Pain impairs the retention of motor learning

📖 Literature Information and Abstract Translation

Acute pain impairs the retention of locomotor learning

[Background/Objective] Despite abundant evidence that pain alters motor performance, little is known about the potential effects of pain on motor learning. Some of the brain regions involved in pain processing are also involved in specific aspects of motor learning, suggesting that these two functions may interact, but it is unclear whether this is actually the case.

[Methods] In Experiment 1, young healthy individuals were randomly assigned to a group that experienced pain by applying capsaicin and heat to the lower leg during learning, or a group that received no stimulation, to compare the acquisition and retention of a new motor pattern. On day 1, participants learned a new asymmetric gait pattern using distorted visual feedback. Retention was tested 24 hours later.

[Results] There was no difference between groups in acquisition on day 1, but those who experienced pain on day 1 showed reduced retention on day 2.The mean step length asymmetry in the pain group during learning retention (3.4% ± 2.1 SD) was only about 60% of that in the non-stimulated group (5.4% ± 1.7 SD), indicating that 24-hour learning retention was reduced in the pain group. Furthermore, the degree of forgetting over the days was correlated with pain ratings during learning.

[Conclusion] Thus, pain experienced during explicit and strategic motor learning interferes with the consolidation process of motor memory, and this is likely to occur through pain mechanisms rather than the effects of distraction. These findings provide important implications for understanding basic motor learning processes and for clinical rehabilitation, where painful conditions are often treated with interventions based on motor learning.

🌱 So What?: What did I find interesting?

The human body is mysterious.
Because just a few dozen minutes of practice can change how one "moves".
Of course, no organic muscle hypertrophy occurs there.
In other words, the materials have not changed (presumably).
Yet, the performance called "movement" can change significantly.

This suggests the existence of software—an independent pilot—for the hardware of body structure and function.
Just as the performance of driving changes drastically when the driver changes, even though the hardware of the car or airplane remains the same.
And the activity that brings about changes in the pilot's skills is motor learning.
That is truly the main battlefield for physical therapists.
How can we improve a patient's movement, and what methods can we use?
There is infinite potential, individuality, and drama there.

This literature review study presented results that make one think that "pain" might be taboo in motor learning.
It says that if pain is present during motor learning, the retention of motor learning the next day is impaired.
For us physical therapists, this is a matter of life and death.
The fact that the effects of motor learning worked so hard on the previous day are not retained!
That is why it may be important to perform tasks that cause as little pain as possible during motor learning.
Or, it might be desirable to perform pain relief interventions before motor learning, and then intervene for motor learning.
I want to keep in mind the harmful effects of pain on motor learning.

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