Pain and Motor Learning in Older Adults

项目摘要 大多数寻求物理治疗的老年患者都有疼痛。许多人的身体康复 疼痛的骨科和神经系统疾病通常涉及使用运动学习策略，其中新的 使用反复的试错练习来教导运动模式。然而，我们实验室的初步数据 表明疼痛可能会对新学习的运动模式的保持产生负面影响。如果正确的话，这将 表明疼痛的存在可能会限制通过基于运动学习的 干预措施。到目前为止，急性或慢性疼痛对运动学习的影响尚未得到彻底的研究。 在临床人群中进行研究。此外，还不知道疼痛如何影响老年人的运动学习 具体来说，尽管老年人的认知能力下降也可能 对学习和运动记忆有负面影响。概括地说，这项研究的目的是调查 急性和慢性疼痛对年轻人和老年人运动学习和记忆的影响， 老年人慢性腰痛。我们的中心假设是，急性和慢性疼痛都损害了 在老年人中，这些缺陷恶化，并与运动学习的保留有关。 认知能力下降的程度。我们将从三个方面来研究这一假说：（1）利用我们的实验性疼痛 范式，比较急性疼痛对健康年轻人和健康人运动学习保持的影响。 老年人;（2）确定慢性腰痛的老年人是否有受损的保留， 运动学习;（3）评估慢性疼痛、认知和运动学习之间的关系 老年人的记忆力。运动学习和它的保留将使用我们的新的视觉评估- 驱动运动学习范式。认知的几个方面将用认知电池进行量化， 特别关注注意力和工作记忆。最后，将通过以下评估量化疼痛： 强度、干扰和灵敏度。这项工作的结果将提供有关 老年临床人群中疼痛与运动学习的关系。鉴于许多康复 干预措施利用基于运动学习的策略来恢复正常的运动模式， 知识可能从根本上改善多个患者群体的康复治疗， 经历痛苦

PROJECT SUMMARY The majority of older adult patients who seek physical therapy have pain. Physical rehabilitation for many painful orthopedic and neurologic conditions often involves the use of motor learning strategies, in which new movement patterns are taught using repeated trial-and-error practice. However, preliminary data from our lab suggests that pain may negatively affect the retention of newly learned motor patterns. If correct, this would suggest that the presence of pain may limit rehabilitation outcomes sought through motor learning-based interventions. To date, the effects of acute or chronic pain on motor learning have not been thoroughly investigated in clinical populations. Further, it is not known how pain affects motor learning in older adults specifically, despite the fact that cognitive declines, which are well-documented in the elderly, could also negatively affect learning and motor memory. Broadly, the purpose of this research is to investigate the impact of both acute and chronic pain on locomotor learning and its retention in young and older adults as well as older adults with chronic low back pain. Our central hypothesis is that both acute and chronic pain impair retention of locomotor learning and that in older adults, these deficits are worsened and are related to the degree of cognitive decline. We will investigate this hypothesis with three aims: (1) using our experimental pain paradigm, to compare effects of acute pain on retention of locomotor learning in healthy young and healthy older adults; (2) to determine whether older adults with chronic low back pain have impaired retention of locomotor learning; and (3) to assess relationships between chronic pain, cognition, and motor learning retention capacity in older adults. Motor learning and its retention will be assessed using our novel visually- driven locomotor learning paradigm. Several aspects of cognition will be quantified with a cognitive battery, with special focus on attention and working memory. Finally, pain will be quantified with assessments of intensity, interference and sensitivity. Results from this work will provide much needed data concerning the relationship between pain and motor learning in older adult clinical populations. Given that many rehabilitation interventions utilize motor learning-based strategies to recover normal movement patterns, gaining this new knowledge is likely to fundamentally improve delivery of rehabilitation in multiple patient populations that experience pain.