下背痛患者学会适应具有不良继发后果的运动行为。

Low-Back Pain Patients Learn to Adapt Motor Behavior With Adverse Secondary Consequences.

作者信息

van Dieën Jaap H, Flor Herta, Hodges Paul W

机构信息

1Department of Human Movement Science, MOVE Research Institute Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands, 2Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University and Department of Psychology, School of Social Sciences, University of Mannheim, Germany; and 3The University of Queensland, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane Queensland, Australia.

出版信息

Exerc Sport Sci Rev. 2017 Oct;45(4):223-229. doi: 10.1249/JES.0000000000000121.

DOI:10.1249/JES.0000000000000121

PMID:28704216

Abstract

We hypothesize that changes in motor behavior in individuals with low-back pain are adaptations aimed at minimizing the real or perceived risk of further pain. Through reinforcement learning, pain and subsequent adaptations result in less dynamic motor behavior, leading to increased loading and impoverished sensory feedback, which contribute to cortical reorganization and proprioceptive impairments that reduce the ability to control lumbar movement in a robust manner.

摘要

我们推测，下背痛患者运动行为的改变是一种适应性变化，旨在将进一步疼痛的实际风险或感知风险降至最低。通过强化学习，疼痛及随后的适应性变化导致动态运动行为减少，进而导致负荷增加和感觉反馈不足，这会促使皮质重组和本体感觉受损，从而降低以稳健方式控制腰椎运动的能力。