Low-Back Pain Patients Learn to Adapt Motor Behavior With Adverse Secondary Consequences
Jaap H van Dieën1, Herta Flor, Paul W Hodges
11Department of Human Movement Science, MOVE Research Institute Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands, 2Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University and Department of Psychology, School of Social Sciences, University of Mannheim, Germany; and 3The University of Queensland, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane Queensland, Australia.
Abstract:
We hypothesize that changes in motor behavior in individuals with low-back pain are adaptations aimed at minimizing the real or perceived risk of further pain. Through reinforcement learning, pain and subsequent adaptations result in less dynamic motor behavior, leading to increased loading and impoverished sensory feedback, which contribute to cortical reorganization and proprioceptive impairments that reduce the ability to control lumbar movement in a robust manner.
