Pain and Motor Learning in Older Adults

老年人的疼痛和运动学习

基本信息

批准号：
10551859
负责人：
Susanne M Morton
金额：
$ 55.05万
依托单位：
UNIVERSITY OF DELAWARE
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-02-01 至 2027-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10551859
关键词：
Acute Pain Adult Affect Age Area Attention Awareness Back Brain Chronic disabling pain Chronic low back pain Clinical Cognition Cognitive Data Dementia Educational process of instructing Elderly Goals Impaired cognition Impairment Intervention Knowledge Learning Lifting Link Literature Longitudinal cohort Measures Mechanics Mediating Memory Motor Movement Neurologic Neuronal Plasticity Orthopedics Pain Pathway Analysis Patients Pattern Persistent pain Physical Function Physical Rehabilitation Physical therapy Play Population Prefrontal Cortex Probability Process Provider Recommendation Rehabilitation Outcome Rehabilitation therapy Research Role Short-Term Memory Testing Therapeutic Intervention Visual Work chronic pain chronic painful condition cognitive ability disability experience functional improvement improved insight learning strategy motor learning negative affect neural circuit non-opioid analgesic novel pain reduction patient population response somatosensory young adult

Acute Pain Adult Affect Age Area Attention Awareness Back Brain Chronic disabling pain Chronic low back pain Clinical Cognition Cognitive Data Dementia Educational process of instructing Elderly Goals Impaired cognition Impairment Intervention Knowledge Learning Lifting Link Literature Longitudinal cohort Measures Mechanics Mediating Memory Motor Movement Neurologic Neuronal Plasticity Orthopedics Pain Pathway Analysis Patients Pattern Persistent pain Physical Function Physical Rehabilitation Physical therapy Play Population Prefrontal Cortex Probability Process Provider Recommendation Rehabilitation Outcome Rehabilitation therapy Research Role Short-Term Memory Testing Therapeutic Intervention Visual Work chronic pain chronic painful condition cognitive ability disability experience functional improvement improved insight learning strategy motor learning negative affect neural circuit non-opioid analgesic novel pain reduction patient population response somatosensory young adult

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项目摘要

PROJECT SUMMARY The majority of older adult patients who seek physical therapy have pain. Physical rehabilitation for many painful orthopedic and neurologic conditions often involves the use of motor learning strategies, in which new movement patterns are taught using repeated trial-and-error practice. However, preliminary data from our lab suggests that pain may negatively affect the retention of newly learned motor patterns. If correct, this would suggest that the presence of pain may limit rehabilitation outcomes sought through motor learning-based interventions. To date, the effects of acute or chronic pain on motor learning have not been thoroughly investigated in clinical populations. Further, it is not known how pain affects motor learning in older adults specifically, despite the fact that cognitive declines, which are well-documented in the elderly, could also negatively affect learning and motor memory. Broadly, the purpose of this research is to investigate the impact of both acute and chronic pain on locomotor learning and its retention in young and older adults as well as older adults with chronic low back pain. Our central hypothesis is that both acute and chronic pain impair retention of locomotor learning and that in older adults, these deficits are worsened and are related to the degree of cognitive decline. We will investigate this hypothesis with three aims: (1) using our experimental pain paradigm, to compare effects of acute pain on retention of locomotor learning in healthy young and healthy older adults; (2) to determine whether older adults with chronic low back pain have impaired retention of locomotor learning; and (3) to assess relationships between chronic pain, cognition, and motor learning retention capacity in older adults. Motor learning and its retention will be assessed using our novel visually- driven locomotor learning paradigm. Several aspects of cognition will be quantified with a cognitive battery, with special focus on attention and working memory. Finally, pain will be quantified with assessments of intensity, interference and sensitivity. Results from this work will provide much needed data concerning the relationship between pain and motor learning in older adult clinical populations. Given that many rehabilitation interventions utilize motor learning-based strategies to recover normal movement patterns, gaining this new knowledge is likely to fundamentally improve delivery of rehabilitation in multiple patient populations that experience pain.

项目摘要寻求物理治疗的大多数老年人患者都会疼痛。许多人的身体康复疼痛的骨科和神经系统状况通常涉及运动学习策略，其中新的使用反复的反复试验来教授运动模式。但是，我们实验室的初步数据表明疼痛可能会对新学习的运动模式的保留产生负面影响。如果正确，这将表明疼痛的存在可能会限制通过基于运动学习的康复结果干预措施。迄今为止，急性或慢性疼痛对运动学习的影响尚未彻底在临床人群中进行了研究。此外，尚不知道疼痛如何影响老年人的运动学习具体而言，尽管事实是，认知能力下降（在老年人中都有证明是有据可查的）负面影响学习和运动记忆。从广义上讲，这项研究的目的是调查影响运动性学习急性和慢性疼痛及其在年轻人和老年人中的保留率以及慢性下背痛的老年人。我们的中心假设是急性和慢性疼痛障碍保留运动学习，并且在老年人中，这些缺陷恶化，并且与认知能力下降程度。我们将以三个目的研究这一假设：（1）使用我们的实验疼痛范式，以比较急性疼痛对健康的年轻健康中运动学习的保留的影响老年人；（2）确定患有慢性腰痛的老年人是否损害了运动学习；（3）评估慢性疼痛，认知和运动学习之间的关系老年人的保留能力。运动学习及其保留将使用我们的新颖的视觉评估 - 驱动的运动学习范式。认知的几个方面将通过认知电池进行量化，特别关注注意力和工作记忆。最后，通过评估将量化疼痛强度，干扰和灵敏度。这项工作的结果将提供有关该工作的急需数据老年人临床人群的疼痛与运动学习之间的关系。鉴于许多康复干预措施利用基于运动学习的策略来恢复正常运动模式，获得了这种新的知识可能会从根本上改善多个患者人群的康复交付经历痛苦。