Abstract：
BACKGROUND: Aberrant movement in chronic low back pain (CLBP) is associated with a deficit in the lumbar multifidus (LM) and changes in cortical topography. Anodal transcranial direct current stimulation (a-tDCS) can be used to enhance cortical excitability by priming the neuromuscular system for motor control exercise (MCE), thereby enhancing LM activation and movement control. This study aimed to determine the effects of a 6-week MCE program combined with a-tDCS on cortical topography, LM activation, movement patterns, and clinical outcomes in individuals with CLBP.
METHODS: Twenty-two individuals with CLBP were randomly allocated to the a-tDCS group (a-tDCS; n = 12) or sham-tDCS group (s-tDCS; n = 10). Both groups received 20 min of tDCS followed by 30 min of MCE. The LM and erector spinae (ES) cortical topography, LM activation, movement control battery tests, and clinical outcomes (disability and quality of life) were measured pre- and post-intervention.
RESULTS: Significant interaction (group × time; p < 0.01) was found in the distance between LM and ES cortical locations. The a-tDCS group demonstrated significantly fewer discrete peaks (p < 0.05) in both ES and LM and significant improvements (p < 0.05) in clinical outcomes post-intervention. The s-tDCS group demonstrated a significant increase (p < 0.05) in the number of discrete peaks in the LM cortical topography. No significant changes (p > 0.05) in LM activation were observed in either group; however, both groups demonstrated improved movement patterns.
CONCLUSIONS: Our findings suggest that combined a-tDCS with MCE can separate LM and ES locations over time while s-tDCS (MCE alone) reduces the distance. Our study did not find superior benefits of adding a-tDCS before MCE for LM activation, movement patterns, or clinical outcomes.
METHODS: Twenty-two individuals with CLBP were randomly allocated to the a-tDCS group (a-tDCS; n = 12) or sham-tDCS group (s-tDCS; n = 10). Both groups received 20 min of tDCS followed by 30 min of MCE. The LM and erector spinae (ES) cortical topography, LM activation, movement control battery tests, and clinical outcomes (disability and quality of life) were measured pre- and post-intervention.
RESULTS: Significant interaction (group × time; p < 0.01) was found in the distance between LM and ES cortical locations. The a-tDCS group demonstrated significantly fewer discrete peaks (p < 0.05) in both ES and LM and significant improvements (p < 0.05) in clinical outcomes post-intervention. The s-tDCS group demonstrated a significant increase (p < 0.05) in the number of discrete peaks in the LM cortical topography. No significant changes (p > 0.05) in LM activation were observed in either group; however, both groups demonstrated improved movement patterns.
CONCLUSIONS: Our findings suggest that combined a-tDCS with MCE can separate LM and ES locations over time while s-tDCS (MCE alone) reduces the distance. Our study did not find superior benefits of adding a-tDCS before MCE for LM activation, movement patterns, or clinical outcomes.
摘要：
背景：慢性下腰痛（CLBP）的异常运动与腰椎多裂（LM）的缺陷和皮质地形图的变化有关。阳极经颅直流电刺激（a-tDCS）可用于通过启动神经肌肉系统进行运动控制锻炼（MCE）来增强皮质兴奋性，从而增强LM激活和运动控制。本研究旨在确定为期6周的MCE计划与a-tDCS相结合对皮质地形图的影响，LM激活，运动模式,和CLBP患者的临床结果。
方法：将22名CLBP患者随机分为a-tDCS组（a-tDCS;n=12）和假tDCS组（s-tDCS;n=10）。两组均接受20分钟的tDCS，然后接受30分钟的MCE。LM和竖脊肌(ES)皮质地形图，LM激活，移动控制电池测试，并在干预前后测量临床结局(残疾和生活质量).
结果：在LM和ES皮层位置之间的距离中发现了显着的相互作用（组×时间；p<0.01）。a-tDCS组的ES和LM的离散峰明显较少（p<0.05），干预后临床结果显着改善（p<0.05）。s-tDCS组表现出LM皮层形貌中离散峰数量的显著增加(p<0.05)。两组中LM激活均无明显变化(p>0.05);然而,两组均表现出改善的运动模式.
结论：我们的研究结果表明，将a-tDCS与MCE结合可以随着时间的推移将LM和ES位置分开，而s-tDCS（单独的MCE）可以缩短距离。我们的研究没有发现在MCE之前添加a-tDCS用于LM激活的优势，运动模式,或临床结果。
方法：将22名CLBP患者随机分为a-tDCS组（a-tDCS;n=12）和假tDCS组（s-tDCS;n=10）。两组均接受20分钟的tDCS，然后接受30分钟的MCE。LM和竖脊肌(ES)皮质地形图，LM激活，移动控制电池测试，并在干预前后测量临床结局(残疾和生活质量).
结果：在LM和ES皮层位置之间的距离中发现了显着的相互作用（组×时间；p<0.01）。a-tDCS组的ES和LM的离散峰明显较少（p<0.05），干预后临床结果显着改善（p<0.05）。s-tDCS组表现出LM皮层形貌中离散峰数量的显著增加(p<0.05)。两组中LM激活均无明显变化(p>0.05);然而,两组均表现出改善的运动模式.
结论：我们的研究结果表明，将a-tDCS与MCE结合可以随着时间的推移将LM和ES位置分开，而s-tDCS（单独的MCE）可以缩短距离。我们的研究没有发现在MCE之前添加a-tDCS用于LM激活的优势，运动模式,或临床结果。
