The White Matter Fiber Changes Under Different Exercises In Patients With Knee Osteoarthritis:a DTI-TBSS Study

Objectives:To observe the effects of different exercises on the white matter fibers in patients with knee osteoarthritis,and explore the central mechanism of different exercises to reduce the pain of knee osteoarthritis.Methods:140 knee osteoarthritis were randomly divided into four groups:taichi group,banduanjin group,cycling group and health education group.A health education course was taught to the health education group(one time a week,60 minutes every time).The Tai Chi group received both health education and Tai Chi exercise,the Tai Chi exercise last 12 weeks(one time a day,60 minutes every time,5 days a week).The baduanjin group received both baduanjin exercise and health education,the baduanjin exercise took place 5 days per week for 12 weeks with each session lasting 60 minutes.The cycling group received cycling exercise and health education,the same frequency and period as the Tai Chi group and the baduanjin group.Before and after intervention,all the subjects underwent the KOOS knee pain scores and adopted magnetic resonance scanner to collect DTI data.Tract-based spatial statistics(TBSS)was used to explore the difference values of fractional anisotropy(FA)between Tai Chi and the baduanjin,Tai Chi group and cycling group,Tai Chi group and health education group,baduanjin group and cycling group,baduanjin group and health education group,cycling group and health education group after intervention.At the same time,the correlation between FA value and the KOOS pain scores was analyzed.Results:1.Before intervention,there were no significant differences in KOOS pain scores and demographic data such as age,sex,et al(P>0.05).2.The score of KOOS:After the intervention,there was significant difference between the four groups in the improvement of pain(P=0.003),the KOOS pain scores of the Tai Chi group,the baduanjin group and the cycling group were better than the control group,the differences were statistically significant(P<0.05).There was no significant difference between the Tai Chi group and baduanjin group,Tai Chi group and cycling group,baduanjin group and the cycling group in the improvement of KOOS knee pain scores(P>0.05).3.TBSS analysis results:After the intervention,compared with the health education group,the taichi group was characterized by increased fractional anisotropy in aspects of the right cingulum,right corticospinal tract,right superior longitudinal fasciculus.Decreased fractional anisotropy in aspects of the left anterior thalamic radiation,right anterior thalamic radiation,right superior longitudinal fasciculus.After contrasted to the health education group,the baduanjin group was characterized by increased fractional anisotropy in aspects of right forceps minor and right corticospinal tract.Decreased fractional anisotropy was detected left anterior thalamic radiation,right anterior thalamic radiation,right fronto-occipital fasciculus,left fronto-occipital fasciculus and body of corpus callosum.After contrasted to the health education group,the cycling group characterized by increased fractional anisotropy in aspects of right superior longitudinal fasciculus,right inferior fronton-occipital fasciculus and right uncinate fasciculus.Decreased fractional anisotropy was detected in left anterior thalamic radiation,right anterior thalamic radiation,left inferior fronto-occipital fasciculus and body of corpus callosum.Compared with the baduanjin group,the Tai Chi Group characterized by increased fractional anisotropy in aspects of the left and right superior longitudinal fasciculus,decreased on the right superior longitudinal fasciculus;compared with the cycling group,the Tai Chi Group characterized by increased fractional anisotropy in aspects of right inferior fronton-occipital fasciculus.Decreased fractional anisotropy was detected in right inferior fronton-occipital fasciculus and left inferior longitudinal fasciculus.Compared with the cycling group,baduanjin group characterized by increased fractional anisotropy in aspects of the right superior longitudinal fasciculus.Decreased fractional anisotropy was detected in the left inferior longitudinal fasciculus,right inferior fronton-occipital fasciculus and right anterior thalamic radiation.4.Correlation analysis:KOOS knee pain scores was positively related to FA in the left corticospinal tract after exercise intervention(r=0.28,P=0.01).Conclusion:1.A11 of the three difference exercises(taichi,baduanjin,cycling)can reduce knee pain in knee osteoarthritis and they were effect exercises to knee osteoarthritis.2.1n knee osteoarthritis,the effect of Tai Chi,baduanjin and cycling may lead to change the cerebral white matter fiber structure.The pain relief may be associated with the right cingulate gyrus,the right frontal corpus callosum,the superior longitudinal fasciculus,etc.3.One of the central mechanism of exercises relieved pain may be associated with left corticospinal tract.