Background: The aim of this study was to assess the effects of functional training (FT) on pain, function, and performance in elite male taekwondo players with CMLBP. Method: 27 elite male taekwondo players (mean ...Background: The aim of this study was to assess the effects of functional training (FT) on pain, function, and performance in elite male taekwondo players with CMLBP. Method: 27 elite male taekwondo players (mean ± standard deviation: age 24.4 ± 4.9 years, body mass 75.7 ± 15.1 kg, height 181.4 ± 7.8 cm) were allocated to two experimental (n = 15) and control (n = 12) groups. The eight-week FT was divided into four distinct phases for the subjects of the experimental group. Variables of pain and function were assessed by Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), respectively. The movement time of Ap Douliou Chagi kick (MTAK) and speed of Ap Douliou Chagi kick (SAK) was used for the variable of performance. Results: Considering the results of pretest before the implementation of the scores protocol, after FT intervention, VAS (p = 0.004), ODI (p = 0.005), MTAK on the right leg (p = 0.029) and the left leg (p = 0.013) decreased and SAK on both legs (p = 0.000) increased significantly in comparison with the control group. Conclusion: It is assumed that FT can reduce the pain intensity and improve the function and performance in taekwondo players.展开更多
Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain p...Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain patients with lumbar disc herniation were treated with balanced acupuncture or body acupuncture. Central mechanisms of vaded acupunctures were compared using resting-state functional MRI. Patients from both groups received functional MRI before and after acupuncture. Functional connectivity in brain regions that were strongly associated with the bilatera amygdala was analyzed utilizing AFNI software. Visual analogue scale scores were greater in the balanced acupuncture group compared with the body acupuncture group. Function of the endogenous pain regulation network was enhanced in patients in the balanced acupuncture group, but was not changed in the body acupuncture group. This result indicates that the analgesic effects of body acupuncture do not work through the central nervous system. These data suggest that balanced acupuncture exerts analgesic effects on low-back and leg pain patients with lumbar disc herniation by regulating the function of the endogenous pain regulation network.展开更多
Functional magnetic resonance imaging studies have shown that the insular cortex has a signif- icant role in pain identification and information integration, while the default mode network is associated with cognitive...Functional magnetic resonance imaging studies have shown that the insular cortex has a signif- icant role in pain identification and information integration, while the default mode network is associated with cognitive and memory-related aspects of pain perception. However, changes in the functional connectivity between the defauk mode network and insula during pain remain unclear. This study used 3.0 T functional magnetic resonance imaging scans in 12 healthy sub- jects aged 24.8 ± 3.3 years to compare the differences in the functional activity and connectivity of the insula and default mode network between the baseline and pain condition induced by intramuscular injection of hypertonic saline. Compared with the baseline, the insula was more functionally connected with the medial prefrontal and lateral temporal cortices, whereas there was lower connectivity with the posterior cingulate cortex, precuneus and inferior parietal lobule in the pain condition. In addition, compared with baseline, the anterior cingulate cortex exhibited greater connectivity with the posterior insula, but lower connectivity with the anterior insula, during the pain condition. These data indicate that experimental low back pain led to dysfunction in the connectivity between the insula and default mode network resulting from an impairment of the regions of the brain related to cognition and emotion, suggesting the impor- tance of the interaction between these regions in pain processing.展开更多
