Is Musculoskeletal Body Image Relevant for Pelvic Health?

Various categories of therapeutic exercises have a strong evidence base in pelvic floor rehabilitation, including motor control exercise. Explicit motor skill learning principles are recommended to teach patients specific motor control exercise. This requires the participant to have adequate sensory motor function, working memory, attention and executive function. Motor Imagery is often used during the initial phase of motor skill learning, however some patient subgroups have deficits in motor imagery, sensory motor function and neurocognitive function.

This influences the ability of clients to learn the exercise and benefit from the therapy. Hence there is considerable variation in learning ability, which is likely involved in the time frame for rehabilitation and overall outcomes.

There is now a greater understanding of the virtual body in musculoskeletal dysfunction. One related topic is musculoskeletal body image. Body image is the way one’s body feels to its owner. This feeling includes, the shape, outline, alignment in space, weight, muscle tone and ownership. The feeling of one’s body is involved in producing an accurate image of their body to be used for motor skill learning.

This lecture will discuss our research on motor skill learning, body image and the implications for clinical practice.

At the end of this lecture, the learner will be able to:

• Recognize clients with poor motor skill learning abilities
• Reflect on motor skill learning ability in pelvic health clients
• Identify patients with body image deficits
• Consider rehabilitation options for clients with poor motor skill learning

Sean Gibbons, BSc RPT, MSc Ergonomics, PhD, MCPA

Sean Gibbons graduated from Manchester University in 1995. He has been rehabilitating movement patterns and chronic pain for over 20 years. 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: Neurological Factors, which are related to extremely poor movement and the ability to learn coordination exercises; Midline as a sensory system which is critical to Central Body Image Pain; and Neuro-Immune-Cardiometabolic-Endocrine dysregulation, which is critical for Central Sensitization and Psychosocial Factors. His current work follows this and aims to further understand the mechanisms of non-mechanical pain and the Individual Factors influencing treatment. His dissection and research into psoas major, gluteus maximus, and other muscles have 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 Assistant Clinical Professor (Adjunct) at McMaster’s Advanced Orthopaedic Musculoskeletal / Manipulative Physiotherapy specialization and lectures at Manchester Metropolitan University’s Masters in Advanced Physiotherapy program.