Chronic low back pain is associated with altered affordance perception

Individuals with chronic low back pain (CLBP) often modify their movement patterns and limit engagement in motor activities, which may reduce the exploration of affordances-action possibilities offered by the environment. From an ecological-enactive perspective, pain may progressively narrow the affordance field, constraining both the perception of what is possible and the strategies used to explore those possibilities. This experimental study investigated whether CLBP affects (a) the perception of action capabilities and (b) the exploratory movement patterns used when approaching environmental constraints.

Twenty-seven adults with CLBP and 28 adults without pain walked through openings of 50, 70, and 120 cm and judged the passability of an adjustable aperture. Perceived action threshold and the perception-action ratio were used to assess affordance perception, and pelvis-trunk coordination was used to characterize exploratory movement patterns during locomotion.

Compared with controls, individuals with CLBP demonstrated a higher perceived action threshold (mean difference = 5.28 cm; medium effect size) and a larger perception-action ratio (mean difference = .08), indicating underestimation of their action capabilities. The perceived action threshold correlated positively with pain intensity. In contrast, pelvis-trunk coordination did not differ between groups across passage widths (mean differences = -0.01 and 0.09).

CLBP influenced affordance perception but not pelvis-trunk dissociation during movement exploration, suggesting preserved exploratory movement patterns despite altered perception of action capabilities. These findings suggest that rehabilitation targeting perception-action coupling may improve functional outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).