Possíveis alterações no mecanismo minimizador de energia da caminhada em decorrência da dor lombar crônica ‐ revisão de literatura

Abstract

One goal of the locomotion is to move the body in the space at the most economical way possible. However, little is known about the mechanical and energetic aspects of locomotion that are affected by low back pain. And in case of occurring some damage, little is known about how the mechanical and energetic characteristics of the locomotion are manifested in functional activities, especially with respect to the energy-minimizer mechanisms during locomotion. This study aimed: a) to describe the main energy-minimizer mechanisms of locomotion; b) to check if there are signs of damage on the mechanical and energetic characteristics of the locomotion due to chronic low back pain (CLBP) which may endanger the energy-minimizer mechanisms. This study is characterized as a narrative literature review. The main theory that explains the minimization of energy expenditure during the locomotion is the inverted pendulum mechanism, by which the energy-minimizer mechanism converts kinetic energy into potential energy of the center of mass and vice-versa during the step. This mechanism is strongly influenced by spatio-temporal gait (locomotion) parameters such as step length and preferred walking speed, which, in turn, may be severely altered in patients with chronic low back pain. However, much remains to be understood about the effects of chronic low back pain on the individual's ability to practice an economic locomotion, because functional impairment may compromise the mechanical and energetic characteristics of this type of gait, making it more costly. Thus, there are indications that such changes may compromise the functional energy-minimizer mechanisms.

Influence of Cognitive Orientation and Attentional Focus on Pain Perception

“…The role of attention and hypervigilance in the experience of pain has been addressed in several recent publications [1,2]. Since pain is physiologically an alarm signal, the demand for attention is due to the need to modify functional patterns in order to escape or avoid tissue damage [3]. When pain, especially pain with neuropathic origins, becomes chronic, usually after 3 months, it can bring poor quality of life, anxiety, depression and sleep disorders, and regular treatment useful for nociceptive pain such as analgesics does not usually work [4], with a consequent constant focus on the pain.…”