HU University of Applied Sciences, Institute for Human Movement Studies, Postbus 12011, Utrecht 3501 AA, the Netherlands; Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam 1081 BT, the Netherlands.
HU University of Applied Sciences, Institute for Human Movement Studies, Postbus 12011, Utrecht 3501 AA, the Netherlands; Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam 1081 BT, the Netherlands.
Hum Mov Sci. 2023 Dec;92:103159. doi: 10.1016/j.humov.2023.103159. Epub 2023 Nov 17.
Pain-related cognitions are associated with motor control changes in people with chronic low-back pain (CLBP). The mechanism underlying this association is unclear. We propose that perceived threat increases muscle-spindle-reflex-gains, which reduces the effect of mechanical perturbations, and simultaneously decreases movement precision.
To evaluate effects of CLBP and pain-related cognitions on the impact of mechanical perturbations on trunk movement, and associations between these perturbation effects and movement precision.
30 participants with CLBP and 30 healthy controls, performed two consecutive trials of a seated repetitive reaching task. During both trials participants were warned for mechanical perturbations, which were only administered during the second trial. The perturbation effect was characterized by the deviation of the trajectory of the T8 vertebra relative to the sacrum. Trunk movement precision was expressed as tracking error during a trunk movement target tracking task. We assessed pain-related cognitions with the task-specific 'Expected Back Strain'-scale (EBS). We used a two-way-Anova to assess the effect of Group (CLBP vs back-healthy) and dichotomized EBS (higher vs lower) on the perturbation effect, and a Pearson's correlation to assess associations between perturbation effects and movement precision.
Higher EBS was associated with smaller perturbation effects (p ≤ 0.011). A negative correlation was found between the perturbation effect and the tracking error, in the higher EBS-group (r = -0.5, p = 0.013).
These results demonstrate that pain-related cognitions influence trunk movement control and support the idea that more negative pain-related cognitions lead to an increased resistance against perturbations, at the expense of movement precision.
疼痛相关认知与慢性下背痛（CLBP）患者的运动控制变化有关。这种关联的机制尚不清楚。我们假设感知到的威胁会增加肌梭反射增益，从而降低机械干扰的影响，同时降低运动精度。
评估 CLBP 和疼痛相关认知对机械干扰对躯干运动影响的影响，以及这些干扰效应与运动精度之间的相关性。
30 名 CLBP 患者和 30 名健康对照组参与者进行了两次连续的坐姿重复伸展任务。在两次试验中，参与者都收到了机械干扰的警告，但只有在第二次试验中才会进行干扰。通过 T8 椎体相对于骶骨的轨迹偏差来描述干扰效应。躯干运动精度表示为在躯干运动目标跟踪任务中跟踪误差。我们使用特定任务的“预期背部劳损”量表（EBS）评估与疼痛相关的认知。我们使用双向方差分析来评估组（CLBP 与背部健康）和 EBS （较高与较低）对干扰效应的影响，并使用皮尔逊相关来评估干扰效应与运动精度之间的相关性。
较高的 EBS 与较小的干扰效应相关（p≤0.011）。在 EBS 较高的组中，发现干扰效应与跟踪误差之间存在负相关（r=-0.5，p=0.013）。
这些结果表明疼痛相关认知会影响躯干运动控制，并支持这样一种观点，即更消极的疼痛相关认知会导致对干扰的抵抗力增加，而牺牲运动精度。
