A transition to a more efficient attentional strategy facilitates motor learning in the presence and absence of movement-evoked experimental pain. A cross-sectional experimental study.

Pain demands attention and can disrupt task-related goals. Attention allocation is a key cognitive process supporting motor learning and disruption of internal schemas associated with attentional control during motor learning can result in interference in improvements in performance. Movement-contingent pain is an important characteristic of persistent musculoskeletal pain. Despite this, research exploring pain interference with motor learning and attention has exclusively utilised tonic pain paradigms. Understanding the impacts of movement-contingent pain on motor learning and attention may provide important insights into the interaction between pain and motor learning. The aim of this study was to; 1) explore the robustness of a movement-contingent pain paradigm across an extended period of training, 2) explore the impact of movement-contingent pain on improvements in performance and attentional allocation during motor learning. Three groups (healthy non-pain, healthy experimental-pain and persistent pain experimental-pain) completed ten trials of a motor sequence learning task while experiencing a movement-contingent electrical stimulation. Three task performance measures and five gaze indices, previously associated with attentional control, were collected. Results showed that; 1) low frequency electro-cutaneous stimulation could produce a valid and consistent pain experience across a sustained period of training, 2) attentional allocation becomes more efficient across learning, accompanied by improvements in task performance, 3) changes in task performance and attentional measures across training were similar in all groups despite the presence of pain, 4) movement-contingent experimental pain enhanced spatial performance at all time points in healthy participants but was not accompanied by a different pattern of attentional allocation. This study demonstrates that the impact of movement-contingent pain on motor learning is comparable to the impacts of tonic experimental pain and provides interesting insights into patterns of attentional allocation across time but little evidence that these attentional allocations are impacted by the presence of pain or a past history of pain.