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Sensory-Motor Dysregulation - An Effective Target for Persistent Pain

Sensory-Motor Dysregulation - An Effective Target for Persistent Pain

Sensory-Motor Dysregulation - An Effective Target for Persistent Pain

This course includes
11:26:17 of Course Material (View)
Patient Exercises (View)
1 Year access after purchase
Certificate of completion
This course was recorded in August 2023


This online course is designed to build awareness and a toolkit for addressing sensory-motor dysregulation, also known as "smudging" of the sensory-motor cortex.  Exercise prescription is an evidence-based approach to persistent pain. However, many clinicians find that pain often improves with exercise, but that exercise doesn't resolve the pain. 

What if exercise programs could be targeted to the phenotype of pain that the person in front of you is presenting with?

Learn how to phenotype persistent pain using a broad-based biopsychosocial approach utilizing exercise that is directed at a variety of characteristics that we see in our persistent pain population. This course will focus on a major component of persistent 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.

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.

This course is paired with a resource package of curated novel movement videos for every joint in the body (except for the hands) that can be easily prescribed to your patients to resolve this important component of their pain story.  The Resource Package - Novel Exercises for a Sensitive Nervous System contains 26 exercise videos for remapping for the neck, TMJ, hip flexors, pelvis, among many more. These novel movement videos have been created using principles learned from the Feldenkrais and Franklin methods. Patients love these exercises, compliance is high and results are astounding when paired with objective measures of sensory-motor dysregulation.

Learning Objectives

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

  • Assess body image using the Fremantle Questionnaires as it relates to changes in sensory-motor representation
  • Prioritize which components of central pain mechanisms 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.



This online course is for all healthcare professionals, including physiotherapists, occupational therapists, kinesiologists, chiropractors, osteopaths, massage therapists or other movement specialists who treat people with persistent pain. 

Bonuses and More!

Upon purchase, you will have 1-year to complete the course. If you complete the course within 1 year, you will be provided with lifetime access as well as the bonus courses:

The instructors
Carolyn Vandyken

Carolyn 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 37 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.

Reframe Rehab
Online Teaching Company

We are a passionate group of highly trained clinicians who champion virtual, live online education courses to develop a biopsychosocial framework for your clinical practice. Our mission is to break down the silos in clinical practice between musculoskeletal pain, pelvic pain, pain neuroscience education, and psychology by providing timely, cost-effective, live online learning opportunities from the world's leading clinical educators on these topics.

Interested in learning more about Reframe Rehab or taking a course with us? Check us out on Instagram @reframerehab or visit our website to view all our course offerings.

