悬吊训练对慢性腰痛患者运动皮质区神经网络的影响

关键词：慢性腰痛  经颅磁刺激  悬吊训练  神经可塑性

Keywords:chronic low back pain  transcranial magnetic stimulation  sling exercise  neuroplasticity

摘要：

      摘要 目的：研究悬吊训练对慢性腰痛（chronic low back pain， cLBP）患者运动皮质区神经网络的影响。 方法：招募20例cLBP患者和与之年龄等特征相匹配的10例健康对照者，对cLBP患者进行2周悬吊训练干预。使用经颅磁刺激技术记录干预前后cLBP患者和健康对照组多裂肌的运动诱发电位，经过数据处理绘制脑部地形图；干预前后对cLBP患者进行数字疼痛评分法（numerical pain rating scale，NPRS）、Oswestry残疾指数（Oswestry disability index， ODI）和平衡功能评估。 结果：2周悬吊训练干预后，cLBP患者运动皮质代表区地形图与干预前比较向外侧和向前侧移动，接近健康对照组；治疗干预后NPRS分数和ODI与干预前相比均具有显著性差异（P＜0.05）；平衡功能未出现显著性差异（P＞0.05）。 结论：该研究揭示了悬吊训练可以逆转cLBP患者运动皮层神经网络的适应性改变。

Abstract:

      Abstract Objective： To explore the influence of sling exercise on motor cortex neural network in patients with chronic low back pain (cLBP). Method： Twenty cLBP patients and age-matched 10 healthy controls were recruited. Two weeks sling exercise intervention was performed on cLBP patients. Transcranial magnetic stimulation (TMS) was used to record the motor evoked potential of multifidus muscle (MF) in cLBP patients and healthy controls before and after intervention， and the data were processed to produce the brain mapping. Numerical Pain Rating Scale (NPRS)， Oswestry Disability Index (ODI) and balance function assessment were performed on cLBP patients before and after the intervention. Result： After two weeks， sling exercise induced an anterior and medial shift in motor cortical representation of MF， towards that observed in healthy individuals. NPRS score and ODI were significantly different after the intervention (P＜0.05). There was no significant difference in balance function (P＞0.05). Conclusion： Sling exercise can reverse the adaptive changes in motor cortex neural networks in people with cLBP.