Graven-Nielsen Thomas, Arendt-Nielsen Lars
Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7D-3, DK-9220 Aalborg E, Denmark.
Curr Rheumatol Rep. 2008 Dec;10(6):475-81. doi: 10.1007/s11926-008-0078-6.
A reorganized motor control system is a key factor in musculoskeletal pain conditions, and its relevance in the transition from acute pain to chronic pain is most likely underestimated. The interaction between muscle pain and motor control depends on the specific motor task. Muscle pain causes no increase in electromyographic activity at rest and reduces maximal voluntary contraction and endurance time during submaximal contractions. Furthermore, muscle pain causes an adaptive change in the coordination during dynamic exercises. Increased muscle activity reflecting reorganized muscle coordination and strategy is also a component of the functional adaption to muscle pain. In general, the "vicious cycle" hypothesis is not supported by these findings. Instead, they support an adaptive model predicting reduced agonistic muscle activity eventually advanced by changed antagonistic muscle activity. The motor control assessment procedures provide complementary clinical information and give further support for optimizing treatment regimens and prevention procedures for musculoskeletal pain.
重组的运动控制系统是肌肉骨骼疼痛状况的关键因素，其在从急性疼痛向慢性疼痛转变过程中的相关性很可能被低估了。肌肉疼痛与运动控制之间的相互作用取决于特定的运动任务。肌肉疼痛在静息时不会导致肌电图活动增加，并且会降低次最大收缩时的最大自主收缩和耐力时间。此外，肌肉疼痛会导致动态运动过程中协调性的适应性变化。反映重组肌肉协调性和策略的肌肉活动增加也是对肌肉疼痛功能适应的一个组成部分。总体而言，这些发现不支持“恶性循环”假说。相反，它们支持一种适应性模型，该模型预测最终因拮抗肌活动改变而导致主动肌活动减少。运动控制评估程序提供了补充性临床信息，并为优化肌肉骨骼疼痛的治疗方案和预防程序提供了进一步支持。
