近年来，我国老龄化现象日趋严重，老年人的身心健康引发社会广泛关注。“健康中国2030规划纲要”将促进健康老龄化作为重点工作，强调加强老年慢性疾病的健康指导和综合干预。“十四五”规划纲要提出“实施积极应对人口老龄化”的国家战略，将提高老年人生活质量作为重要任务。慢性非特异性下腰痛是常见的老年慢性疾病之一，前期研究发现，慢性非特异性下腰痛老年人不仅表现为痛觉过敏，往往还伴有认知功能下降。执行功能是认知和社会功能的核心，与老年人的身心健康和社会适应息息相关。近期有研究发现，慢性非特异性下腰痛老年人的执行功能衰退更加严重，若不能及时得到有效改善，会加剧轻度认知功能障碍、阿尔茨海默症等疾病的患病风险，不仅影响其身心健康，还给老年生活带来沉重压力。因此，探索改善慢性非特异性下腰痛老年人执行功能的有效手段成为多学科领域的前沿热点。

来自运动心理学领域的研究发现正念运动既可以缓解慢性疼痛，又可以改善老年人的执行功能。慢性非特异性下腰痛老年人由于长期处于疼痛的状态，强度大、外周肌群负荷大的运动不适合其参与。太极拳是身心合一、心静体松的正念运动，涉及身体活动（尤其是核心肌群）和认知控制，其运动强度也更适合慢性非特异性下腰痛老年人练习。但以往的太极拳套路门槛较高，动作结构较复杂，不利于老年人练习。国家体育总局委托研究团队以太极拳中核心共性元素“八法五步”技术为基础创编结构和数量适宜的太极（八法五步）普及套路，以其易学易练的特征更加适合慢性非特异性下腰痛老年人的参与。那么太极（八法五步）对慢性非特异性下腰痛老年人的执行功能具有怎样的影响，其脑机制如何，值得深入探讨。

基于此，本研究以老年人为对象，首次综合运用体育测量、心理测量、EEG-fNIRS联合同步采集分析技术，在全面分析慢性非特异性下腰痛老年人执行功能特征的基础上，进一步探讨了长期太极（八法五步）运动干预对慢性非特异性下腰痛老年人执行功能的影响，并从神经血管耦合的角度揭示影响执行功能的脑机制。为改善慢性非特异性下腰痛老年人的执行功能提供科学途径，为采用太极（八法五步）为干预手段改善老年人的执行功能提供实践基础。本研究具体包括以下三部分内容：

研究一 慢性非特异性下腰痛老年人执行功能的特征

以招募并筛选出的50名慢性非特异性下腰痛老年人（疼痛组）和50名健康老年人（健康对照组）为研究对象，采用独立样本T检验比较两组老年人执行功能各子功能反应正确率及反应时的差异。进一步采用Spearman相关分析探讨疼痛评分与执行功能各子功能的关系。研究结果发现：（1）疼痛组老年人的抑制、刷新、转换功能反应正确率与健康对照组老年人相比无显著性差异，表明慢性非特异性下腰痛老年人执行功能各子功能的运行效能与健康老年人相比均无差异。（2）疼痛组老年人的抑制、刷新、转换功能反应时均显著高于健康对照组老年人，表明慢性非特异性下腰痛老年人执行功能各子功能的运行效率均显著低于健康老年人。（3）疼痛组老年人执行功能各子功能反应时与疼痛评分存在正相关关系，表明慢性非特异性下腰痛老年人的执行功能呈现出随疼痛水平升高，运行效率降低的特征。

