By David Matthews, PhD student at CPR Spine
Every day we are exposed to new challenges or have to adapt to new environments. Our propensity to learn complex skills is what sets us apart from much of the animal kingdom. In many cases, we are able to acquire multiple skills at once which compete for resources but ultimately do not interfere with achieving the final goal. It could be argued that the majority of us take this ability to learn or adapt for granted. But what about circumstances where the capacity to learn is impeded? We can all relate to the impact of age on learning. The frustration of the slow progress when picking up a tennis racquet or musical instrument in the middle to later years of our life, while observing younger members of your community becoming adept at the same task in half the time. Neurological conditions, such as stroke, impact on the ability of the nervous system to change (neuroplasticity) and therefore the ability of the individual to learn skills. Pain is another condition that interferes with neuroplasticity yet its impact on skill learning is not fully understood. This is particularly important as learning approaches are used throughout rehabilitation where pain is present.
Pain is a complex experience influenced by physical, psychological and social factors. In my PhD I plan to complete three different experiments to explore the different aspects of pain and skill learning and how they interact. The first experiment extends the pre-existing research by exploring a movement-related experimental pain procedure. Previous research has been limited to pain models not altered by movement. The first goal of this experiment will be to induce pain during movement in a specific direction while completing one session of repeated practice of a visuomotor skill, with a joystick. This will investigate whether this type of pain interferes with early stages of skill learning. The second part of this experiment will include a random pain stimulation which has been shown to influence the psychological concept of fear of pain. This will enable exploration as to whether the presence of fear associated with pain, may play a role in the impact on skill learning.
The last two experiments aim to study the impact of the above pain model on longer periods of learning (up to 5 sessions). This will either be repeated practice of the same visuomotor skill or repeated practice of a progressively more challenging visuomotor skill. This will allow us to explore not only the impact on acquisition but also the consolidation and retention of learning across the 5 days. The final part of the experiment is to collect data on activity of the brain and spinal cord using functional magnetic resonance imaging (fMRI) to understand the neural pathways underlying the interaction between pain and motor skill learning. Overall, I hope to expand the knowledge around the interactions of pain and motor learning to be able to direct further research in this area but also support clinicians to provide effective rehabilitation approaches for people in pain.