Influence of remote pain on movement control and muscle endurance during repetitive movements

Jeffrey C. Cowley, Deanna H. Gates

During fatiguing tasks, people adapt their movement strategies to offset effects of muscle fatigue. Painful stimuli may compete for cognitive resources during this process, impairing fatigue adaptation. This study determined how pain affected movement control and muscle endurance during a repetitive task and how pain catastrophizing moderated these effects. Twenty-two healthy young adults performed timed reaching movements until voluntary exhaustion on two separate days. On 1 day, subjects simultaneously experienced ischemic pain in the contralateral arm. Subjective pain, and effort were recorded at regular intervals. Timing errors, distance and speed were calculated for each movement. Detrended fluctuation analysis was used to quantify temporal persistence in each time series. Subjects made shorter, slower movements during the last compared to the first minute of fatigue on both days (p < 0.001). Deviations in movement speed were corrected faster in the no pain condition compared to the pain condition (p = 0.042), but only early during the condition. Time to fatigue was influenced by pain and the order of testing. Subjects performed the task longer on the second day whether the condition was pain or no pain. This effect was larger when the pain condition was first (3.4 compared to 1.1 min. increase). Subjects with high and low pain catastrophizing responded similarly to the painful stimuli. The results suggest that pain causes people to adopt more conservative movement strategies which can affect the fatigue rate, but these effects depend on familiarity with the painful stimulus and the fatiguing task.