Young adults with recurrent low back pain demonstrate altered trunk coordination during gait independent of pain status and attentional demands
Young adults with recurrent low back pain demonstrate altered trunk coordination during gait independent of pain status and attentional demands
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DOI：
10.1007/s00221-021-06106-8
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发表时间：
2021-04-19
影响因子：
2
通讯作者：
Kulig, Kornelia
中科院分区：
文献类型：
--
作者：
Shih, Hai-Jung Steffi;Winstein, Carolee J.;Kulig, Kornelia
疼痛影响注意力和运动行为。我们使用双任务干扰范式来研究（1）注意力表现的改变，（2）切换任务优先级的能力，（3）注意力需求对复发性腰痛（LBP）患者在狭窄基础上行走进出疼痛发作期间躯干协调的影响。我们测试了20名患有LBP的年轻人，无论是在疼痛发作期间还是之后，并将他们与20名背部健康的人进行了比较。参与者同时进行了一个狭窄的步长匹配任务和算术任务，有和没有指示，以优先考虑任何一个任务。运动捕捉系统被用来记录运动学数据，额状面躯干协调分析使用矢量编码的胸部和骨盆的角度。采用配对t检验或重复测量双因素方差分析对单任务绩效、双任务效应、双任务绩效变异性、任务优先级转换和躯干协调进行分析。结果表明，活动性疼痛对注意力过程有不利影响，表现为单任务表现较差，双任务表现变异性增加，复发性LBP的个体。患有LBP的人，无论疼痛状况如何，都能够将任务优先级转换到与背部健康的人相似的程度。与对照组相比，复发性LBP的个体在窄基行走过程中表现出较少的同相，更多的骨盆主导躯干协调，独立于疼痛状态，无论注意力操作如何。因此，LBP患者躯干协调性的改变似乎是习惯性的、自动的，并且持续超过症状持续时间。
Pain influences both attention and motor behavior. We used a dual-task interference paradigm to investigate (1) alterations in attentional performance, (2) the ability to switch task prioritization, and (3) the effect of attentional demand on trunk coordination during narrow-based walking in and out of a painful episode in individuals with recurrent low back pain (LBP). We tested twenty young adults with LBP both in and out of a painful episode and compared them to twenty matched back-healthy individuals. Participants simultaneously performed a narrow step width matching task and an arithmetic task, with and without instructions to prioritize either task. A motion capture system was used to record kinematic data, and frontal plane trunk coordination was analyzed using vector coding on the thorax and pelvis angles. Single-task performance, dual-task effect, dual-task performance variability, task prioritization switch, and trunk coordination were analyzed using paired t tests or repeated measures two-way ANOVAs. Results indicated that active pain has a detrimental effect on attentional processes, indicated by poorer single-task performance and increased dual-task performance variability for individuals with recurrent LBP. Individuals with LBP, regardless of pain status, were able to switch task prioritization to a similar degree as their back-healthy counterparts. Compared to the control group, individuals with recurrent LBP exhibited a less in-phase, more pelvis-dominated trunk coordination during narrow-based walking, independent of pain status and regardless of attentional manipulations. Thus, altered trunk coordination in persons with LBP appears to be habitual, automatic, and persists beyond symptom duration.