: Combined Effect Of Transcranial Direct Current Electrical Stimulation And Transcutaneous Electrical Nerve Stimulation With Exercise Intervention On Pain In Cervical Radiculopathy

Background: Cervical radiculopathy is defined as a syndrome of pain and a sensory motor deficits due to compression of a cervical nerve root. Understanding of this disease is vital for rapid diagnosis and treatment of patients with this condition and improve there quality of life. There is no such therapeutic intervention is available to cure the pain and provide long .
Purpose: To find combined transcranial direct electrical stimulation and transcutaneous electrical nerve stimulation with an exercise intervention on pain in individuals with cervical radiculopathy to provide a evidence on long lasting and current effect of intervention.
Method: Subjects are selected on the study basis of inclusion criteria.. Firstly the pain, functional disability and Quality of life was measured by NPRS, NDI and nerve root involvement was assessed and defferencitated by ULTT. All the selected individuals (n=20) was be divided in two groups (1,2) In experimental group(1, n=11) active anodal tDCS (M1 area and supra orbital area) is applied for 20 min with an intensity of 2mA along with the active TENS over the pain distribution area for 20 min with 5 Hz intensity and 80-150 ms pulse duration followed by neck specific exercises. In control group(2, n=9) sham anodal tDCS was be used along with active TENS over the pain distribution area for 20 min with 5 Hz intensity and 80-150 ms pulse duration followed by neck specific exercises. This protocol was given for 5 days in a week for 2 weeks. And all the participants was assessed again by the outcome measures to check the effect of the intervention at the end of the session

Result: Shapiro-wilk test was used to check the normality distribution as data is normally distributed. Paired t test was used for within group analysis and its shows the significant effect in both group. In Between group analysis group 1 (active tDCS) effect was more profound and the alternate hypothesis is proved.
Conclusion: the result of the study had investigated the effect of active tDCS along with TENS and exercise intervention on pain, disability and quality of life patient with cervical radiculopathy. Study concluded that combined approach is more effective than using a single treatment technique.

【背景】神经根型颈椎病（Cervical Radiculopathy）是指因颈神经根受压引发的疼痛及感觉运动功能障碍综合征。对该疾病的深入认知，是实现此类患者快速诊断与治疗、提升其生活质量的关键前提。目前尚无能够根治此类疼痛并实现长期疗效的治疗方案。
【目的】本研究旨在探讨经颅直流电刺激（Transcranial Direct Current Stimulation, tDCS）联合经皮神经电刺激（Transcutaneous Electrical Nerve Stimulation, TENS）与运动干预对神经根型颈椎病患者疼痛的改善效果，为该干预手段的即时与长期疗效提供循证依据。
【方法】本研究依据纳入标准筛选受试者。首先采用数字疼痛评定量表（NPRS）、颈椎功能障碍指数（NDI）评估受试者的疼痛程度、功能障碍情况及生活质量，并通过上肢张力试验（Upper Limb Tension Test, ULTT）评估并明确颈神经根受累情况。最终纳入的20名受试者被分为两组：实验组（n=11）接受主动阳极经颅直流电刺激（刺激M1区与眶上区，时长20分钟，电流强度2mA），同时在疼痛分布区域给予经皮神经电刺激（频率5Hz，脉宽80~150ms，时长20分钟），随后进行针对性颈部运动训练；对照组（n=9）接受假阳极经颅直流电刺激，其余操作与实验组一致，即疼痛区域经皮神经电刺激联合颈部针对性运动。上述干预方案每周实施5天，持续2周。干预结束后，采用相同的结局指标对所有受试者再次进行评估，以验证干预效果。
【结果】本研究采用夏皮罗-威尔克检验（Shapiro-Wilk Test）进行正态性分布检验，结果显示数据符合正态分布。组内分析采用配对t检验，结果显示两组受试者的干预均产生了显著效果；组间分析则显示，实验组（主动经颅直流电刺激组）的干预效果更为显著，研究的备择假设得以验证。
【结论】本研究探讨了主动经颅直流电刺激联合经皮神经电刺激与运动干预对神经根型颈椎病患者疼痛、功能障碍及生活质量的影响。研究结果表明，联合干预手段的疗效优于单一治疗方案。