Laterality Training and Pain Drawings

Summary

The goal of this clinical trial is to learn if laterality training (a type of brain-based therapy) can help reduce pain and change how people with chronic musculoskeletal pain experience and describe their pain. The study will focus on adults with shoulder or knee pain lasting longer than 6 months.

The main questions it aims to answer are:

Does laterality training lead to a reduction in self-reported pain levels?

Does laterality training reduce the area of the body that participants indicate as painful in their pain drawings?

Does laterality training improve accuracy and speed in left/right judgment tasks?

Researchers will compare participants who complete laterality training to those who complete a non-therapeutic cognitive task (a word puzzle) to see if laterality training changes pain drawings and improves pain outcomes.

Participants will:

Complete a pre-intervention assessment including pain ratings, pain drawings, and a left/right judgment test

Be randomly assigned to one of two groups:

Intervention group: Complete 5 one-minute sessions of laterality training using a tablet-based app called Recognise™, identifying left or right hand/foot images depending on the location of their pain

Control group: Complete a 10-minute crossword puzzle activity (non-therapeutic)

Complete the same assessments after the activity (pain ratings, pain drawings, left/right judgment test)

The study will take place at two outpatient physical therapy clinics. Participation involves a single session lasting approximately 30-45 minutes. There is no cost to participate, and no compensation is provided. Participation is voluntary, and all personal data will be kept confidential.

This research will help determine whether laterality training, a non-invasive brain-based technique, can reduce pain and improve quality of life in people with long-standing musculoskeletal pain.

Conditions

• Chronic Musculoskeletal Pain
• Chronic Shoulder Pain
• Chronic Knee Pain

Interventions

BEHAVIORAL

Laterality Training

Participants complete a structured laterality training session using a tablet-based application that presents images of hands or feet. Depending on their pain location (shoulder or knee), participants identify whether each image shows a left or right body part. The session consists of 5 one-minute training bouts with 60-second rest intervals between each. The task is designed to engage and retrain cortical body maps associated with the painful region, based on principles of graded motor imagery. Participants are instructed to prioritize accuracy over speed.

OTHER

Sham (No Treatment)

Participants in this arm will complete a non-therapeutic cognitive activity by working independently on a standard word-based crossword puzzle for 10 minutes. This task is designed to match the duration and engagement level of the laterality training without influencing sensorimotor processing or cortical body maps. It serves as a sham comparator to help isolate the specific effects of the laterality training intervention.

Sponsors & Collaborators

• Therapeutic Neuroscience Research Group

  collaborator NETWORK

• Hawaii Pacific University

  lead OTHER

Principal Investigators

• Adriaan P Louw, PhD · Therapeutic Neuroscience Research Group

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-08-31

Primary Completion

2026-02-28

Completion

2026-02-28

Countries

• United States

Study Locations