Thermal therapy is frequently used as an adjunct to treatment in patients suffering from chronic low back pain. It is also an inherent part of patients’ self-administered pain treatment. This review aims to update th...Thermal therapy is frequently used as an adjunct to treatment in patients suffering from chronic low back pain. It is also an inherent part of patients’ self-administered pain treatment. This review aims to update the evidence for thermal therapy treatments in non-specific chronic low back pain patients and to rate the methodological quality of the corresponding clinical trials. Previous studies have reported contradictory evidence for the effectiveness of thermal therapy. An electronic search on MEDLINE (PubMed), PEDro, CENTRAL and CINHAL databases was conducted between May 2016 and February 2018. Clinical trials comparing local thermal therapy to conservative or no treatment were assessed for eligibility. Pain, physical function and global health were defined as outcome parameters. A total of n = 9 studies met the inclusion criteria. All of them applied an electrophysical agent as the thermal treatment: continuous ultrasound (n = 6), short-wave diathermy (n = 2), microwave diathermy (n = 1). Out of the n = 6 studies on ultrasound treatment, n = 2 reported significant within and between-group results for pain reduction after 4 to 6 weeks of treatment. Both short-wave diathermy studies demonstrated significant between-group results for pain reduction after 3 weeks of treatment. Contradictory results for all other observed outcome parameters were reported regardless of the intervention. Moreover, significant within-group results for the control groups questioned the effectiveness of the intervention treatments. Therefore, the effect of thermal therapy, (electrophysical agents), is not superior to any control treatment except for ultrasound treatment on short-term pain reduction.展开更多
慢性下腰痛(chronic low back pain,CLBP)作为全球致残率最高的肌肉骨骼疾病之一,其临床表现除持续性疼痛和运动功能障碍外,常伴随注意力缺陷、执行功能下降和工作记忆障碍等认知损害。多模态磁共振成像研究为阐明CLBP的神经机制提供了...慢性下腰痛(chronic low back pain,CLBP)作为全球致残率最高的肌肉骨骼疾病之一,其临床表现除持续性疼痛和运动功能障碍外,常伴随注意力缺陷、执行功能下降和工作记忆障碍等认知损害。多模态磁共振成像研究为阐明CLBP的神经机制提供了重要证据:功能磁共振成像(functional magnetic resonance imaging,fMRI)显示前额叶、扣带回和岛叶等认知控制脑区激活异常;静息态fMRI分析揭示默认模式网络、前额叶-顶叶控制网络及显著性网络功能连接失衡;弥散张量成像发现额叶-顶叶通路和胼胝体白质纤维完整性下降,且与认知测评表现相关;磁共振波谱提示N-乙酰天冬氨酸降低及谷氨酸/γ-氨基丁酸平衡失调,反映神经元功能和兴奋-抑制调节受损。现有证据支持CLBP通过“疼痛-情绪-认知”环路和三大脑网络失衡机制导致认知障碍。现有研究主要存在以下局限:大多数为横断面设计,无法确立因果关系;缺乏长期随访数据;样本代表性有限。基于这些局限,未来研究应当:(1)开展纵向追踪和干预性研究以验证神经机制与认知损害的因果关系;(2)整合多模态MRI技术与精细认知行为评估,建立CLBP认知损害的预测模型;(3)探索影像学生物标志物的临床转化价值,为早期识别和干预提供依据。通过解决这些问题,有望为改善CLBP患者的认知结局提供新思路。本综述系统梳理了CLBP相关认知损害的神经影像学研究进展,旨在为从事慢性疼痛与认知神经机制研究的科研人员及临床医生提供理论参考与研究思路,推动该领域从现象描述向机制探索与临床干预的转化。展开更多
In this study, we aimed to investigate the functional network changes that occur in patients with lower back pain(LBP). We also investigated the link between LBP and the small-world properties of functional networks w...In this study, we aimed to investigate the functional network changes that occur in patients with lower back pain(LBP). We also investigated the link between LBP and the small-world properties of functional networks within the brain. Functional MRI(fMRI) was performed on 20 individuals with LBP and 17 age and gender-matched normal controls during the resting state. The severity of the pain in the individuals with LBP ranged from 5 to 8 on a 0–10 scale, with 0 indicating no pain. Network-based statistics were performed to investigate the differences between the brain networks of individuals with LBP and those of normal controls. Several small-world parameters of brain networks were calculated, including the clustering coefficient, characteristic path length, local efficiency, and global efficiency. These criteria reflect the overall network efficiency. The brain networks in the individuals with LBP due to herniation of a lumbar disc demonstrated a significantly longer characteristic path length as well as a lower clustering coefficient, global efficiency, and local efficiency compared to those in control subjects. We found that LBP patients tended to have unstable and inefficient brain networks when compared with healthy controls. In addition, LBP individuals showed significantly decreased functional connectivity in the anterior cingulate cortex, middle cingulate cortex, post cingulate cortex, inferior frontal gyrus, middle temporal gyrus, occipital gyrus, postcentral gyrus, precentral gyrus, supplementary motor area, thalamus, fusiform, caudate, and cerebellum. We believe that these regions may be involved in the pathophysiology of lower back pain.展开更多
