首页|双侧M1区阳极经颅直流电刺激对慢性非特异性腰痛患者疼痛及情绪的影响

双侧M1区阳极经颅直流电刺激对慢性非特异性腰痛患者疼痛及情绪的影响

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  • 国家科技期刊平台
  • NETL
  • NSTL
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目的 观察一种新型"Halo Sport"经颅直流电刺激(tDCS)设备作用于双侧初级运动皮层(M1区)对慢性非特异性腰痛(NSCLBP)患者疼痛及情绪的影响.方法 选择2023年7月—2024年3月在南京医科大学附属无锡人民医院康复医学科门诊就诊的NSCLBP患者42例,采用随机数字表法分为对照组和试验组,每组21例.治疗过程中对照组和试验组分别有1例患者脱落/中止,最终对照组和试验组均纳入20例.试验组采用2.0 mA、20 min双侧M1区阳极的新型"Halo Sport"tDCS治疗20 min,再进行运动治疗45 min(包括牵伸训练5 min,核心训练 20 min,有氧训练 20 min).2组均对照组采用假tDCS治疗结合运动疗法.2组治疗周期均为3 d/周,持续4周.分别在治疗前、治疗4周后采用数字评定量表(NRS)评估疼痛程度,采用Oswestry功能残疾指数量表(ODI)评估腰椎功能障碍程度,采用疼痛灾难化量表(PCS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)评估相关负性情绪.结果 ① 疼痛程度:治疗后,2组NRS评分相较基线均明显降低(P＜0.05),且试验组NRS差值明显高于对照组(P＜0.05).② 腰椎功能障碍程度:治疗后,2组ODI评分相较基线均明显降低(P＜0.05),但2组ODI差值差异无统计学意义(P＞0.05).③ 负性情绪:治疗后,2组PCS、SDS、SAS评分相较基线均明显降低(P＜0.05),而治疗后2组PCS、SDS、SAS评分差值差异无统计学意义(P＞0.05).结论 双侧M1区阳极tDCS治疗可明显降低NSCLBP患者的疼痛程度,而无论是否结合tDCS,进行运动治疗后均可以改善NSCLBP患者的腰椎功能障碍和负性情绪.
Effects of Bilateral M1 Anodal Transcranial Direct Current Stimulation on Pain and Mood in Patients with Non-Specific Chronic Low Back Pain
Objective To observe the effects of a novel transcranial direct current stimulation(tDCS)device known as"Halo Sport"on pain and mood in patients with non-specific chronic low back pain(NSCLBP),by specifically targeting the bilateral primary motor cortex(M1 region).Methods Forty-two patients with NSCLBP who were treated in the Rehabilitation Medicine Depart-ment of Wuxi People's Hospital Affiliated to Nanjing Medical University from July 2023 to March 2024 were recruited.According to the random number table method,the patients were divided into control group and experimental group,with 21 patients in each group.During the course of treatment,one patient withdrew in each group and 20 patients were included in both groups.The experi-mental group received treatment using the new"Halo Sport"tDCS at 2.0 mA for 20 minutes with bilateral M1 anodes,followed by 45-minute exercise treatment,including 5 minutes of stretching exercises,20 minutes of core training exercises,and 20 minutes of aerobic training exercises.The control group received sham tDCS in combination with exercise therapy.The treatment period for both groups was three days a week for four weeks.Before and after 4 weeks of treatment,the numerical rating scale(NRS)was used to evaluate pain intensity,the oswestry disability index(ODI)was used to evaluate lumbar dysfunction degree,while the pain cata-strophizing scale(PCS),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to assess related nega-tive emotions.Results 1)Pain intensity:After treatment,the NRS scores in the experimental and control groups significantly decreased compared with those at the baseline(P<0.05).The difference of NRS score in the experimental group was significantly higher than that in the control group(P<0.05).2)Lumbar dysfunction degree:After treatment,ODI scores of the experimental and control groups significantly decreased compared with those at the baseline(P<0.05).However,the difference of ODI scores between the two groups was not statistically significant(P>0.05).3)Negative emotions:After treatment,both groups showed a significant decrease in PCS,SDS and SAS scores compared to the baseline(P<0.05),while the difference of PCS,SDS and SAS scores between the two groups was not statistically significant(P>0.05).Conclusion Bilateral M1 area anodal tDCS with the Halo Sport device can significantly reduce pain in patients with NSCLBP.Whether combined with tDCS or not,exercise therapy can improve lum-bar spine dysfunction and alleviate negative emotions in NSCLBP patients.

chronic non-specific low back paintranscranial direct current stimulationpainbilateral primary motor cortex arealumbar spine dysfunction

鲁薛芳、袁鹏、邓淑坤、苏秋菊、方向明、陈钢锐、杨涵、沈滢

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南京医科大学附属无锡人民医院,江苏 无锡 214023

南京体育学院运动健康学院,江苏 南京 210014

南京医科大学第一附属医院,江苏 南京 210029

慢性非特异性腰痛 经颅直流电刺激 疼痛 双侧初级运动皮层区 腰椎功能障碍

国家重点研发计划项目江苏省卫生健康委科研项目无锡卫健委科技成果与适宜技术推广项目

2022YFC2009700ZD2021055T202308

2024

10.3724/SP.J.1329.2024.03003

康复学报
福建中医药大学

康复学报

CSTPCD
影响因子：0.545
ISSN：2096-0328
年,卷(期)：2024.34(3)
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