研究二 太极（八法五步）对慢性非特异性下腰痛老年人执行功能影响的实验研究

以50名慢性非特异性下腰痛老年人和50名健康老年人为研究对象，采用3（组别：太极拳组、对照组、健康对照组）×2（时间：干预前、干预后）的二因素重复测量方差分析，分析、比较12周太极（八法五步）运动干预前后三组老年人执行功能各子功能运行效率的变化及差异；采用2（组别：太极拳组、对照组）×2（时间：干预前、干预后）的二因素重复测量方差分析，分析、比较12周太极（八法五步）运动干预前后两组老年人疼痛水平的变化及差异。进一步采用Pearson相关及回归分析探讨疼痛评分变化与执行功能各子功能运行效率变化的关系。研究结果发现：（1）在抑制功能上，太极拳组后测的不一致、一致任务和抑制能力反应时均显著低于前测，对照组和健康对照组均无显著性变化；太极拳组后测的不一致、一致任务和抑制能力反应时显著低于对照组。以上结果表明12周太极（八法五步）能够改善慢性非特异性下腰痛老年人抑制功能的运行效率。（2）在刷新功能上，太极拳组后测的1-back、2-back任务和刷新能力反应时均显著低于前测，对照组和健康对照组均无显著性变化；太极拳组后测的1-back、2-back任务和抑制能力反应时显著低于对照组；太极拳组后测的1-back、2-back任务和刷新能力反应时显著高于健康对照组，但有向健康老年人改善的趋势。以上结果表明12周太极（八法五步）能够改善慢性非特异性下腰痛老年人刷新功能的运行效率。（3）在转换功能上，太极拳组后测的混合判断任务和转换能力反应时均显著低于前测，对照组和健康对照组均无显著性变化；太极拳组后测的混合判断任务和转换能力反应时显著低于对照组；太极拳组后测的混合判断任务和转换能力反应时显著高于健康对照组，但有向健康老年人改善的趋势。以上结果表明12周太极（八法五步）能够改善慢性非特异性下腰痛老年人转换功能的运行效率。（4）在疼痛评分上，太极拳组后测的疼痛评分显著低于前测，对照组无显著性变化；太极拳组后测的疼痛评分显著低于对照组。太极拳组干预前后的疼痛评分变化值分别与抑制能力、刷新能力和转换能力反应时变化值之间存在显著正相关关系。以上结果表明12周太极（八法五步）能够改善慢性非特异性下腰痛老年人的疼痛水平，且疼痛水平的降低能够预测执行功能运行效率的改善。

研究三 太极（八法五步）影响慢性非特异性下腰痛老年人执行功能的脑机制研究

以50名慢性非特异性下腰痛老年人为研究对象，采用EEG-fNIRS联合同步采集技术采集任务态皮层电生理活动和脑区功能活动，采用2（组别：太极拳组、对照组）×2（时间：干预前、干预后）的二因素重复测量方差分析，分析、比较12周太极（八法五步）运动干预前后两组老年人在任务态下的ERS响应幅值和氧合血红蛋白浓度的变化及差异。进一步分析EEG与fNIRS指标的线性拟合特征，探讨运动干预前后两组老年人神经血管耦合关系的变化。研究结果发现：（1）在ERS响应幅值上，运动干预后，太极拳组老年人在进行执行功能任务时的前额叶θ波ERS响应幅值显著增强，对照组无显著性变化，表明12周太极（八法五步）运动干预增强了慢性非特异性下腰痛老年人进行执行功能任务时的神经元活动。（2）在氧合血红蛋白浓度上，运动干预后，太极拳组老年人在进行执行功能任务时的背外侧额上回氧合血红蛋白浓度显著提升，对照组无显著性变化，表明12周太极（八法五步）运动干预增强了慢性非特异性下腰痛老年人进行执行功能任务时的局部脑血流。（3）在神经血管耦合关系上，运动干预后，太极拳组在进行执行功能任务时的神经血管耦合关系提高，对照组无显著性变化，表明12周太极（八法五步）运动干预提高了老年人进行执行功能任务时神经元活动与局部脑血流的耦合关系，即神经元活动与局部脑血流通过效率同步性提高，改善了认知加工效率。

综合上述研究结果，得出以下研究结论：

（1）慢性非特异性下腰痛老年人执行功能各子功能的运行效率低于健康老年人，且呈现出随疼痛水平升高，运行效率降低的特征。（2）12周太极（八法五步）能够有效改善慢性非特异性下腰痛老年人的疼痛水平和抑制、刷新、转换功能的运行效率，且疼痛水平的降低能够预测执行功能运行效率的改善。（3）12周太极（八法五步）改善慢性非特异性下腰痛老年人执行功能的脑机制涉及前额叶θ波ERS响应幅值增强，背外侧额上回氧合血红蛋白浓度提升，以及神经元活动与局部脑血流耦合关系的提高。

