经颅电刺激联合核心肌锻炼治疗非特异性腰痛△

Transcranial direct current stimulation combined with core exercise for nonspecific low back pain

摘要:

[目的]观察采用经颅电刺激(transcranial direct current stimulation, tDCS)联合核心肌锻炼治疗非特异性腰痛(nonspecific low back pain, NLBP) 的临床疗效。[方法] 2017 年 6 月—2020 年 6 月，64 例 NLBP 患者纳入本研究，随机分为两组。 其中，32 例采用经颅电刺激联合核心肌锻炼进行治疗(联合组)，32 例采用常规理疗(常规组)。比较两组患者早期及随访结果。[结果]联合组治疗周期小于常规组，但差异无统计学意义(P＞0.05)。治疗过程中患者无不良反应发生，两组患者治疗顺应性差异无统计学意义 (P＞0.05)。联合组治疗费用及患者满意度显著高于常规组 (P＜0.05)。所有患者均获随访，平均 (9.34± 4.12)个月。联合组恢复日常工作时间及复发率均显著优于常规组(P＜0.05)。治疗后及随访过程中联合组 VAS 评分、ODI 指数、 OSI、APSI、MLSI 稳定指数较治疗前均显著下降(P＜0.05)， JOA 评分显著增高(P＜0.05)。常规组治疗后及随访过程中 VAS 评分、ODI 指数较治疗前显著降低(P＜0.05)，JOA 评分显著增高(P＜0.05)，而 OSI、APSI、MLSI 稳定指数与治疗前相比，差异均无统计学意义(P＞0.05)。治疗前两组患者上述指标的差异均无统计学意义(P＞0.05)。治疗终、治疗后 6 个月及末次随访时，联合组上述指标均显著优于常规组(P＜0.05)。[结论] 经颅电刺激联合核心肌锻炼能有效缓解非特异性腰痛患者的疼痛症状，改善功能障碍及姿势控制能力。

Abstract:

[Objective] To evaluate the clinical efficacy of transcranial direct current stimulation (tDCS) combined with core exercise for non-specific low back pain (NLBP) . [Methods] From June 2017 to June 2020, 64 patients with NLBP were enrolled in this study and random- ly divided into two groups. Among them, 32 patients were treated with transcranial electrical stimulation combined with core exercise (com- bined group) , while the remaining 32 patients were treated with conventional physical therapy (conventional group). The early and follow-up consequences were compared between the two groups. [Results] The treatment period of the combined group was shorter than that of the conven- tional group, but the difference was not statistically significant (P＞0.05) . There were no adverse reactions during treatment without a significant difference in treatment compliance between the two groups (P＞0.05) . However, the treatment cost and patient satisfaction in the combined group were significantly higher than those in the conventional group (P＜0.05) . All patients were followed up for an average of (9.34±4.12) months. The combined group proved significantly superior to the conventional group in the time to recover previous work and recurrence rate (P＜ 0.05) . The combined group got significant decline in terms of VAS and ODI scores, as well as core instability parameters, such as OSI, APSI and MLSI (P＜0.05) , whereas significant increment of JOA score after treatment compared with those before treatment (P＜0.05) . By contrast, the con- ventional group also got significant improvements in terms of VAS, ODI and JOA scores after treatment compared with those before treatment (P＜ 0.05) , however, remained unchanged in the OSI, APSI and MLSI (P＞0.05) . Although there were no significant differences in the abovesaid items between the two groups before treatment (P＜0.05) , the combined group proved significantly superior to the conventional group in all above- mentioned parameters at the end of treatment, 6 months after treatment and the last follow-up (P＜0.05) . [Conclusion] The transcranial direct current stimulation combined with core exercise does effectively relieve pain, improve function and postural control ability for NLBP.