Tabor Abby, O'Daly Owen, Gregory Robert W, Jacobs Clair, Travers Warren, Thacker Michael A, Moseley Graham Lorimer
*Sansom Institute for Health Research, University of South Australia, Adelaide, SA ¶Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia †School of Biomedical Sciences, Centre of Human and Aerospace Physiological Sciences and Pain Research Section, Neuroimaging, Institute of Psychiatry, King's College London §INPUT Pain Management ∥Physiotherapy Department, Guy's and St Thomas' NHS Foundation Trust, London ‡East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, Surrey, UK.
Clin J Pain. 2016 Jul;32(7):588-93. doi: 10.1097/AJP.0000000000000305.
The experience of chronic pain critically alters one's ability to interact with their environment. One fundamental issue that has received little attention, however, is whether chronic pain disrupts how one perceives their environment in the first place. The Economy of Action hypothesis purports that the environment is spatially scaled according to the ability of the observer. Under this hypothesis it has been proposed that the perception of the world is different between those with and without chronic pain. Such a possibility has profound implications for the investigation and treatment of pain. The present investigation tested the application of this hypothesis to a heterogenous chronic pain population.
Individuals with chronic pain (36; 27F) and matched pain-free controls were recruited. Each participant was required to judge the distance to a series of target cones, to which they were to subsequently walk. In addition, at each distance, participants used Numerical Rating Scales to indicate their perceived effort and perceived pain associated with the distance presented.
Our findings do not support the Economy of Action hypothesis: there were no significant differences in distance estimates between the chronic pain and pain-free groups (F1,60=0.927; P=0.340). In addition, we found no predictive relationship in the chronic pain group between anticipated pain and estimated distance (F1,154=0.122, P=0.727), nor anticipated effort (1.171, P=0.281) and estimated distance (F1,154=1.171, P=0.281).
The application of the Economy of Action hypothesis and the notion of spatial perceptual scaling as a means to assess and treat the experience of chronic pain are not supported by the results of this study.
慢性疼痛的经历会严重改变一个人与周围环境互动的能力。然而，一个很少受到关注的基本问题是，慢性疼痛是否首先会扰乱一个人对周围环境的感知。行动经济性假说认为，环境是根据观察者的能力在空间上进行缩放的。根据这一假说，有人提出，慢性疼痛患者和非慢性疼痛患者对世界的感知是不同的。这种可能性对疼痛的研究和治疗具有深远的影响。本研究测试了这一假说在异质性慢性疼痛人群中的应用。
招募了慢性疼痛患者（36人；27名女性）和相匹配的无疼痛对照组。要求每位参与者判断到一系列目标锥体的距离，随后他们要朝着这些目标锥体走去。此外，在每个距离处，参与者使用数字评定量表来表明他们对与所呈现距离相关的感知努力和感知疼痛。
我们的研究结果不支持行动经济性假说：慢性疼痛组和无疼痛组之间在距离估计上没有显著差异（F1,60 = 0.927；P = 0.340）。此外，我们发现在慢性疼痛组中，预期疼痛与估计距离之间没有预测关系（F1,154 = 0.122，P = 0.727），预期努力（F1,154 = 1.171，P = 0.281）与估计距离之间也没有预测关系（F1,154 = 1.171，P = 0.281）。
本研究结果不支持将行动经济性假说以及空间感知缩放的概念作为评估和治疗慢性疼痛体验的一种方法。
