Effect of tonic pain on motor acquisition and retention while learning to reach in a force field.
Effect of tonic pain on motor acquisition and retention while learning to reach in a force field.
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DOI：
10.1371/journal.pone.0099159
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Mercier C
中科院分区：
文献类型：
--
作者：
Lamothe M;Roy JS;Bouffard J;Gagné M;Bouyer LJ;Mercier C
大多数接受强化康复以改善上肢功能的患者都会感到疼痛。尽管如此，疼痛对学习特定运动任务的能力的影响仍然未知。这项研究的目的是确定实验性紧张性疼痛的存在是否干扰了与到达任务的训练相关的运动学习的获得和保持阶段。29名健康受试者被随机分为对照组或疼痛组(在第一天的训练中，在上臂局部使用辣椒素乳膏)。在连续两天里，受试者使用机器人外骨骼向两个目标(近/远)做弹道运动。在第一天，任务是在没有(基线)和有力场(适应)的情况下进行的。在第2天重复适应任务。在到达运动结束时，使用距离目标的指数来评估任务绩效。运动规划的评估是通过索引轨迹从直线到目标的初始偏离角来进行的。结果表明，紧张性疼痛不影响基线到达。随着时间的推移，两组都提高了任务绩效(p<；0.001)，但在获得和保持过程中，疼痛组对远目标的最终错误(补偿不足)都比控制组大(p = 0.030)。此外，在初始偏差角度上观察到了x组时间交互作用(p = 0.028)，这表明疼痛的受试者随着时间的推移在运动的前馈部分做出了更大的调整。有趣的是，从第一天结束(有疼痛)到第二天开始(无疼痛)，疼痛组的行为非常稳定，这表明观察到的差异不能完全用疼痛对即刻表现的影响来解释。这表明，如果人们学会了在疼痛面前以不同的方式移动，随着时间的推移，他们可能会保持这种改变的策略。
Most patients receiving intensive rehabilitation to improve their upper limb function experience pain. Despite this, the impact of pain on the ability to learn a specific motor task is still unknown. The aim of this study was to determine whether the presence of experimental tonic pain interferes with the acquisition and retention stages of motor learning associated with training in a reaching task. Twenty-nine healthy subjects were randomized to either a Control or Pain Group (receiving topical capsaicin cream on the upper arm during training on Day 1). On two consecutive days, subjects made ballistic movements towards two targets (NEAR/FAR) using a robotized exoskeleton. On Day 1, the task was performed without (baseline) and with a force field (adaptation). The adaptation task was repeated on Day 2. Task performance was assessed using index distance from the target at the end of the reaching movement. Motor planning was assessed using initial angle of deviation of index trajectory from a straight line to the target. Results show that tonic pain did not affect baseline reaching. Both groups improved task performance across time (p<0.001), but the Pain group showed a larger final error (under-compensation) than the Control group for the FAR target (p = 0.030) during both acquisition and retention. Moreover, a Group x Time interaction (p = 0.028) was observed on initial angle of deviation, suggesting that subjects with Pain made larger adjustments in the feedforward component of the movement over time. Interestingly, behaviour of the Pain group was very stable from the end of Day 1 (with pain) to the beginning of Day 2 (pain-free), indicating that the differences observed could not solely be explained by the impact of pain on immediate performance. This suggests that if people learn to move differently in the presence of pain, they might maintain this altered strategy over time.
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