Update on the Relation Between Pain and Movement: Consequences for Clinical Practice
Update on the Relation Between Pain and Movement: Consequences for Clinical Practice
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DOI：
10.1097/ajp.0b013e3181e0174f
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发表时间：
2010-11-01
影响因子：
2.9
通讯作者：
Bement, Marie K. Hoeger
中科院分区：
文献类型：
--
作者：
Cote, Julie N.;Bement, Marie K. Hoeger
人们普遍认为运动有助于减轻疼痛。然而，由于低阈值运动单位的过载，长时间的运动可能导致疼痛性损伤的发展。特别是在个人的疼痛状况，运动处方和疲劳的影响是不太清楚。这可能是因为疲劳对疼痛的双重影响，加重和缓解。本综述的目的是确定疼痛和运动系统之间的关系，无论是在发展和管理的疼痛。最近的研究表明，疲劳改变了疼痛引起的皮质运动兴奋性的增加，并导致肌肉内和肌肉间的适应。对急性疼痛的研究显示了复杂的适应性，如运动变异性增加，这可能是因为寻找运动解决方案以延长整体任务表现。相比之下，慢性疼痛似乎限制了运动的持续时间、速度和可变性，这在短期内可能是保护性的，但随着时间的推移也会适得其反。由于这些适应运动策略，疼痛慢性化可能有助于规定运动处方。例如，正确剂量的多肌、动力练习会起到促进运动变异性的作用。因此，似乎涉及使用不同运动策略的运动可以有效地帮助人们获得运动引起的益处，同时避免受伤和疼痛加重。
It is generally thought that exercise is beneficial to alleviate pain. However, prolonged movement may lead to the development of painful injuries, because of the overload of low-threshold motor units. Especially in individuals with a pain condition, exercise prescription and the impact of fatigue is less clear. This may be because of the dual effects, aggravation and relief, which fatigue has on pain. The purpose of this review is to ascertain the relation between pain and the motor system, both in the development and management of pain. Recent studies show that fatigue alters pain-induced increases in corticomotor excitability and leads to within and between-muscle adaptations. Studies of acute pain have shown complex adaptations such as increased movement variability, which may be because of a search for motor solutions to prolong overall task performance. In contrast, chronic pain seems to limit movement duration, speed, and variability which could be protective in the short term but also counterproductive over time. Owing to these adaptations in movement strategies, pain chronicity may help to dictate exercise prescription. For example, the correct dosage of multimuscle, dynamic exercises would act to promote movement variability. Thus, it seems that exercise involving the use of different movement strategies could be effective in helping people to obtain exercise-induced benefits while avoiding injury and pain reaggravation.