文摘Background: The aim of this study was to assess the effects of functional training (FT) on pain, function, and performance in elite male taekwondo players with CMLBP. Method: 27 elite male taekwondo players (mean ± standard deviation: age 24.4 ± 4.9 years, body mass 75.7 ± 15.1 kg, height 181.4 ± 7.8 cm) were allocated to two experimental (n = 15) and control (n = 12) groups. The eight-week FT was divided into four distinct phases for the subjects of the experimental group. Variables of pain and function were assessed by Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), respectively. The movement time of Ap Douliou Chagi kick (MTAK) and speed of Ap Douliou Chagi kick (SAK) was used for the variable of performance. Results: Considering the results of pretest before the implementation of the scores protocol, after FT intervention, VAS (p = 0.004), ODI (p = 0.005), MTAK on the right leg (p = 0.029) and the left leg (p = 0.013) decreased and SAK on both legs (p = 0.000) increased significantly in comparison with the control group. Conclusion: It is assumed that FT can reduce the pain intensity and improve the function and performance in taekwondo players.
基金funded by the Scientific Research Innovation Program regarding Traditional Chinese Medicine of Guangzhou University of Chinese Medicine (Central mechanism of balanced acupuncture for lumbar disc herniationusing functional MRI), No. 09CX068
文摘Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain patients with lumbar disc herniation were treated with balanced acupuncture or body acupuncture. Central mechanisms of vaded acupunctures were compared using resting-state functional MRI. Patients from both groups received functional MRI before and after acupuncture. Functional connectivity in brain regions that were strongly associated with the bilatera amygdala was analyzed utilizing AFNI software. Visual analogue scale scores were greater in the balanced acupuncture group compared with the body acupuncture group. Function of the endogenous pain regulation network was enhanced in patients in the balanced acupuncture group, but was not changed in the body acupuncture group. This result indicates that the analgesic effects of body acupuncture do not work through the central nervous system. These data suggest that balanced acupuncture exerts analgesic effects on low-back and leg pain patients with lumbar disc herniation by regulating the function of the endogenous pain regulation network.
基金supported by the Science and Technology Foundation of Guangdong Province of China,No.2012B031800305
文摘Functional magnetic resonance imaging studies have shown that the insular cortex has a signif- icant role in pain identification and information integration, while the default mode network is associated with cognitive and memory-related aspects of pain perception. However, changes in the functional connectivity between the defauk mode network and insula during pain remain unclear. This study used 3.0 T functional magnetic resonance imaging scans in 12 healthy sub- jects aged 24.8 ± 3.3 years to compare the differences in the functional activity and connectivity of the insula and default mode network between the baseline and pain condition induced by intramuscular injection of hypertonic saline. Compared with the baseline, the insula was more functionally connected with the medial prefrontal and lateral temporal cortices, whereas there was lower connectivity with the posterior cingulate cortex, precuneus and inferior parietal lobule in the pain condition. In addition, compared with baseline, the anterior cingulate cortex exhibited greater connectivity with the posterior insula, but lower connectivity with the anterior insula, during the pain condition. These data indicate that experimental low back pain led to dysfunction in the connectivity between the insula and default mode network resulting from an impairment of the regions of the brain related to cognition and emotion, suggesting the impor- tance of the interaction between these regions in pain processing.
