Speech motor control and chronic back pain: a preliminary investigation.
OBJECTIVE
Chronic back pain and its sequelae can influence cognitive, affective, and neuromuscular functioning. Speech production--a complex sensorimotor activity--integrates shared cognitive, neuromuscular, and musculoskeletal resources, and therefore could be altered by chronic pain. The purpose of this preliminary investigation was twofold: 1) to determine whether speech alternating motion rates (i.e., speech AMRs) which require rapid, reciprocally coordinated articulatory movements were associated with chronic back pain; and 2) to identify factors that might mediate any observed alterations.


METHODS
Fifty participants, fully or partially disabled by chronic back pain, completed standardized protocols related to pain, depression, disability, medications, as well as speech AMRs.


RESULTS
Higher levels of back pain were significantly associated with slower speech AMRs. Stepwise multiple regression assessed the unique and cumulative effects of specific variables such as degree of back pain, depression, level of disability, and medication use on speech motor performance. Speech motor slowness was uniquely related to back pain and the use of nonprescription pain medications, but not to level of depression or disability.


CONCLUSIONS
Chronic back pain independently influences speech motor rates. Several explanatory models are proposed including pain-induced centrally mediated motor retardation/inhibition, reduced selective attention, and peripherally based "bracing/holding" of shared musculoskeletal environments.
Roy
Nelson
N
Department of Communication Sciences & Disorders, The University of Utah, Salt Lake City, Utah 84112-0252, USA. nelson.roy@health.utah.edu
Volinn
Ernest
E
Merrill
Ray M
RM
Chapman
C Richard
CR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001416:Back Pain / Q000188:drug therapy / Q000503:physiopathology*; D002908:Chronic Disease; D003863:Depression / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010147:Pain Measurement; D013060:Speech / Q000502:physiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal