Grant: Operating Grant

Pain is one of the most common and disabling symptoms following injury. In motor rehabilitation programs, a large proportion of patients receiving intensive training to improve their motor function 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? Specifically, we will determine whether the presence of pain interferes with motor learning associated with training in a new motor task, as well as investigate underlying mechanisms in the brain and the spinal cord. To attain this objective, two studies will be conducted to investigate both the effect of experimental pain (e.g. induced in healthy participants) and of clinical pain resulting of different types of injury on motor learning capacities. These capacities will be assessed using robotic devices that can perturb movement (either gait or upper limb movement) and measure how well and how quickly people can compensate for that perturbation to retrieve their natural movement pattern. If our hypothesis that pain interfere with motor learning is confirmed, it would suggest that the same motor rehabilitation intervention would be less effective if administered in the presence of pain, or if it induces post-intervention pain. The next step would be to assess potential intervention approaches that might decrease this negative impact of pain on motor learning.