Descarreaux Martin, Blouin Jean-Sébastien, Teasdale Normand
Faculté de Médecine, Division de Kinésiologie, U, Laval, Canada.
BMC Musculoskelet Disord. 2005 Feb 9;6:6. doi: 10.1186/1471-2474-6-6.
The control of force and its between-trial variability are often taken as critical determinants of motor performance. Subjects performed isometric trunk flexion and extension forces without and with experiment pain to examine if pain yields changes in the control of trunk forces. The objective of this study is to determine if experimental low back pain modifies trunk isometric force production.
Ten control subjects participated in this study. They were required to exert 50 and 75% of their isometric maximal trunk flexion and extension torque. In a learning phase preceding the non painful and painful trials, visual and verbal feedbacks were provided. Then, subjects were asked to perform 10 trials without any feedback. Time to peak torque, time to peak torque variability, peak torque variability as well as constant and absolute error in peak torque were calculated. Time to peak and peak dF/dt were computed to determine if the first peak of dF/dt could predict the peak torque achieved.
Absolute and constant errors were higher in the presence of a painful electrical stimulation. Furthermore, peak torque variability for the higher level of force was increased with in the presence of experimental pain. The linear regressions between peak dF/dt, time to peak dF/dt and peak torque were similar for both conditions. Experimental low back pain yielded increased absolute and constant errors as well as a greater peak torque variability for the higher levels of force. The control strategy, however, remained the same between the non painful and painful condition. Cutaneous pain affects some isometric force production parameters but modifications of motor control strategies are not implemented spontaneously.
It is hypothesized that adaptation of motor strategies to low back pain is implemented gradually over time. This would enable LBP patients to perform their daily tasks with presumably less pain and more accuracy.
力量控制及其试验间变异性常被视为运动表现的关键决定因素。受试者在无实验性疼痛和有实验性疼痛的情况下进行等长躯干屈伸力量测试,以检验疼痛是否会导致躯干力量控制的变化。本研究的目的是确定实验性下背痛是否会改变躯干等长力量产生。
十名对照受试者参与了本研究。他们被要求施加其等长最大躯干屈伸扭矩的50%和75%。在无痛和疼痛试验之前的学习阶段,提供视觉和言语反馈。然后,要求受试者在没有任何反馈的情况下进行10次试验。计算达到峰值扭矩的时间、达到峰值扭矩的时间变异性、峰值扭矩变异性以及峰值扭矩的恒定误差和绝对误差。计算达到峰值的时间和峰值dF/dt,以确定dF/dt的第一个峰值是否可以预测达到的峰值扭矩。
在存在疼痛性电刺激时,绝对误差和恒定误差更高。此外,在实验性疼痛存在的情况下,较高力量水平的峰值扭矩变异性增加。两种情况下,峰值dF/dt、达到峰值dF/dt的时间与峰值扭矩之间的线性回归相似。实验性下背痛导致较高力量水平的绝对误差和恒定误差增加,以及更大的峰值扭矩变异性。然而,在无痛和疼痛条件下,控制策略保持不变。皮肤疼痛会影响一些等长力量产生参数,但不会自发实施运动控制策略的改变。
据推测,运动策略对下背痛的适应是随着时间逐渐实现的。这将使下背痛患者能够在日常任务中可能以更少的疼痛和更高的准确性完成任务。