Pain and motor control: From the laboratory to rehabilitation

Hodges, P. W. (2011) Pain and motor control: From the laboratory to rehabilitation. Journal of Electromyography and Kinesiology, 21 2: 220-228. doi:10.1016/j.jelekin.2011.01.002


Author Hodges, P. W.
Title Pain and motor control: From the laboratory to rehabilitation
Journal name Journal of Electromyography and Kinesiology   Check publisher's open access policy
ISSN 1050-6411
Publication date 2011-04-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.jelekin.2011.01.002
Volume 21
Issue 2
Start page 220
End page 228
Total pages 9
Place of publication Oxford , United Kingdom
Publisher Elsevier
Collection year 2012
Language eng
Abstract Movement is changed in pain and is the target of clinical interventions. Yet the understanding of the physiological basis for movement adaptation in pain remains limited. Contemporary theories are relatively simplistic and fall short of providing an explanation for the variety of permutations of changes in movement control identified in clinical and experimental contexts. The link between current theories and rehabilitation is weak at best. New theories are required that both account for the breadth of changes in motor control in pain and provide direction for development and refinement of clinical interventions. This paper describes an expanded theory of the motor adaptation to pain to address these two issues. The new theory, based on clinical and experimental data argues that: activity is redistributed within and between muscles rather than stereotypical inhibition or excitation of muscles; modifies the mechanical behaviour in a variable manner with the objective to “protect” the tissues from further pain or injury, or threatened pain or injury; involves changes at multiple levels of the motor system that may be complementary, additive or competitive; and has short-term benefit, but with potential long-term consequences due to factors such as increased load, decreased movement, and decreased variability. This expanded theory provides guidance for rehabilitation directed at alleviating a mechanical contribution to the recurrence and persistence of pain that must be balanced with other aspects of a multifaceted intervention that includes management of psychosocial aspects of the pain experience.
Keyword Motor control
Pain
Musculoskeletal pain
Rehabilitation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2012 Collection
School of Health and Rehabilitation Sciences Publications
 
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Created: Sun, 06 Mar 2011, 10:09:31 EST