Visuospatial perception is thought to be adaptive-ie, hills are perceived as steeper when capacity is low, or threat is high-guiding appropriate interaction with the environment. Pain (bodily threat) may similarly modulate visuospatial perception, with the extent of modulation influenced by threat magnitude (pain intensity, fear) and associated with behaviour (physical activity). We compared visuospatial perception of the environment between 50 people with painful knee osteoarthritis and 50 age-/sex-matched pain-free control participants using 3 virtual reality tasks (uphill steepness estimation, downhill steepness estimation, and a distance-on-hill measure), exploring associations between visuospatial perception, clinical characteristics (pain intensity, state and trait fear), and behaviour (wrist-worn accelerometry) within a larger knee osteoarthritis group (n = 85). People with knee osteoarthritis overestimated uphill (F1,485 = 19.4, P < 0.001) and downhill (F1,480 = 32.3, P < 0.001) steepness more so than pain-free controls, but the groups did not differ for distance-on-hill measures (U = 1273, P = 0.61). There was also a significant group x steepness interaction for the downhill steepness task (F4,480 = 3.11, P = 0.02). Heightened overestimation in people with knee osteoarthritis relative to pain-free controls increased as downhill slopes became steeper. Results were unchanged in a replication analysis using all knee osteoarthritis participants (n = 85), except the downhill steepness interaction was no longer significant. In people with knee osteoarthritis, higher state fear was associated with greater over-estimation of downhill slope steepness (rho = 0.69, P < 0.001), and greater visuospatial overestimation (distance-on-hill) was associated with lower physical activity levels (rho = -0.22, P = 0.045). These findings suggest that chronic pain may shift perception of the environment in line with protection, with overestimation heightened when threat is greater (steeper hills, more fearful), although impact on real-world behaviour is uncertain.

中文翻译：

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痛苦的扭曲：患有痛苦的膝骨关节炎的人对环境的视觉空间感知有偏差。

视觉空间感知被认为是自适应的，即，当容量较低时，山丘会被感知为更陡峭，或者威胁较高时，会指导与环境的适当交互。疼痛（身体威胁）可能类似地调节视觉空间感知，调节程度受威胁程度（疼痛强度、恐惧）影响并与行为（身体活动）相关。我们使用 3 个虚拟现实任务（上坡陡度估计、下坡陡度估计和山上距离测量）比较了 50 名患有疼痛性膝骨关节炎的人和 50 名年龄/性别匹配的无痛对照参与者对环境的视觉空间感知。 ，探索更大的膝骨关节炎组 (n = 85) 中视觉空间感知、临床特征（疼痛强度、状态和特质恐惧）和行为（腕戴式加速度测量）之间的关联。患有膝骨关节炎的人比无痛对照组高估了上坡（F1,485 = 19.4，P < 0.001）和下坡（F1,480 = 32.3，P < 0.001）的陡度，但各组在距离上没有差异。山丘测量值（U = 1273，P = 0.61）。下坡陡度任务也存在显着的组 x 陡度交互作用（F4,480 = 3.11，P = 0.02）。随着下坡变得更陡，膝骨关节炎患者相对于无痛对照组的高估程度也随之增加。使用所有膝骨关节炎参与者 (n = 85) 进行的重复分析结果没有变化，只是下坡陡度相互作用不再显着。在膝骨关节炎患者中，较高的状态恐惧与对下坡陡度的更大高估相关（rho = 0.69，P < 0.001），并且更大的视觉空间高估（山上距离）与较低的体力活动水平相关（rho = -0.22，P = 0.045）。这些发现表明，慢性疼痛可能会改变人们对环境的感知，以适应保护，当威胁更大时（山越陡，越可怕），高估就会加剧，尽管对现实世界行为的影响尚不确定。