Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.
Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom.
PLoS One. 2022 Sep 13;17(9):e0274403. doi: 10.1371/journal.pone.0274403. eCollection 2022.
Motor learning underpins successful motor skill acquisition. Although it is well known that pain changes the way we move, it's impact on motor learning is less clear. The aim of this systematic review was to synthesize evidence on the impact of experimental and clinical pain on task performance and activity-dependent plasticity measures across learning and explore these findings in relation to different pain and motor learning paradigms. Five databases were searched: Web of Science, Scopus, MEDLINE, Embase and CINAHL. Two reviewers independently screened the studies, extracted data, and assessed risk of bias using the Cochrane ROB2 and ROBIN-I. The overall strength of evidence was rated using the GRADE guidelines. Due to the heterogeneity of study methodologies a narrative synthesis was employed. Twenty studies were included in the review: fifteen experimental pain and five clinical pain studies, covering multiple motor paradigms. GRADE scores for all outcome measures suggested limited confidence in the reported effect for experimental pain and clinical pain, on motor learning. There was no impact of pain on any of the task performance measures following acquisition except for 'accuracy' during a tongue protrusion visuomotor task and 'timing of errors' during a motor adaptation locomotion task. Task performance measures at retention, and activity dependent measures at both acquisition and retention showed conflicting results. This review delivers a detailed synthesis of research studies exploring the impact of pain on motor learning. This is despite the challenges provided by the heterogeneity of motor learning paradigms, outcome measures and pain paradigms employed in these studies. The results highlight important questions for further research with the goal of strengthening the confidence of findings in this area.
运动学习是成功掌握运动技能的基础。尽管众所周知疼痛会改变我们的运动方式，但它对运动学习的影响还不太清楚。本系统评价的目的是综合实验性和临床疼痛对学习过程中任务表现和活动依赖性可塑性测量的影响，并探讨这些发现与不同的疼痛和运动学习范式之间的关系。共检索了五个数据库：Web of Science、Scopus、MEDLINE、Embase 和 CINAHL。两名审查员独立筛选研究、提取数据，并使用 Cochrane ROB2 和 ROBIN-I 评估偏倚风险。使用 GRADE 指南评估总体证据强度。由于研究方法的异质性，采用了叙述性综合。本综述共纳入 20 项研究：15 项实验性疼痛研究和 5 项临床疼痛研究，涵盖了多种运动范式。所有结局指标的 GRADE 评分均表明，对实验性疼痛和临床疼痛对运动学习的影响的报告效应的信心有限。除了在舌突出视觉运动任务中的“准确性”和在运动适应运动任务中的“错误时间”外，疼痛对获得后任何任务表现指标均无影响。保留时的任务表现指标以及获得和保留时的活动依赖性指标均显示出相互矛盾的结果。本综述详细综合了研究疼痛对运动学习影响的研究。尽管这些研究采用的运动学习范式、结局指标和疼痛范式存在异质性，但仍提供了详细的综合。结果突出了进一步研究的重要问题，目的是加强该领域研究结果的可信度。
