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成人脑瘫患者体感治疗后疼痛敏感性降低。

Reduction of pain sensitivity after somatosensory therapy in adults with cerebral palsy.

机构信息

Research Institute on Health Sciences, University of the Balearic Islands, Palma de Mallorca , Spain ; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca , Spain.

出版信息

Front Hum Neurosci. 2013 Jun 24;7:276. doi: 10.3389/fnhum.2013.00276. eCollection 2013.

Abstract

OBJECTIVE

Pain and deficits in somatosensory processing seem to play a relevant role in cerebral palsy (CP). Rehabilitation techniques based on neuroplasticity mechanisms may induce powerful changes in the organization of the primary somatosensory cortex and have been proved to reduce levels of pain and discomfort in neurological pathologies. However, little is known about the efficacy of such interventions for pain sensitivity in CP individuals.

METHODS

Adults with CP participated in the study and were randomly assigned to the intervention (n = 17) or the control group (n = 20). The intervention group received a somatosensory therapy including four types of exercises (touch, proprioception, vibration, and stereognosis). All participants were asked to continue their standardized motor therapy during the study period. Several somatosensory (pain and touch thresholds, stereognosis, proprioception, texture recognition) and motor parameters (fine motor skills) were assessed before, immediately after and 3 months after the therapy (follow-up).

RESULTS

Participants of the intervention group showed a significant reduction on pain sensitivity after treatment and at follow-up after 3 months, whereas participants in the control group displayed increasing pain sensitivity over time. No improvements were found on touch sensitivity, proprioception, texture recognition, or fine motor skills.

CONCLUSION

Data suggest the possibility that somatosensory therapy was effective in eliciting changes in central somatosensory processing. This hypothesis may have implications for future neuromodulatory treatment of pain complaints in children and adults with CP.

摘要

目的

疼痛和躯体感觉处理缺陷似乎在脑瘫(CP)中起重要作用。基于神经可塑性机制的康复技术可能会引起初级躯体感觉皮层组织的强大变化,并已被证明可降低神经病理学中疼痛和不适的程度。然而,对于 CP 个体的疼痛敏感性,此类干预措施的效果知之甚少。

方法

CP 成人患者参与了该研究,并被随机分配到干预组(n = 17)或对照组(n = 20)。干预组接受了包括四种类型的练习(触摸、本体感觉、振动和触觉辨别)的躯体感觉治疗。所有参与者在研究期间都被要求继续进行标准化的运动治疗。在治疗前、治疗后即刻和治疗后 3 个月(随访)时评估了几种躯体感觉(疼痛和触觉阈值、触觉辨别、本体感觉、纹理识别)和运动参数(精细运动技能)。

结果

干预组患者在治疗后和 3 个月的随访时疼痛敏感性显著降低,而对照组患者的疼痛敏感性随时间增加。触觉敏感性、本体感觉、纹理识别或精细运动技能均无改善。

结论

数据表明躯体感觉治疗有可能引起中枢躯体感觉处理的变化。这一假设可能对未来脑瘫儿童和成人疼痛治疗的神经调节治疗具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4443/3690353/3668d38bb67e/fnhum-07-00276-g001.jpg

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