Lipid and metabolic alteration involvement in physiotherapy for chronic nonspecific low back pain

Zhang, Zhou; Zhang, Chanjuan; Li, Yuelong; Wang, Chuhuai; Yu, Qiuhua

doi:10.1186/s12944-022-01737-4

Cited by 4 publications

(3 citation statements)

References 52 publications

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“…Both interventions were conducted for 6 weeks, with three sessions per week. 17 Participants in both groups were not allowed to receive other treatments or a home exercise program during the 6-week intervention period.…”

Section: Methodsmentioning

confidence: 99%

Alterations in functional connectivity in patients with non-specific chronic low back pain after motor control exercise: a randomized trial

ZHANG,

et al. 2024

Eur J Phys Rehabil Med

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BACKGROUND Motor control exercise (MCE) is effective in alleviating non-specific chronic low back pain (NCLBP). Neuro-imaging research is warranted to explore the underlying neural mechanisms of MCE. AIM We used resting-state functional magnetic resonance imaging (rs-fMRI) to explore the central mechanism underpinning the effects of MCE in patients with NCLBP. DESIGN A randomized, single-blinded, controlled trial. SETTING The setting was out-patient and community. POPULATION Fifty-eight patients with NCLBP. METHODS Patients were randomized into the MCE or manual therapy (MT) group. All the participants completed pain-related clinical assessments and rs-fMRI scans before and after intervention. We performed exploratory whole-brain analyses in regional homogeneity (ReHo) and resting-state functional connectivity (rsFC) with significant post-pre differences in ReHo before and after intervention, and investigated associations between imaging and pain-related clinical assessments. RESULTS Compared with the MT group, a greater alleviation in pain intensity and disability was observed in the MCE group after intervention, and was sustained at the 6-month follow-up (P<0.001). Only the MCE group showed increased ReHo values in the right pre-central gyrus and decreased ReHo values in the bilateral posterior cerebellum (voxel level P<0.001, cluster-level FWE corrected P<0.05). Decreased rsFC of the right posterior cerebellum-left superior parietal gyrus and left insula were significantly positively associated with pain-related disability (voxel level P<0.001, cluster-level FWE corrected P<0.05). CONCLUSIONS These findings demonstrated that MCE had superior effects in relieving pain and pain-related disability, which might be associated with its modulation of rsFC between the cerebellum and areas involved in sensory-discriminative processing of noxious and somato-sensory stimuli, affection, and cognition. CLINICAL REHABILITATION IMPACT This study provided preliminary evidence that MCE might alleviate NCLBP through its modulation of the function of brain areas related to chronic pain and postural control. Those results support MCE’s clinical application and help physiotherapists to provide better multidisciplinary interventions with the combination of MCE and other first-line treatments.

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Section: Methodsmentioning

confidence: 99%

Alterations in functional connectivity in patients with non-specific chronic low back pain after motor control exercise: a randomized trial

ZHANG,

et al. 2024

Eur J Phys Rehabil Med

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“…It was reported that dyslipidemia has been linked to multiple pathological conditions such as cancers, type 2 diabetes, atherosclerosis, liver disease and osteoarthritis [16]. Recently, the association between abnormal lipid metabolism and LBP has also been revealed [17][18][19]. In addition, in vivo and in vitro studies have demonstrated that IDD, as the pathological basis of LBP, could be directly exacerbated by excess cholesterol but could also be alleviated by cholesterol-lowering drugs [20][21][22].…”

Section: Introductionmentioning

confidence: 99%

The impact of dyslipidemia on lumbar intervertebral disc degeneration and vertebral endplate modic changes: a cross-sectional study of 1035 citizens in China

