Journal Article

Effects of horticultural therapy versus handiwork on anterior cingulate cortex activity in people with chronic low back pain: A randomized, controlled, cross-over, pilot study

Groupe hospitalier universitaire Paris psychiatrie & neurosciences [Paris] (GHU Paris Psychiatrie et Neurosciences), Rören, Alexandra, Abdoul, Hendy, Direction de la Recherche Clinique et de l'Innovation [AP-HP] (DRCI) ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité) ; Université Paris Cité (UPCité), Bedin, Catherine, Lefèvre-Colau, Marie-Martine, Clinical Epidemiology Applied to Osteoarticular Diseases | Épidémiologie clinique appliquée aux maladies rhumatismales et musculo-squelettiques (ECaMO - [CRESS - U1153 / UMR_A 1125]) ; Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques (CRESS (U1153 / UMR_A 1125)) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)

2024

Overview

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.

• Publisher: CCSD,Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Agricultural sciences / Anterior cingulate cortex / Asymptomatic / Back pain / Biology and Life Sciences / Care and treatment / Catastrophization - psychology / Catastrophization - therapy / Chronic illnesses / Chronic pain / Chronic Pain - physiopathology / Chronic Pain - therapy / Clinical trials / Cognitive science / Computer Science / Cortex (cingulate) / Cross-Over Studies / Drug dosages / Efficiency / Evaluation / Exercise / Female / Gyrus Cinguli - diagnostic imaging / Gyrus Cinguli - physiopathology / Horticultural Therapy / Horticulture / Hospitals / Human health and pathology / Humans / Life Sciences / Low back pain / Low Back Pain - physiopathology / Low Back Pain - psychology / Low Back Pain - therapy / Magnetic Resonance Imaging / Male / Medical Imaging / Medicine and Health Sciences / Middle Aged / Musculoskeletal diseases / Neuroimaging / Neuroscience / Occupational therapy / Pain / Patient outcomes / Perfusion / Pilot Projects / Questionnaires / Rehabilitation / Research and Analysis Methods / Rumination / Spin labeling / Therapy / Treatment Outcome