Sensory-Motor Dysregulation: A Key Exercise Target for Persistent Pain

Course Description: (Please bring your own yoga mat.)

Exercise prescription and pain education have Level 1 evidence for persistent pain. However, many clinicians find that pain often improves with exercise, but that exercise doesn't resolve the pain.

Should exercise be prescribed based on the pain mechanisms evident in your patient's presentation? Is their pain nociceptive, neuropathic, or nociplastic?

Learn how to phenotype persistent pain using a broad-based biopsychosocial approach utilizing exercise that is directed specifically at nociplastic pain. This course will focus on a major target of nociplastic pain documented in the literature, namely sensory-motor dysregulation.

It has been shown that 98% of low back pain patients show moderate sensory-motor changes when assessed using the Fremantle Back Awareness Questionnaire. Similarly, moderate levels of sensory-motor dysregulation have been shown in the knees, shoulders, neck and perineum. The RESOLVE study (2022) provides Level 1 evidence that addressing sensory-motor dysregulation along with pain education significantly reduces pain and disability in chronic LBP.

Most clinicians do not measure sensory-motor dysregulation and this becomes a potential missed target in exercise prescription.

Join Carolyn Vandyken as she explores her ten-year journey of addressing sensory-motor changes through novel, fun and non-threatening exercises to retrain the nervous system with the goal of improving pain, strength and range of motion.

Objectives:

At the end of this course, participants will develop new skills in order to confidently:

● Assess nociplastic pain mechanisms using the Fremantle Questionnaires as it relates to changes in sensory-motor representation

● Prioritize which components of nociplastic pain (central sensitization) to address with individual persistent pain patients. This includes the review of SAD CLLIFSS, an acronym created by Carolyn Vandyken and Antony Lo to help describe how to personalize a biopsychosocial approach with patients

● Understand how changes in sensory-motor representation within a sensitized nervous system require us to move beyond typical therapeutic stretching and strengthening exercises.

● Develop therapeutic skills for addressing sensory-motor changes including novel movement strategies for all of the major joints in the body.

● Teach your patients to create ease of movement using novel movement approaches.

● Increase your patient’s variability of movement using a functional approach to exercise.

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Licensing

All participants are responsible for ensuring that they have a current license to practice from the College of Physical Therapists of British Columbia (CPTBC). If participants are from out of BC, they must acquire a Courtesy License from CPTBC.

About the Instructor:

Carolyn Vandyken is the co-owner of Reframe Rehab, a teaching company engaged in breaking down the barriers internationally between pelvic health, orthopaedics and pain science. Carolyn has practiced in orthopaedics and pelvic health for the past 35 years. She is a McKenzie Credentialled physiotherapist (1999), certified in acupuncture (2002), and obtained a certificate in Cognitive Behavioural Therapy (CBT) in 2017.

Carolyn received the YWCA Women of Distinction award (2004) and the distinguished Education Award from the OPA (2015). Carolyn was recently awarded the Medal of Distinction from the Canadian Physiotherapy Association in 2021 for her work in pelvic health and pain science.

Carolyn has been heavily involved in post-graduate pelvic health education, research in lumbopelvic pain, speaking at numerous international conferences and writing books and chapters for the past twenty years in pelvic health, orthopaedics and pain science.