In recent years, the issue of aging has become increasingly severe, and there is widespread concern regarding older adults' physical and mental health. The "Healthy China 2030 Planning Outline" emphasizes the promotion of healthy aging as a critical task. This involves strengthening health guidance and implementing comprehensive interventions for chronic diseases among older adults. The "14th Five-Year Plan's Outline" proposes a national strategy of "actively responding to population aging," focusing on improving the quality of life of older adults as an essential task. Chronic Nonspecific Low Back Pain(CNLBP) is a prevalent chronic disease among older adults. Previous studies revealed that this condition causes hyperalgesia and is often accompanied by cognitive decline. This significantly affects older adults' physical and mental health and social adaptation, leading to adverse effects. Executive function is at the core of cognitive and social functions and is closely related to older adults' physical and mental health and social adjustment. Recent studies have found that the decline in executive function in older adults with CNLBP is more severe, if it cannot be effectively improved over time. In that case, it will increase the risk of mild cognitive impairment, Alzheimer's disease, and other diseases, affecting old age and burdening society and families. Therefore, exploring effective means of improving executive function in elderly individuals with CNLBP has become a frontier hotspot in the multidisciplinary field.

Research in sports psychology has found that mindful exercise can effectively relieve chronic pain and improve executive function in older adults. Tai Chi is a mindful exercise that unites the body and mind, calms the mind, and relaxes the body. It emphasizes the balance between “Yin” and “Yang” and the coordination of mind and energy. Further, it simultaneously focuses on relaxation and concentration. It involves physical activity, cognitive control, and social interactions during group practice. Studies have found that the benefits of practicing Tai Chi are mainly reflected in improving cognitive and motor functions. However, the previous routines of Tai Chi had complex movement structures and high routine thresholds that were not conducive to practice and popularization. Accordingly, the General Administration of Sport of China commissioned a research group to create Tai Chi (Bafa Wubu) routines with simple structure and reasonable quantity based on the common core elements of Tai Chi, the "Bafa Wubu." Given its easy-to-learn and easy-to-practice features, Tai Chi (Bafa Wubu) is more suitable for older adults with CNLBP. Therefore, the effects of Tai Chi (Bafa Wubu) on the executive function of older adults with CNLBP and the underlying brain mechanisms are worth exploring in depth.

This study focuses on older adults and utilizes physical measurements, psychological measurements, and EEG-fNIRS combined with synchronous acquisition and analysis technology. To the best of our knowledge, this is the first time such an approach has been used to comprehensively examine the long-term effects of Tai Chi on the executive function and brain mechanism of older adults with CNLBP. To provide a scientific path for improving the executive function of older adults with CNLBP, to provide a theoretical and practical basis for the use of Tai Chi (Bafa Wubu) to improve the executive function of older adults. This study comprised the following three parts.

Study 1: Characteristics of Executive Function of Older Adults with Chronic Nonspecific Low Back Pain

This study recruited and screened 50 older adults with CNLBP (pain group) and 50 healthy older adults (healthy control group) using a medical examination. The independent samples t-test was conducted to compare the difference in Accuracy Rate (AR) and Reaction Time (RT) of each subfunction of executive function between the two groups of older adults. Additionally, Spearman correlation analysis was conducted to explore the relationship between pain level and each subfunction of the executive function. The study's results showed that: (1) The AR of inhibitory control, updating function, and cognitive flexibility function responses among older adults in the pain group does not significantly differ from that of the healthy control group. This suggests that the performance effectiveness of each subfunction of executive function among older adults with CNLBP was not different from that of healthy older adults. (2) The RT of inhibitory control, updating function, and cognitive flexibility function of older adults in the pain group were significantly higher than those of the healthy control group. This implies that the processing efficiency of each subfunction of the executive function among older adults with CNLBP was significantly lower than that of healthy older adults. (3) There was a positive correlation between the response time of each subfunction of executive function and pain level among older adults in the pain group. This indicates that the executive function of older adults with CNLBP exhibits a change in processing efficiency, with a decrease in processing efficiency as the pain level increases.

Study 2: Effects of Tai Chi (Bafa Wubu) on the Executive Function of Older Adults with Chronic Nonspecific Low Back Pain

