Ippersiel Patrick, Preuss Richard, Kim Byungjin, Giannini Cristina, Robbins Shawn M
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
Centre for Interdisciplinary Research in Rehabilitation, Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, Quebec, Canada.
Eur J Pain. 2025 Feb;29(2):e4717. doi: 10.1002/ejp.4717. Epub 2024 Aug 24.
Trunk co-contraction during lifting may reflect a guarded motor response to a threatening task. This work estimated the impact of pain catastrophizing on trunk co-contraction during lifting, in people with and without low back pain.
Adults with high pain catastrophizing (back pain: n = 29, healthy: n = 7) and low pain catastrophizing (back pain: n = 20, healthy: n = 11), performed 10 repetitions of a lifting task. Electromyography data of rectus abdominis, erector spinae and external oblique muscles were collected, bilaterally. Co-contraction indices were determined for rectus abdominis/erector spinae and external oblique/erector spinae pairings, bilaterally. Pain catastrophizing was measured using the pain catastrophizing scale and task-specific fear using the Photograph series of daily activities scale. Three-way mixed ANOVAs tested the effects of group (back pain vs. healthy), pain catastrophizing (high vs. low), lifting phase (lifting vs. replacing) and their interactions.
There were no main effects of pain catastrophizing, lifting phase, nor any interactions (p > 0.05). Group effects revealed greater co-contraction for bilateral erector spinae/rectus abdominis pairings (but not erector spinae-external oblique pairings) in people with back pain, compared to healthy participants, independent of pain catastrophizing and lifting phase (p < 0.05). Spearman correlations associated greater task-specific fear and greater erector spinae-left external oblique co-contraction, only in people with back pain (p < 0.05).
Greater co-contraction in the back pain group occurred independent of pain catastrophizing, as measured with a general questionnaire. A task-specific measure of threat may be more sensitive to detecting relationships between threat and co-contraction.
This work contributes evidence that people with back pain commonly exhibit trunk co-contraction when lifting. The lack of a relationship between pain catastrophizing and trunk co-contraction, however, challenges evidence linking psychological factors and guarded motor behaviour in this group. Together, this suggests that other factors may be stronger determinants of co-contraction in people with LBP or that a general construct like pain catastrophizing may not accurately represent this relationship.
在提起重物时躯干协同收缩可能反映出对具有威胁性任务的一种保护性运动反应。本研究评估了疼痛灾难化对有和没有下背痛的人群在提起重物时躯干协同收缩的影响。
疼痛灾难化程度高的成年人（背痛：n = 29，健康：n = 7）和疼痛灾难化程度低的成年人（背痛：n = 20，健康：n = 11）进行了10次提起重物任务的重复操作。双侧收集腹直肌、竖脊肌和腹外斜肌的肌电图数据。确定双侧腹直肌/竖脊肌和腹外斜肌/竖脊肌配对的协同收缩指数。使用疼痛灾难化量表测量疼痛灾难化程度，使用日常活动照片系列量表测量特定任务恐惧。采用三因素混合方差分析来检验组（背痛与健康）、疼痛灾难化程度（高与低）、提起阶段（提起与放回）及其交互作用的影响。
疼痛灾难化程度、提起阶段均无主效应，也不存在任何交互作用（p > 0.05）。组间效应显示，与健康参与者相比，背痛患者双侧竖脊肌/腹直肌配对（而非竖脊肌-腹外斜肌配对）的协同收缩更强，且与疼痛灾难化程度和提起阶段无关（p < 0.05）。仅在背痛患者中，Spearman相关性显示特定任务恐惧增加与竖脊肌-左腹外斜肌协同收缩增加相关（p < 0.05）。
背痛组中更大的协同收缩与使用一般问卷测量的疼痛灾难化程度无关。特定任务的威胁测量可能对检测威胁与协同收缩之间的关系更敏感。
本研究提供了证据表明背痛患者在提起重物时通常会出现躯干协同收缩。然而，疼痛灾难化与躯干协同收缩之间缺乏关联，这对将心理因素与该组中保护性运动行为联系起来的证据提出了挑战。综合来看，这表明其他因素可能是背痛患者协同收缩更强的决定因素，或者像疼痛灾难化这样的一般概念可能无法准确反映这种关系。
