Abstract
BackgroundNeuromuscular electrical stimulation (NMES) is used to improve muscle strength clinically when rehabilitating various musculoskeletal disorders. However, the effects of NMES on muscle morphology and function in individuals with non-specific chronic low back pain (CLBP) have scarcely been investigated. Although research links deficits in the paraspinal musculature with subjective reports of pain and disability, it is unknown if treatment with NMES can help reverse these deficits. Therefore, the primary aim of this study is to compare the effects of two muscle therapy protocols with a medium-frequency electrotherapy device (the StimaWELL 120MTRS system) on multifidus muscle morphology in CLBP patients. The secondary aims are to determine the effects of these protocols on multifidus muscle function, as well as subjective reports of pain intensity, pain interference, disability, and catastrophizing. MethodsA total of 30 participants with non-specific CLBP, aged 18-60, will be recruited from local orthopedic clinics and databases. Participants will be randomized (1:1) to either the phasic or combined (phasic + tonic) muscle therapy protocols on the StimaWELL 120MTRS system. Participants will undergo 20 supervised electrotherapy treatments over a 10-week period. The primary outcomes will be multifidus cross-sectional area (CSA) and fat infiltration. Secondary outcomes will include multifidus contraction (measured via %thickness change from a rested to contracted state), multifidus stiffness (at rest, and during contraction), as well as pain intensity, interference, disability, and catastrophizing. Both primary and secondary outcomes will be obtained at baseline and at 11-weeks; secondary outcomes measured via questionnaires will also be obtained at 6-weeks, while low back pain intensity will be measured before and after each treatment. Paired t-tests will be used to assess within-group changes for all primary outcome measures. A two-way repeated-measures analysis of variance will be use to assess changes in secondary outcomes over time. DiscussionThe results of this trial will help clarify the role of medium-frequency NMES on lumbar multifidus morphology and function. Trial RegistrationNCT04891692 Trial SponsorConcordia University, Montreal, Quebec, Canada
The Effect of Phasic Versus Combined Neuromuscular Electrical Stimulation Using the StimaWELL 120MTRS System on Multifidus Muscle Morphology and Function in Patients with Chronic Low Back Pain: A Randomized Pilot Control Trial Protocol