Roessingh Research and Development, Enschede, The Netherlands.
BMC Musculoskelet Disord. 2011 Sep 27;12:211. doi: 10.1186/1471-2474-12-211.
Chronic low back pain (CLBP) is often accompanied by an abnormal motor performance. However, it has not been clarified yet whether these deviations also occur during motor tasks not involving the back and whether the performance is influenced by pain and pain-related cognitions. Therefore, the aim of the present study is to get insight in the contribution of both pain experience and pain-related cognitions to general motor task performance in CLBP.
13 CLBP patients and 15 healthy subjects performed a hand-function task in three conditions: sitting, lying prone (lying) and lying prone without trunk support (provoking). The last condition was assumed to provoke pain-related cognitions, which was considered successful when a patients' pain expectancy on a numeric rating scale was at least 1 point higher than actual pain experienced. Subjects' performance was expressed in reaction time and movement time. Repeated measures analysis of variance was performed to detect main effect for group and condition. Special interest was given to group*condition interaction, since significant interaction would indicate that patients and healthy subjects performed differently throughout the three conditions.
Patients were slower throughout all conditions compared to healthy subjects. With respect to the provoking condition, patients showed deteriorated performance compared to lying while healthy subjects' performance remained equal between these two conditions. Further analysis of patients' data showed that provocation was successful in 54% of the patients. Especially this group showed deteriorated performance in the provoking condition.
It can be concluded that CLBP patients in general have worse motor task performance compared to healthy subjects and that provoking pain-related cognitions further worsened performance.
慢性下背痛（CLBP）常伴有异常的运动表现。然而，目前尚不清楚这些偏差是否也出现在不涉及背部的运动任务中，以及表现是否受到疼痛和与疼痛相关的认知的影响。因此，本研究旨在深入了解疼痛体验和与疼痛相关的认知对 CLBP 患者一般运动任务表现的贡献。
13 例 CLBP 患者和 15 例健康受试者在三种条件下进行手部功能任务：坐姿、俯卧位（卧位）和无躯干支撑的俯卧位（诱发）。假设最后一种情况会引起与疼痛相关的认知，当患者的数字评分量表上的疼痛预期值比实际疼痛高至少 1 分时，就认为是成功的。受试者的表现以反应时间和运动时间表示。采用重复测量方差分析来检测组和条件的主要影响。特别关注组*条件的相互作用，因为显著的相互作用表明患者和健康受试者在三种条件下的表现不同。
与健康受试者相比，患者在所有条件下的反应都较慢。就诱发条件而言，与卧位相比，患者的表现恶化，而健康受试者在这两种条件下的表现保持不变。对患者数据的进一步分析表明，在 54%的患者中，诱发是成功的。特别是这个组在诱发条件下表现出更差的表现。
可以得出结论，CLBP 患者的运动任务表现总体上比健康受试者差，而诱发与疼痛相关的认知会进一步恶化表现。