The study utilized 50 older adults with CNLBP and 50 healthy older adults. A mix-model experiment was conducted with a 3 (Tai Chi group, control group, healthy control groups) × 2 (time: before and after intervention) design. 2 (Tai Chi group, control group) × 2 (time: before and after intervention) design. Repeated-measures analysis of variance was conducted to analyze and compare the differences in the processing efficiency of each subfunction of the executive function and pain level of older adults before and after 12 weeks of Tai Chi (Bafa Wubu) exercise intervention. Additionally, Pearson correlation analysis and regressive analysis was conducted to explore the relationship between change in pain level and change in each subfunction of the executive function. The results found that: (1) Regarding the inhibitory control function, the inconsistency, consistency task, and inhibitory ability RT of the posttest Tai Chi group were significantly faster than those of the pretest. Further, there was no significant change in the control and healthy groups. The above results show that 12 weeks of Tai Chi (Bafa Wubu) can improve the processing efficiency of inhibitory control function in older adults with CNLBP. (2) Regarding updating function, the 1-back, 2-back task, and updating ability RT of the Tai Chi group after the test were significantly lower than those of the pretest. There was no significant change in the control and healthy control groups. The 1-back and 2-back tasks and updating ability RT of the Tai Chi group were significantly faster than those of the control group. The above results show that 12 weeks of Tai Chi (Bafa Wubu) can improve the processing efficiency of updating function in older adults with CNLBP. (3) Regarding cognitive flexibility function, Tai Chi group showed a significant decrease in the mixed judgment task and flexibility ability RT after the 12-week intervention period, compared to their pretest scores. However, no significant change was observed in the control and healthy control groups. After the test, the mixed judgment task RT and flexibility ability of the Tai Chi group were significantly higher than those of the healthy control group, indicating that the Tai Chi group still had lower processing efficiency. Nevertheless, there was a tendency towards improvement in the healthy elderly group. The above results show that 12 weeks of Tai Chi (Bafa Wubu) can improve the processing efficiency of cognitive flexibility function in older adults with CNLBP. (4) Regarding pain score, posttest pain score of the Tai Chi group was significantly lower than that of the pretest, and there was no significant change in the control group. The posttest pain score of the Tai Chi group was significantly lower than the control group. The above results showed that 12 weeks of Tai Chi (Bafa Wubu) can improve the pain score of older adults with CNLBP, and the decrease in pain level can predict an improvement in the processing efficiency of executive function.

Study 3: Effect of Tai Chi (Bafa Wubu) on Executive Function in Older Adults with Chronic Nonspecific Low Back Pain: An EEG-fNIRS study

The study utilized 50 older adults with CNLBP. A mix-model experiment was conducted with a 2 (Tai Chi and control groups) × 2 (before and after intervention) design. The study utilized EEG-fNIRS combined synchronous acquisition and analysis technology to explore the changes and differences in the ERS and Oxygenated-Hemoglobin concentration (Oxy-Hb) of the two groups before and after 12 weeks of Tai Chi (Bafa Wubu) exercise intervention while performing functional behavioral tasks. The linear fitting characteristics of the EEG-fNIRS indicators were further analyzed, and the changes in Neurovascular Coupling (NC) between the two groups of older adults before and after the exercise intervention were discussed. (1) Regarding ERS, the frontal cortex theta wave was significantly increased when performing executive function tasks. There was no significant change in the control group. This indicates that 12 weeks of Tai Chi (Bafa Wubu) exercise intervention enhanced the executive function of older adults with CNLBP neuronal activity during the task. (2) Regarding Oxy-Hb, after exercise intervention, Oxy-Hb in the dorsolateral superior frontal gyrus of older adults in the Tai Chi group was significantly increased when performing functional tasks. There was no significant change in the control group. This indicates that 12 weeks of Tai Chi (Bafa Wubu) enhanced regional cerebral blood flow during executive function tasks in older adults with CNLBP. (3) Regarding NC, after exercise intervention, the NC in the Tai Chi group improved when performing tasks. There was no significant change in the control group. This indicates that the 12-week Tai Chi (Bafa Wubu) exercise intervention improved the coupling relationship between neuronal activity and local cerebral blood flow when the older adults conducted functional tasks. The efficiency of cognitive processing was improved.

In conclusion, the results showed that, (1) the processing efficiency of the executive function of older adults with CNLBP is lower than that of healthy older adults, showing a characteristic of reducing operating efficiency with increased pain level. (2) 12 weeks of Tai Chi (Bafa Wubu) can effectively improve the pain level and the processing efficiency of inhibitory control, updating, and cognitive flexibility functions in older adults with CNLBP, and the decrease in pain level can predict an improvement in the processing efficiency of executive function. (3) The brain mechanism by which 12 weeks Tai Chi (Bafa Wubu) improves executive function in older adults with CNLBP is the ERS response was enhanced, the Oxy-Hb in the dorsolateral superior frontal gyrus was increased, and the coupling relationship between neuronal activity and local cerebral blood flow was improved.