et al. 2023

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Background Intervertebral disc degeneration (IDD) and vertebral endplate Modic changes (MCs) are common lumbar degenerative phenotypes related to low back pain (LBP). Dyslipidemia has been linked to LBP but its associations with IDD and MCs have not been fully elucidated. The present study aimed to address the possible link between dyslipidemia, IDD and MCs in the Chinese population. Methods 1035 citizens were enrolled in the study. The levels of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were collected. IDD was evaluated based on the Pfirrmann grading system and subjects with an average grade ≥ 3 were defined as having degeneration. MCs were classified into typical types 1, 2 and 3. Covariables, including age, sex, BMI and fasting plasma glucose, were included for the adjustment of the logistic analyses. Results The degeneration group included 446 subjects while the nondegeneration group included 589 subjects. The degeneration group had significant higher levels of TC and LDL-C (p < 0.001) whereas TG and HDL-C were not significantly different between the two groups. TC and LDL-C concentrations were significantly positively correlated with average IDD grades (p < 0.001). Multivariate logistic regression revealed that high TC (≥ 6.2 mmol/L, adjusted OR = 1.775, 95% CI = 1.209–2.606) and high LDL-C (≥ 4.1 mmol/L, adjusted OR = 1.818, 95% CI = 1.123–2.943) were independent risk factors for IDD. Type 1 MC presented in 84 (8.12%) subjects, type 2 MC presented in 244 (23.57%) subjects, type 3 MC presented in 27 (2.61%) subjects and no MC was observed in the remaining 680 (65.70%) subjects. The type 2 MC group demonstrated a higher level of TC, but the association between serum lipids and MCs could not be confirmed in further multivariate logistic regression. Conclusions High TC (≥ 6.2 mmol/L) and LDL-C (≥ 4.1 mmol/L) concentrations were independent risk factors for IDD for citizens in China. However, the association between dyslipidemia and MCs could not be determined. The effect of excess serum cholesterol may be critical for IDD and cholesterol lowering treatment may provide new opportunities in the management of lumbar disc degeneration.

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Section: Introductionmentioning

confidence: 99%

The impact of dyslipidemia on lumbar intervertebral disc degeneration and vertebral endplate modic changes: a cross-sectional study of 1035 citizens in China

Yuan

Huang

Han

et al. 2023

Preprint

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Background: Intervertebral disc degeneration (IDD) and vertebral endplate Modic changes (MCs) are common lumbar degenerative phenotypes related to low back pain (LBP). Dyslipidemia has been linked to LBP but its associations with IDD and MCs have not been fully elucidated. The present study aimed to address the possible link between dyslipidemia, IDD and MCs in the Chinese population. Methods: 1035 citizens were enrolled in the study. The levels of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were collected. IDD was evaluated based on the Pfirrmann grading system and subjects with an average grade ≥3 were defined as having degeneration. MCs were classified into typical types 1, 2 and 3. Covariables, including age, sex, BMI and fasting plasma glucose, were included for the adjustment of the logistic analyses. Results: The degeneration group included 446 subjects while the nondegeneration group included 589 subjects. The degeneration group had significant higher levels of TC and LDL-C (p<0.001) whereas TG and HDL-C were not significant different between the two groups. TC and LDL-C concentrations were significantly positively correlated with average IDD grades (p<0.001). Multivariate logistic regression revealed that high TC (≥6.2 mmol/L, adjusted OR=1.775, 95% CI=1.209-2.606) and high LDL-C (≥4.1 mmol/L, adjusted OR=1.818, 95% CI=1.123-2.943) were independent risk factors for IDD. Type 1 MC presented in 84 (8.12%) subjects, type 2 MC presented in 244 (23.57%) subjects, type 3 MC presented in 27 (2.61%) subjects and no MC was observed in the remaining 680 (65.70%) subjects. The type 2 MC group demonstrated a higher level of TC, but the association between serum lipids and MCs could not be confirmed in further multivariate logistic regression. Conclusions: High TC (≥6.2 mmol/L) and LDL-C (≥4.1 mmol/L) concentrations were recognized as independent risk factors for IDD for citizens in China. However, the epidemiological association between dyslipidemia and MCs could not be determined. The biomolecular effect of excess serum cholesterol may play a vital role in the development of IDD. Hypolipidemic treatment, especially when targeting cholesterol, may provide new opportunities in the management of lumbar disc degenerative diseases.

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Lipid and metabolic alteration involvement in physiotherapy for chronic nonspecific low back pain

Cited by 4 publications

References 52 publications

Alterations in functional connectivity in patients with non-specific chronic low back pain after motor control exercise: a randomized trial

Alterations in functional connectivity in patients with non-specific chronic low back pain after motor control exercise: a randomized trial

The impact of dyslipidemia on lumbar intervertebral disc degeneration and vertebral endplate modic changes: a cross-sectional study of 1035 citizens in China

The impact of dyslipidemia on lumbar intervertebral disc degeneration and vertebral endplate modic changes: a cross-sectional study of 1035 citizens in China

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