Interactions entre la douleur et l'apprentissage moteur : mécanismes, impacts et nouvelles avenues pour la réadaptation

 

Catherine Mercier

Centre interdisciplinaire de recherche en réadaptation et intégration sociale de l'IRDPQ

 

Domaine : appareil locomoteur et arthrite

Programme chercheurs-boursiers - Senior

Concours 2014-2015

Pain is one of the most common and disabling symptoms following injury. In physical rehabilitation, a large proportion of patients receiving intensive motor training to improve their motor functions are experiencing pain. Compared to patients with similar injuries but without associated pain, patients experiencing pain exhibit poorer recovery. Basic research using experimental pain in humans and animals have shown that pain interfere with the functioning of the regions of the brain and the spinal cord that are involved in the control of movements, and that these influences can interfere with motor learning capacities.

The general aim of this research program is to answer a very simple, but highly clinically relevant, question: How well can patients learn new motor tasks (and even more importantly retain what they have learned) if they are in pain while receiving rehabilitation? We will conduct several studies to determine whether the presence of pain (either artificial pain induced in volunteers, or clinical pain in patients) interferes with learning associated with training in a new motor task, as well as investigate underlying mechanisms in the brain and the spinal cord. The capacity to learn new movements will be assessed using robotic devices that can perturb movement (either gait or upper limb movements) and measure how well and how quickly people can compensate for that perturbation to retrieve their natural movement pattern.

The next step will be to assess potential interventions that might simultaneously decrease both pain and motor deficits. For this purpose, we are developing a virtual reality system that uses avatars to provide artificial visual feedback about body movements to the patient. This system will be used to treat pain and promote motor recovery in paraplegics, as well as to decrease fear of movement in people with chronic back pain.