慢性腰痛（cLBP）是康复医学领域最常见的骨骼肌肉疼痛，患病率约为35.6%，呈逐年增高、年轻化趋势。cLBP发生发展和预后与中枢神经机制密切相关，但其确切机理尚不清楚。最新证据显示cLBP皮质运动区功能改变与腰椎多裂肌协调运动障碍相关，提示核心稳定肌及中枢控制障碍是其关键病因。前期我们发表文章报道：LBP前额叶、运动区、扣带回等局部一致性异常，深层多裂肌激活延迟，但cLBP脑网络模式与腰椎稳定肌的内在联系机制还不明确。本项目拟首先采用静息态fMRI和功能连接等方法，探讨cLBP大脑内在活动及功能网络改变；再通过sEMG结合丝电极测量深层多裂肌、腹横肌电活动和超声检测形态学特征，观察核心稳定肌功能结构变化；最后对cLBP进行核心稳定训练，通过比较干预前后脑功能网络的差异及与肌电超声形态改变的相关性，探讨脑网络与核心稳定肌之间的因果关联性及功能重建机制，为cLBP临床康复与预防提供理论依据。

Chronic low back pain (cLBP) is the most common forms of musculoskeletal pain in rehabilitation medicine, its prevalence rate in Chinese has been 35.6% with a rapidly increasing and younger trend. Previous researches have showed that the development and prognosis of cLBP are closely related to the central nervous system, but the etiology and pathogenesis is still unknown. Recent studies show that cLBP is often associated with impaired control of deep lumbar multifidus and functional changes of the primary motor cortex, suggesting that impaired corticomotor control of core muscles involved in spine stability may be of vital role in patients with cLBP. We had published articles revealed that LBP demonstrated significant regional homogeneity changes in the prefrontal cortex, motor cortex and cingulated cortex. The onsets of the bilateral multifidus were significantly delayed in the cLBP group compared with the healthy group. However, the mechanisms of brain functional networks and its potential relationship with impaired control of core stabilization muscles such as the transversus abdominis and lumbar multifidus. Thus, this project firstly intends to use resting-state functional magnetic resonance imaging and functional connectivity methods to investigate changes in network dynamics and functional activity in cLBP. Then we present a novel method based on surface electromyography (sEMG) system and fine-wire electrodes recording EMG signals to identify the changes in neuromuscular activation of the lumbar multifidus and transversus abdominis during dynamic activities with persistent pain. The muscle thickness, cross-sectional area and contraction activity were also measured by ultrasound imaging to observe potential relationship between EMG activity and structural changes in cLBP. Moreover, two-tailed paired t-test was used to compare the brain functional network differences between two groups before and after the intervention (12 weeks core stability exercise) in cLBP, then find potential association between reorganization of cortical networks and changes of core stability muscles to provide objective basis for clinical rehabilitation.