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安慰剂和反安慰剂效应对客观及主观姿势稳定性的比较:一把双刃剑?

A comparison of placebo and nocebo effects on objective and subjective postural stability: a double-edged sword?

作者信息

Russell Katherine, Duncan Michael, Price Michael, Mosewich Amber, Ellmers Toby, Hill Mathew

机构信息

Centre for Sport, Exercise and Life Sciences, School of Life Sciences, Coventry University, Coventry, United Kingdom.

Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada.

出版信息

Front Hum Neurosci. 2022 Aug 18;16:967722. doi: 10.3389/fnhum.2022.967722. eCollection 2022.


DOI:10.3389/fnhum.2022.967722
PMID:36061498
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9434487/
Abstract

Positive expectations (i.e., placebo effect) can improve postural control during quiet standing. This raises an important question: if postural control is susceptible to positive expectations, is it possible to elicit the opposite, a decline in postural stability, simply by suggesting a performance impairment (i.e., nocebo) will take place? Yet no studies have examined the nocebo effect on balance performance. To better understand both phenomena, comparative studies, which include both placebo and nocebo conditions, are needed. Forty-two healthy adults were initially assessed for objective (center of pressure movement) and subjective (perceived) postural stability and performance expectations. Participants were then randomly assigned in equal numbers to a placebo (positive expectation), nocebo (negative expectation) or control (no suggestion) group. Participants in the placebo/nocebo groups were deceptively administered an inert capsule described as a potent supplement which would either positively or negatively influence their balance performance. Objective and subjective postural stability, and performance expectations were reassessed 20 min later. The nocebo procedure evoked an increase in COP sway movements and reduced perceived stability compared to a control group. The placebo group presented with reductions COP sway movements and increased perceived stability following expectation manipulation. Compared to the control group, the placebo group showed a significantly higher performance expectation whilst the nocebo group showed a significantly lower performance expectation. Regression analyses also revealed that performance expectations following the placebo/nocebo procedure significantly predicted perceptions of postural instability (i.e., perceived performance), accounting for around 50% of the variance. These results remained even when controlling for performance (i.e., objective postural stability). Our findings indicate that positive and negative performance expectations evoked by instructional manipulation can profoundly influence both objective and subjective postural stability. Postural control-and perceptions regarding such-are clearly susceptible to expectation manipulation, which could have important practical implications and repercussions on testing, training interventions and rehabilitation programs. Positive and negative expectancies are a double-edged sword for postural control.

摘要

积极预期(即安慰剂效应)能够改善安静站立时的姿势控制。这就引出了一个重要问题:如果姿势控制容易受到积极预期的影响,那么是否有可能仅仅通过暗示会出现表现下降(即反安慰剂效应)来引发相反的情况,即姿势稳定性下降呢?然而,尚无研究考察反安慰剂效应对平衡表现的影响。为了更好地理解这两种现象,需要进行包括安慰剂和反安慰剂条件的对比研究。42名健康成年人最初接受了客观(压力中心移动)和主观(感知到的)姿势稳定性以及表现预期的评估。然后,参与者被随机等分为安慰剂组(积极预期)、反安慰剂组(消极预期)或对照组(无暗示)。安慰剂/反安慰剂组的参与者被欺骗性地给予一种惰性胶囊,该胶囊被描述为一种强效补充剂,会对他们的平衡表现产生积极或消极影响。20分钟后重新评估客观和主观姿势稳定性以及表现预期。与对照组相比,反安慰剂程序引发了压力中心摆动运动增加以及感知稳定性降低。安慰剂组在预期操纵后压力中心摆动运动减少且感知稳定性增加。与对照组相比,安慰剂组表现出显著更高的表现预期,而反安慰剂组表现出显著更低的表现预期。回归分析还显示,安慰剂/反安慰剂程序后的表现预期显著预测了姿势不稳定性的感知(即感知到的表现),约占方差的50%。即使在控制了表现(即客观姿势稳定性)后,这些结果仍然成立。我们的研究结果表明,通过指令操纵引发的积极和消极表现预期能够深刻影响客观和主观姿势稳定性。姿势控制以及对此的感知显然容易受到预期操纵的影响,这可能对测试、训练干预和康复计划产生重要的实际影响和后果。积极和消极预期对姿势控制来说是一把双刃剑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/6925d19e996f/fnhum-16-967722-g0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/80ae1a57c779/fnhum-16-967722-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/b9ba9deb7734/fnhum-16-967722-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/e057ce783177/fnhum-16-967722-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/ffbb4ef48578/fnhum-16-967722-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/1a13fcf4e1ae/fnhum-16-967722-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/6925d19e996f/fnhum-16-967722-g0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/80ae1a57c779/fnhum-16-967722-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/b9ba9deb7734/fnhum-16-967722-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/e057ce783177/fnhum-16-967722-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/ffbb4ef48578/fnhum-16-967722-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/1a13fcf4e1ae/fnhum-16-967722-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b386/9434487/6925d19e996f/fnhum-16-967722-g0006.jpg

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引用本文的文献

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[2]
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本文引用的文献

[1]
Persistent Postural-Perceptual Dizziness (PPPD) from Brain Imaging to Behaviour and Perception.

Brain Sci. 2022-6-8

[2]
Nocebo effects on motor performance: A systematic literature review.

Scand J Psychol. 2021-10

[3]
Nocebo Effects on Perceived Muscle Soreness and Exercise Performance Following Unaccustomed Resistance Exercise: A Pilot Study.

J Funct Morphol Kinesiol. 2020-6-9

[4]
Association of nocebo hyperalgesia and basic somatosensory characteristics in a large cohort.

Sci Rep. 2021-1-12

[5]
Consciously processing balance leads to distorted perceptions of instability in older adults.

J Neurol. 2021-4

[6]
What Should Clinicians Tell Patients about Placebo and Nocebo Effects? Practical Considerations Based on Expert Consensus.

Psychother Psychosom. 2021

[7]
The emergence of age-related deterioration in dynamic, but not quiet standing balance abilities among healthy middle-aged adults.

Exp Gerontol. 2020-10-15

[8]
Choose your words wisely: Optimizing impacts on standardized performance testing.

Gait Posture. 2020-6

[9]
Neurological update: dizziness.

J Neurol. 2020-6

[10]
Placebo and Nocebo Effects.

N Engl J Med. 2020-2-6

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