Centre d'Evaluation et de Traitement de la Douleur (CETD), Hôpital Jean Bernard, Centre Hospitalier de Valenciennes, F-59322 Valenciennes, France.
Département Sciences de l'Homme et du Vivant (SHV), Université Polytechnique Hauts-de-France (UPHF), LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France.
Medicina (Kaunas). 2022 Jun 16;58(6):812. doi: 10.3390/medicina58060812.
Motor control, movement impairment, and postural control recovery targeted in rehabilitation could be affected by pain. The main objective of this comprehensive review is to provide a synthesis of the effect of experimental and chronic pain on postural control throughout the available literature. After presenting the neurophysiological pathways of pain, we demonstrated that pain, preferentially localized in the lower back or in the leg induced postural control alteration. Although proprioceptive and cortical excitability seem modified with pain, spinal modulation assessment might provide a new understanding of the pain phenomenon related to postural control. The literature highlights that the motor control of trunk muscles in patient presenting with lower back pain could be dichotomized in two populations, where the first over-activates the trunk muscles, and the second under-activates the trunk muscles; both generate an increase in tissue loading. Taking all these findings into account will help clinician to provide adapted treatment for managing both pain and postural control.
运动控制、运动障碍和康复中针对姿势控制的恢复可能会受到疼痛的影响。本综述的主要目的是通过现有文献综合分析实验性和慢性疼痛对姿势控制的影响。在介绍疼痛的神经生理通路后,我们证明了疼痛,特别是下背部或腿部的疼痛会导致姿势控制的改变。尽管疼痛会导致本体感觉和皮质兴奋性发生变化,但脊髓调制评估可能会提供一种新的理解与姿势控制相关的疼痛现象的方法。文献强调,腰痛患者的躯干肌肉运动控制可以分为两种人群,一种是过度激活躯干肌肉,另一种是过度抑制躯干肌肉;这两种都会增加组织负荷。考虑到所有这些发现,将有助于临床医生为管理疼痛和姿势控制提供适应性治疗。