Course Material included in this course
  • Welcome and Resources
  • Powerpoint Slides (6 slides/page)
  • Powerpoint Slides (2 slides/page)
  • Exercise Reframed Lab Book
  • Reassessment Questionnaires
  • The Fremantle Perineal Awareness Questionnaire
  • Phenotyping Cheat sheet with Questionnaire Scores
  • Free HEP Trial on Embodia for Reframe Rehab Students
  • Pre-Course Reading
  • Sensing the Body in Chronic Pain: A Review of Psychophysical Studies Implicating Altered Body Representation
  • Part 1: Exercise Reframed
  • Introduction
  • Part 1: Section 1
  • Case Study #1: Rosie Camper
  • Case Study #2: Peter Michael
  • Case Study #3: Virtual Consult with Emily
  • Case Study #3: Virtual Consult Debrief
  • Case Study #3: The Problem of Emily
  • Case Study #4: Alexa's Mechanical Assessment
  • Part 1: Section 2
  • Profiling: Does it Matter Which Modality
  • Question and Answer Period
  • Part 1: Homework
  • Theory on Sensory Motor Dysregulation
  • Body Talks Slide Deck
  • Part 1 Feedback
  • Part 2
  • Assessing Sensori-Motor Smudging: Using the FreBAQ
  • Part 2: Section 1
  • We. All. Look. At. The. World. With. A. Bias.
  • Part 2: Section 2
  • Brain Maps Adapt Quickly
  • Part 2: Section 3
  • Why Do We Address Sensory Motor Dysregulation
  • Part 2: Section 4
  • How Do We Assess Sensory-Motor Dysregulation?
  • Part 2: Section 5
  • Fremantle Perineal Awareness Questionnaire
  • Part 2: Section 6
  • Explaining Smudging with Dr. David Butler
  • Homework for Section 2
  • Question and Answer Period
  • Part 2 Feedback
  • Part 3: Section 1
  • Question and Answer Period
  • Part 3: Section 2
  • Week One Review
  • Part 3: Section 3
  • Global Remapping Using Qi Gong
  • Part 3: Section 4
  • Breathing Qi Gong Practice
  • Part 3: Section 5
  • Qi Gong vs. Dynamic ROM vs. Yin Yoga
  • Part 3: Section 6
  • Dynamic Full Body FACE the DAY and Clinical Reasoning
  • Part 3: Section 7
  • Case Study for Clinical Reasoning for Remapping below the Median
  • Part 3: Section 8
  • Dynamic, Non-threatening, Novel Movement
  • Part 3: Section 9
  • Global Remapping; Addressing Function
  • Part 3 Feedback
  • Part 4: Section 1
  • Question and Answer Period
  • Part 4: Section 2
  • Recap of Michelle’s Case Study
  • Part 4: Section 3
  • Breaking Down Biomechanical Beliefs
  • Part 4: Section 4
  • Part 2/3 Review
  • Part 4: Section 5
  • Evoking the Relaxation Response
  • Part 4: Section 6
  • Specific Remapping Exercises Above the Median
  • Part 4: Section 7
  • Body Schema: Three Key Components
  • Part 4: Section 8
  • Cognitive Sensory Discrimination
  • Part 4: Section 9
  • A Guide to Remapping Exercises
  • Part 4: Section 10
  • Novel Movement Practices: Blended Feldenkrais and Franklin Work
  • Part 4: Section 11
  • Using Balls to Create Novelty: Remapping of the Neck/Shoulders/Upper Back
  • Part 4: Section 12
  • Take the Old and Make It New: Rethinking Stretching Exercises For The Neck
  • Part 4: Section 13
  • Creating Arousal: Remapping Exercises for Happy Feet
  • Part 4: Section 14
  • Lumbopelvic Pain Using a Broader Lens
  • Part 4: Section 15
  • Remapping of the Pelvis, Sacrum, Tailbone and Hips
  • Part 4: Section 16
  • Remapping of the Hip Flexors
  • Part 4: Section 17
  • Summary: Benefits of Body Remapping Exercises
  • Part 4 Feedback
  • Part 5
  • Special Considerations for the Pelvic Floor: The Brand- NEW FrePAQ
  • Part 6: Post Course Written Resources
  • Understanding Remapping Exercises
  • Cueing the Pelvic Floor for Strengthening (Women)
  • Cueing the Pelvic Floor for Strengthening (Men)
  • Exploring your Genitals
  • Re-assessment Questionnaires
  • Questionnaire Scoring Summary Sheet
  • Pain Stages of Change Questionnaire
  • Finalized Fremantle Perineal Awareness Questionnaire
  • Congrats and what's next
  • Congrats and what's next
Patient Exercises included in this course
  • Remapping of the Pelvis/Hips/Sacrum/Tailbone
  • Remapping of the Hip Flexors

Once you have completed the course, a certificate of completion (including learning hours and course information) will be generated. You can download this certificate at any time. To learn more about course certificates on Embodia please visit this guide.

This course has been approved for 3 CPD units by the South Africa Society of Physiotherapists (SASP). If you are a physiotherapist in South Africa and would like the number of approved CPDs to appear on your certificate of completion, please follow the steps outlined in this help article. 

This course has been approved for 14 Continuing Education Credits (CECs) with the Canadian Massage & Manual Osteopathic Therapists Association (CMMOTA).

This course falls under Professional Skills and CMMOTA members will receive 14 CECs upon the submission of a certificate of completion.

In order for the appropriate CEC information to be displayed on your certificate of completion, please add your CEU/CEC jurisdiction information on your Embodia profile. Learn how to do so in this guide.

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