文摘Thermal therapy is frequently used as an adjunct to treatment in patients suffering from chronic low back pain. It is also an inherent part of patients’ self-administered pain treatment. This review aims to update the evidence for thermal therapy treatments in non-specific chronic low back pain patients and to rate the methodological quality of the corresponding clinical trials. Previous studies have reported contradictory evidence for the effectiveness of thermal therapy. An electronic search on MEDLINE (PubMed), PEDro, CENTRAL and CINHAL databases was conducted between May 2016 and February 2018. Clinical trials comparing local thermal therapy to conservative or no treatment were assessed for eligibility. Pain, physical function and global health were defined as outcome parameters. A total of n = 9 studies met the inclusion criteria. All of them applied an electrophysical agent as the thermal treatment: continuous ultrasound (n = 6), short-wave diathermy (n = 2), microwave diathermy (n = 1). Out of the n = 6 studies on ultrasound treatment, n = 2 reported significant within and between-group results for pain reduction after 4 to 6 weeks of treatment. Both short-wave diathermy studies demonstrated significant between-group results for pain reduction after 3 weeks of treatment. Contradictory results for all other observed outcome parameters were reported regardless of the intervention. Moreover, significant within-group results for the control groups questioned the effectiveness of the intervention treatments. Therefore, the effect of thermal therapy, (electrophysical agents), is not superior to any control treatment except for ultrasound treatment on short-term pain reduction.
文摘慢性下腰痛(chronic low back pain,CLBP)作为全球致残率最高的肌肉骨骼疾病之一,其临床表现除持续性疼痛和运动功能障碍外,常伴随注意力缺陷、执行功能下降和工作记忆障碍等认知损害。多模态磁共振成像研究为阐明CLBP的神经机制提供了重要证据:功能磁共振成像(functional magnetic resonance imaging,fMRI)显示前额叶、扣带回和岛叶等认知控制脑区激活异常;静息态fMRI分析揭示默认模式网络、前额叶-顶叶控制网络及显著性网络功能连接失衡;弥散张量成像发现额叶-顶叶通路和胼胝体白质纤维完整性下降,且与认知测评表现相关;磁共振波谱提示N-乙酰天冬氨酸降低及谷氨酸/γ-氨基丁酸平衡失调,反映神经元功能和兴奋-抑制调节受损。现有证据支持CLBP通过“疼痛-情绪-认知”环路和三大脑网络失衡机制导致认知障碍。现有研究主要存在以下局限:大多数为横断面设计,无法确立因果关系;缺乏长期随访数据;样本代表性有限。基于这些局限,未来研究应当:(1)开展纵向追踪和干预性研究以验证神经机制与认知损害的因果关系;(2)整合多模态MRI技术与精细认知行为评估,建立CLBP认知损害的预测模型;(3)探索影像学生物标志物的临床转化价值,为早期识别和干预提供依据。通过解决这些问题,有望为改善CLBP患者的认知结局提供新思路。本综述系统梳理了CLBP相关认知损害的神经影像学研究进展,旨在为从事慢性疼痛与认知神经机制研究的科研人员及临床医生提供理论参考与研究思路,推动该领域从现象描述向机制探索与临床干预的转化。
基金supported by the National Natural Science Foundation of China (81401932)the Beijing Natural Science Foundation (7154246)
文摘In this study, we aimed to investigate the functional network changes that occur in patients with lower back pain(LBP). We also investigated the link between LBP and the small-world properties of functional networks within the brain. Functional MRI(fMRI) was performed on 20 individuals with LBP and 17 age and gender-matched normal controls during the resting state. The severity of the pain in the individuals with LBP ranged from 5 to 8 on a 0–10 scale, with 0 indicating no pain. Network-based statistics were performed to investigate the differences between the brain networks of individuals with LBP and those of normal controls. Several small-world parameters of brain networks were calculated, including the clustering coefficient, characteristic path length, local efficiency, and global efficiency. These criteria reflect the overall network efficiency. The brain networks in the individuals with LBP due to herniation of a lumbar disc demonstrated a significantly longer characteristic path length as well as a lower clustering coefficient, global efficiency, and local efficiency compared to those in control subjects. We found that LBP patients tended to have unstable and inefficient brain networks when compared with healthy controls. In addition, LBP individuals showed significantly decreased functional connectivity in the anterior cingulate cortex, middle cingulate cortex, post cingulate cortex, inferior frontal gyrus, middle temporal gyrus, occipital gyrus, postcentral gyrus, precentral gyrus, supplementary motor area, thalamus, fusiform, caudate, and cerebellum. We believe that these regions may be involved in the pathophysiology of lower back pain.
