The effects of pain and a secondary task on postural sway during standing.

Attention Cuff algometry Experimental pain Postural stability Secondary task

Journal

Human movement science
ISSN: 1872-7646
Titre abrégé: Hum Mov Sci
Pays: Netherlands
ID NLM: 8300127

Informations de publication

Date de publication:
Oct 2021
Historique:
received: 28 08 2020
revised: 31 05 2021
accepted: 11 08 2021
pubmed: 22 8 2021
medline: 22 9 2021
entrez: 21 8 2021
Statut: ppublish

Résumé

Pain impairs available cognitive resources and somatosensory information, but its effects on postural control during standing are inconclusive. The aim of this study was to investigate whether postural sway is affected by the presence of pain and a secondary task during standing. Sixteen healthy subjects stood as quiet as possible at a tandem stance for 30s on a force platform at different conditions regarding the presence of pain and a secondary task. Subjects received painful stimulations on the right upper arm or lower leg according to a relative pain threshold [pain 7 out 10 on a Visual Analog Scale (VAS) - 0 representing "no pain" and 10 "worst pain imaginable"] using a computer pressurized cuff. The secondary task consisted of pointing to a target using a head-mounted laser-pointer as visual feedback. Center of Pressure (COP) sway area, velocity, mean frequency and sample entropy were calculated from force platform measures. Compared to no painful condition, pain intensity (leg: VAS = 7; arm VAS = 7.4) increased following cuff pressure conditions (P < .01). Pain at the leg decreased COP area (P < .05), increased COP velocity (P < .05), mean frequency (P < .05) and sample entropy (P < .05) compared with baseline condition regardless the completion of the secondary task. During condition with pain at the leg, completion of the secondary task reduced COP velocity (P < .001) compared with condition without secondary task. Pain in the arm did not affect postural sway. Rather, postural adaptations seem dependent on the location of pain as pain in the lower leg affected postural sway. The completion of a secondary task affected postural sway measurements and reduced the effect of leg pain on postural sway. Future treatment interventions could benefit from dual-task paradigm during balance training aiming to improve postural control in patients suffering from chronic pain.

Sections du résumé

BACKGROUND BACKGROUND
Pain impairs available cognitive resources and somatosensory information, but its effects on postural control during standing are inconclusive. The aim of this study was to investigate whether postural sway is affected by the presence of pain and a secondary task during standing.
METHODS METHODS
Sixteen healthy subjects stood as quiet as possible at a tandem stance for 30s on a force platform at different conditions regarding the presence of pain and a secondary task. Subjects received painful stimulations on the right upper arm or lower leg according to a relative pain threshold [pain 7 out 10 on a Visual Analog Scale (VAS) - 0 representing "no pain" and 10 "worst pain imaginable"] using a computer pressurized cuff. The secondary task consisted of pointing to a target using a head-mounted laser-pointer as visual feedback. Center of Pressure (COP) sway area, velocity, mean frequency and sample entropy were calculated from force platform measures.
FINDINGS RESULTS
Compared to no painful condition, pain intensity (leg: VAS = 7; arm VAS = 7.4) increased following cuff pressure conditions (P < .01). Pain at the leg decreased COP area (P < .05), increased COP velocity (P < .05), mean frequency (P < .05) and sample entropy (P < .05) compared with baseline condition regardless the completion of the secondary task. During condition with pain at the leg, completion of the secondary task reduced COP velocity (P < .001) compared with condition without secondary task.
INTERPRETATION CONCLUSIONS
Pain in the arm did not affect postural sway. Rather, postural adaptations seem dependent on the location of pain as pain in the lower leg affected postural sway. The completion of a secondary task affected postural sway measurements and reduced the effect of leg pain on postural sway. Future treatment interventions could benefit from dual-task paradigm during balance training aiming to improve postural control in patients suffering from chronic pain.

Identifiants

pubmed: 34418802
pii: S0167-9457(21)00111-1
doi: 10.1016/j.humov.2021.102863
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102863

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Rogerio Pessoto Hirata (RP)

Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 12, 9220 Aalborg East, Denmark. Electronic address: rirata@hst.aau.dk.

Mikkel Jacobi Thomsen (MJ)

Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 12, 9220 Aalborg East, Denmark.

Frederik Greve Larsen (FG)

Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 12, 9220 Aalborg East, Denmark.

Nicolai Støttrup (N)

Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 12, 9220 Aalborg East, Denmark.

Marcos Duarte (M)

Federal University of ABC, Biomedical Engineering, São Bernardo do Campo, São Paulo, Brazil.

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Classifications MeSH