New insight into motor adaptation to pain revealed by a combination of modelling and empirical approaches

Hodges, P. W., Coppieters, M. W., Macdonald, D. and Cholewicki, J. (2013) New insight into motor adaptation to pain revealed by a combination of modelling and empirical approaches. European Journal of Pain, 17 8: 1138-1146. doi:10.1002/j.1532-2149.2013.00286.x

Author Hodges, P. W.
Coppieters, M. W.
Macdonald, D.
Cholewicki, J.
Title New insight into motor adaptation to pain revealed by a combination of modelling and empirical approaches
Journal name European Journal of Pain   Check publisher's open access policy
ISSN 1090-3801
Publication date 2013-09
Year available 2013
Sub-type Article (original research)
DOI 10.1002/j.1532-2149.2013.00286.x
Open Access Status
Volume 17
Issue 8
Start page 1138
End page 1146
Total pages 9
Place of publication Chichester, West Sussex, United Kingdom
Publisher John Wiley & Sons
Collection year 2014
Language eng
Formatted abstract
Background: Movement changes in pain. Unlike the somewhat stereotypical response of limb muscles to pain, trunk muscle responses are highly variable when challenged by pain in that region. This has led many to question the existence of a common underlying theory to explain the adaptation. Here, we tested the hypotheses that (1) adaptation in muscle activation in acute pain leads to enhanced spine stability, despite variation in the pattern of muscle activation changes; and (2) individuals would use a similar ‘signature’ pattern for tasks with different mechanical demands.

In 17 healthy individuals, electromyography recordings were made from a broad array of anterior and posterior trunk muscles while participants moved slowly between trunk flexion and extension with and without experimentally induced back pain. Hypotheses were tested by estimating spine stability (Stability Index) with an electromyographydriven spine model and analysis of individual and overall (net) adaptations in muscle activation.

Results: The Stability Index (P < 0.017) and net muscle activity (P < 0.021) increased during pain, although no two individuals used the same pattern of adaptation in muscle activity. For most, the adaptation was similar between movement directions despite opposite movement demands.

Conclusions: These data provide the first empirical confirmation that, in most individuals, acute back pain leads to increased spinal stability and that the pattern of muscle activity is not stereotypical, but instead involves an individual-specific response to pain. This adaptation is likely to provide short-term benefit to enhance spinal protection, but could have long-term consequences for spinal health.
Keyword Low back pain
Experimental muscle pain
Lumbar spine
Transversus abdominis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 30 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 12 Feb 2013, 11:24:45 EST by Dr Michel Coppieters on behalf of School of Health & Rehabilitation Sciences