Shanbehzadeh Sanaz, Salavati Mahyar, Talebian Saeed, Khademi-Kalantari Khosro, Tavahomi Mahnaz
Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Exp Brain Res. 2018 Jul;236(7):1927-1938. doi: 10.1007/s00221-018-5267-6. Epub 2018 Apr 25.
Impaired postural control in chronic low back pain (CLBP) has been attributed to deficits in sensory and motor functions. However, it is not known if pain-related anxiety affects motor and cognitive function of postural control. The aim of this study was to compare the interactive effects of postural and cognitive function in CLBP patients with high and low pain-related anxiety and healthy subjects. Thirty-eight patients with nonspecific CLBP (19 with low and 19 with high pain-related anxiety levels) and 20 asymptomatic subjects participated. Postural control was assessed by center of pressure (COP) parameters including mean total sway velocity, area, anterior-posterior (A-P), and medial-lateral (Med-Lat) range. Postural task was assessed during four conditions (eyes open with and without ankle vibration-eyes closed with and without ankle vibrations). Participants performed the postural task with or without auditory Stroop task. Average reaction time and error ratio of auditory Stroop test were calculated as measures of the cognitive task performance. Significantly reduced sway area was observed in CLBP patients with high pain-related anxiety and control subjects during the dual-task condition as compared with the single task. In addition, A-P range was significantly reduced in CLBP patients with high pain-related anxiety during dual tasking when eyes were closed with ankle vibration. In addition, only the CLBP subjects with high pain-related anxiety showed significantly longer reaction times by increasing the difficulty of standing postural task. Pain-related anxiety may influence the postural cognitive interactions in CLBP patients. Furthermore, it may be considered as a contributing factor for postural strategies adopted by CLBP patients.
慢性下腰痛（CLBP）患者姿势控制受损被认为与感觉和运动功能缺陷有关。然而，尚不清楚疼痛相关焦虑是否会影响姿势控制的运动和认知功能。本研究旨在比较高、低疼痛相关焦虑的CLBP患者与健康受试者在姿势和认知功能方面的交互作用。38例非特异性CLBP患者（19例低疼痛相关焦虑水平和19例高疼痛相关焦虑水平）和20例无症状受试者参与了研究。通过压力中心（COP）参数评估姿势控制，包括平均总摆动速度、面积、前后（A-P）和内外侧（Med-Lat）范围。在四种条件下评估姿势任务（睁眼有和无踝关节振动 - 闭眼有和无踝关节振动）。参与者在有或没有听觉Stroop任务的情况下执行姿势任务。计算听觉Stroop测试的平均反应时间和错误率作为认知任务表现的指标。与单任务相比，在双任务条件下，高疼痛相关焦虑的CLBP患者和对照组受试者的摆动面积显著减小。此外，在闭眼且有踝关节振动的双任务过程中，高疼痛相关焦虑的CLBP患者的A-P范围显著减小。此外，只有高疼痛相关焦虑的CLBP受试者通过增加站立姿势任务的难度显示出显著更长的反应时间。疼痛相关焦虑可能会影响CLBP患者的姿势认知交互作用。此外，它可能被视为CLBP患者采用的姿势策略的一个促成因素。
