The effects of combining sensorimotor training with transcranial direct current stimulation on the anticipatory and compensatory postural adjustments in patients with chronic low back pain.

IF 2.1 4区医学 Q1 REHABILITATION

Disability and Rehabilitation Pub Date : 2025-03-01 Epub Date: 2024-07-10 DOI:10.1080/09638288.2024.2375756

Hanie Sadat Hejazi, Roya Khanmohammadi, Gholamreza Olyaei, Soheila Qanbari

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Abstract

Purpose: To investigate the effects of concurrent sensorimotor training (SMT) and transcranial direct current stimulation (tDCS) on the anticipatory and compensatory postural adjustments (APAs and CPAs) in patients with chronic low back pain (CLBP).

Method: The interventions included (1) SMT plus tDCS and (2) SMT plus sham tDCS. Outcome measures were the normalized integrals of electromyography activity (NIEMG) during the phases of anticipatory and compensatory, and muscle onset latency. The investigated muscles were ipsilateral and contralateral multifidus (MF), transversus abdominus/internal oblique (TrA/IO), and gluteus medius (GM).

Results: Between-group comparisons demonstrated that ipsilateral TrA/IO NIEMG during CPA1 (p = 0.010) and ipsilateral GM NIEMG during CPA1 (p = 0.002) and CPA2 (p = 0.025) were significantly lower in the SMT combined with tDCS than in the control group. Furthermore, this group had greater NIEMG for contralateral GM during APA1 than the control group (p = 0.032). Moreover, the onset latency of contralateral TrA/IO was significantly earlier after SMT combined with tDCS (p = 0.011).

Conclusions: Both groups that received SMT showed positive effects, but anodal tDCS had an added value over sham stimulation for improving postural control strategies in patients with CLBP. Indeed, SMT combined with tDCS leads to stronger APA and less demand for CPA.

Rct registration number: IRCT20220228054149N1.

Registration date: 2022-04-04.

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感知运动训练与经颅直流电刺激相结合对慢性腰痛患者预期和补偿性姿势调整的影响。

目的：研究同时进行的感觉运动训练（SMT）和经颅直流电刺激（tDCS）对慢性腰背痛（CLBP）患者预期性和代偿性姿势调整（APAs和CPAs）的影响：干预措施包括：（1）SMT 加 tDCS；（2）SMT 加假 tDCS。结果测量为预期和代偿阶段肌电活动的归一化积分（NIEMG）以及肌肉起始潜伏期。研究的肌肉包括同侧和对侧多裂肌（MF）、腹横肌/腹内斜肌（TRA/IO）和臀中肌（GM）：组间比较显示，SMT 联合 tDCS 组在 CPA1 期间的同侧 TrA/IO NIEMG（p = 0.010）和在 CPA1（p = 0.002）和 CPA2（p = 0.025）期间的同侧 GM NIEMG 明显低于对照组。此外，与对照组相比，该组在 APA1 期间对侧 GM 的 NIEMG 更大（p = 0.032）。此外，SMT 联合 tDCS 后，对侧 TrA/IO 的起始潜伏期明显提前（p = 0.011）：结论：接受 SMT 的两组患者都表现出了积极的效果，但在改善 CLBP 患者的姿势控制策略方面，阳极 tDCS 比假刺激更有价值。事实上，SMT 与 tDCS 的结合可增强 APA，减少对 CPA 的需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Disability and Rehabilitation 医学-康复医学

CiteScore

5.00

自引率

9.10%

发文量

415

审稿时长

3-6 weeks

期刊介绍： Disability and Rehabilitation along with Disability and Rehabilitation: Assistive Technology are international multidisciplinary journals which seek to encourage a better understanding of all aspects of disability and to promote rehabilitation science, practice and policy aspects of the rehabilitation process.