Rören Alexandra, Debacker Clement, Saghiah Marc, Bedin Catherine, Fayolle Anna, Abdoul Hendy, Lefèvre-Colau Marie-Martine, Rannou François, Oppenheim Catherine, Nguyen Christelle
Département des Sciences de la Rééducation et de la Réadaptation, Faculté de Santé, Université Paris Cité, Paris, France.
INSERM UMR 1153, Centre de Recherche en Épidémiologie et Statistique Sorbonne Paris Cité, Université Paris Cité, Paris, France.
PLoS One. 2024 Dec 17;19(12):e0313920. doi: 10.1371/journal.pone.0313920. eCollection 2024.
To assess the efficacy of horticultural therapy (HT) on anterior cingulate cortex (ACC) activity and the changes in rumination and catastrophizing scores in individuals with chronic low back pain (LBP). We conducted a randomized, controlled, cross-over, 3-week pilot study (ClinicalTrials.gov Identifier: NCT04656158). The departments of physical medicine and rehabilitation (hospital grounds and occupational therapy room) and imaging research were involved. The participants were adults with non-specific chronic LBP. All participants underwent two 90-min HT sessions and two 90-min handiwork sessions per week. The activity sequence order was randomized, and the activities were separated by a wash-out period of 1 week. Each participant underwent 3 brain MRIs: before, after the first, and after the second activity. The primary outcome was the change in ACC perfusion in ml/100g/min using arterial spin labeling MRI. The secondary outcomes were the changes in self-reported rumination and catastrophizing scores after each activity compared to baseline. Sixteen participants were included: 14 women (87.5%), LBP intensity (numeric rating scale) mean (SD) 45.1 (27.2)/100, specific activity limitation (Roland Morris disability questionnaire) 9.3 (4.1)/24. Change in ACC perfusion from baseline was -0.1 (10.7), 95% CI [-5.6, 5.8] ml (blood)/100g (tissue)/min after handiwork and -0.1 (8.7), [-4.7, 4.6] after HT and did not differ between the 2 activities (p = 0.91). Change in rumination [-0.5 (4.4) after handiwork and -0.3 (2.8) after HT] and catastrophizing scores [-2 (2.8) after handiwork and -1.4 (2.3) after HT] did not differ between activities (p = 0.99 and 0.22, respectively). Limited exposure to the interventions and the sample profile (moderate levels of pain) may explain our results. Our results highlight the need for future studies using the most appropriate outcomes to determine the exact effects of nature experiences in people with chronic musculoskeletal disease.
评估园艺疗法（HT）对慢性下腰痛（LBP）患者前扣带回皮质（ACC）活动以及沉思和灾难化评分变化的疗效。我们进行了一项随机、对照、交叉、为期3周的试点研究（ClinicalTrials.gov标识符：NCT04656158）。研究涉及物理医学与康复科（医院场地和职业治疗室）以及影像研究。参与者为患有非特异性慢性LBP的成年人。所有参与者每周接受两次90分钟的HT治疗和两次90分钟的手工制作治疗。活动顺序是随机的，且活动之间有1周的洗脱期。每位参与者接受3次脑部磁共振成像（MRI）：第一次活动前、第一次活动后和第二次活动后。主要结局是使用动脉自旋标记MRI测量的ACC灌注变化，单位为ml/100g/分钟。次要结局是每次活动后与基线相比自我报告的沉思和灾难化评分的变化。纳入了16名参与者：14名女性（87.5%），LBP强度（数字评分量表）平均（标准差）为45.1（27.2）/100，特定活动受限程度（罗兰·莫里斯残疾问卷）为9.3（4.1）/24。手工制作后ACC灌注相对于基线的变化为-0.1（10.7），95%置信区间为[-5.6, 5.8]ml（血液）/100g（组织）/分钟，HT治疗后为-0.1（8.7），[-4.7, 4.6]，两种活动之间无差异（p = 0.91）。沉思评分的变化[手工制作后为-0.5（4.4），HT治疗后为-0.3（2.8）]和灾难化评分的变化[手工制作后为-2（2.8），HT治疗后为-1.4（2.3）]在两种活动之间无差异（分别为p = 0.99和0.22）。干预暴露有限以及样本特征（中度疼痛水平）可能解释了我们的结果。我们的结果凸显了未来研究需要使用最合适的结局来确定自然体验对慢性肌肉骨骼疾病患者的确切影响。
