Abstract
Pain influences both attention and motor behavior. We used a dual-task interference paradigm to investigate (1) alterations in attentional performance, (2) the ability to switch task prioritization, and (3) the effect of attentional demand on trunk coordination during narrow-based walking in and out of a painful episode in individuals with recurrent low back pain (LBP). We tested twenty young adults with LBP both in and out of a painful episode and compared them to twenty matched back-healthy individuals. Participants simultaneously performed a narrow step width matching task and an arithmetic task, with and without instructions to prioritize either task. A motion capture system was used to record kinematic data, and frontal plane trunk coordination was analyzed using vector coding on the thorax and pelvis angles. Single-task performance, dual-task effect, dual-task performance variability, task prioritization switch, and trunk coordination were analyzed using paired t tests or repeated measures two-way ANOVAs. Results indicated that active pain has a detrimental effect on attentional processes, indicated by poorer single-task performance and increased dual-task performance variability for individuals with recurrent LBP. Individuals with LBP, regardless of pain status, were able to switch task prioritization to a similar degree as their back-healthy counterparts. Compared to the control group, individuals with recurrent LBP exhibited a less in-phase, more pelvis-dominated trunk coordination during narrow-based walking, independent of pain status and regardless of attentional manipulations. Thus, altered trunk coordination in persons with LBP appears to be habitual, automatic, and persists beyond symptom duration.
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Acknowledgements
This research was supported by the International Society of Biomechanics Matching Dissertation Grant, with matching contribution from the USC Division of Biokinesiology and Physical Therapy. We would also like to thank our participants for their essential contribution to this study.
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This research was supported by the International Society of Biomechanics Matching Dissertation Grant.
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SS, CW, KK contributed to the study conception and design. Study setup, data collection and analyses were performed by SS. The first draft of the manuscript was written by SS, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the University of Southern California Health Sciences Campus (Date: 01/13/2017/No. HS-16-00980).
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Shih, HJ.S., Winstein, C.J. & Kulig, K. Young adults with recurrent low back pain demonstrate altered trunk coordination during gait independent of pain status and attentional demands. Exp Brain Res 239, 1937–1949 (2021). https://doi.org/10.1007/s00221-021-06106-8
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DOI: https://doi.org/10.1007/s00221-021-06106-8