Abstract
BackgroundChronic low back pain (CLBP) is often accompanied by an abnormal motor performance. However, it has not been clarified yet whether these deviations also occur during motor tasks not involving the back and whether the performance is influenced by pain and pain-related cognitions. Therefore, the aim of the present study is to get insight in the contribution of both pain experience and pain-related cognitions to general motor task performance in CLBP.Methods13 CLBP patients and 15 healthy subjects performed a hand-function task in three conditions: sitting, lying prone (lying) and lying prone without trunk support (provoking). The last condition was assumed to provoke pain-related cognitions, which was considered successful when a patients' pain expectancy on a numeric rating scale was at least 1 point higher than actual pain experienced. Subjects' performance was expressed in reaction time and movement time. Repeated measures analysis of variance was performed to detect main effect for group and condition. Special interest was given to group*condition interaction, since significant interaction would indicate that patients and healthy subjects performed differently throughout the three conditions.ResultsPatients were slower throughout all conditions compared to healthy subjects. With respect to the provoking condition, patients showed deteriorated performance compared to lying while healthy subjects' performance remained equal between these two conditions. Further analysis of patients' data showed that provocation was successful in 54% of the patients. Especially this group showed deteriorated performance in the provoking condition.ConclusionIt can be concluded that CLBP patients in general have worse motor task performance compared to healthy subjects and that provoking pain-related cognitions further worsened performance.
Highlights
Chronic low back pain (CLBP) is often accompanied by an abnormal motor performance
Two of them were excluded after questionnaire assessment, because their visual analogue scale (VAS) scores appeared to be less than 10 mm, indicating no pain experience at the time of testing
Results of the CLBP patients were analyzed on differences between the two subgroups but this analysis revealed no differences with respect to reaction time (RT) between the two subgroups
Summary
Chronic low back pain (CLBP) is often accompanied by an abnormal motor performance It has not been clarified yet whether these deviations occur during motor tasks not involving the back and whether the performance is influenced by pain and pain-related cognitions. According to the fear-avoidance model the relation between pain and motor performance is characterized by a negative vicious circle of to date the majority of research on motor performance in CLBP has been focusing only on motor tasks directly involving the lower back (e.g. reaching, bending) As these lower back motor tasks are often considered both painful and threatening by patients, it is hard to distinguish whether deviations in performance should be attributed to pain experience or to painrelated cognitions. Neither the effect of pain experience nor that of pain-related fear could be individually distinguished
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