suggesting that the distortions may be more related to the presence of pain than the presence of CP.