Does Neuromuscular Electrical Stimulation Have an Additive Effect on Disability, Pain and Abdominal and Lumbar Muscle Thickness in Chronic Low Back Pain? – A Randomized Controlled Double-Blind Study

2021 ◽  
Author(s):  
Ecenur Atli ◽  
Dilber Karagozoglu Coskunsu ◽  
Zeynep Turan ◽  
Ozden Ozyemisci Taskiran
Keyword(s):  
Electrical Stimulation ◽  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
Neuromuscular Electrical Stimulation ◽  
Muscle Thickness ◽  
Transversus Abdominis ◽  
Control Group ◽  
Low Back

Abstract Objective To examine the effect of neuromuscular electrical stimulation (NMES) combined with core stabilization exercises (CSE) in patients with chronic low back pain (CLBP). Methods Thirty-six patients (mean age 33.6±12.6 years) with CLBP were randomly assigned to 4 weeks (12 sessions) of NMES group (NMES combined with CSE) (n=18) vs. Control group (sham NMES and CSE) (n=18). After the 4 weeks, same exercises were given as home exercise program without NMES. The outcome measures were Oswestry Disability Index (ODI), Visual Analog Scale (VAS), Nottingham Health Profile (NHP) and ultrasonography. Ultrasonography was used for measuring transversus abdominis (TrA), internal oblique (IO), external oblique (EO) muscles thickness and lumbar multifidus muscle thickness and area. Assessments were performed at baseline and 4th week and eighth week follow-up. Results In both groups, the change of ODI, VAS and NHP values of the first measurement according to the values of the 4th week and the eighth week were found statistically significant (p=0.001; p<0.01). There were no statistically significant differences in ODI, VAS and NHP scores between the 4th week and the eighth week in both groups (p>0.05). None of NMES and control group measurements with US showed a statistically significant increase in the TrA, IO, EO thickness and multifidus thickness and area (p>0.05). Conclusions It was shown that NMES can be tolerated by patients with CLBP, but the addition of simultaneus NMES to CSE had no contribution to the clinical outcome measures.

Does neuromuscular electrical stimulation have an effect on disabiliy, pain, abdominal and lumbar muscle thickness in chronic low back pain?

2020 ◽  
Vol 81 ◽  
pp. 13-14
Author(s):  
E. Atli ◽  
D. Karagözoğlu Coşkunsu ◽  
O. Ozyemisci Taskıran ◽  
Z. Turan
Keyword(s):  
Electrical Stimulation ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Neuromuscular Electrical Stimulation ◽  
Muscle Thickness ◽  
Low Back ◽  
Lumbar Muscle

scholarly journals Stabilization exercises combined with neuromuscular electrical stimulation for patients with chronic low back pain: a randomized controlled trial

2019 ◽  
Vol 23 (6) ◽  
pp. 506-515 ◽  
Author(s):  
Muhammad Alrwaily ◽  
Michael Schneider ◽  
Gwendolyn Sowa ◽  
Michael Timko ◽  
Susan L. Whitney ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Electrical Stimulation ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Controlled Trial ◽  
Neuromuscular Electrical Stimulation ◽  
Low Back ◽  
Randomized Controlled

scholarly journals Exploring Neuromuscular Electrical Stimulation Intensity Effects on Multifidus Muscle Activity in Adults With Chronic Low Back Pain: An Ultrasound Imaging–Informed Investigation

2019 ◽  
Vol 12 ◽  
pp. 117954411984957 ◽  
Author(s):  
Jaclyn Megan Sions ◽  
DeJ’a Chyanna Crippen ◽  
Gregory Evan Hicks ◽  
Abdulmohsen Meshari Alroumi ◽  
Tara Jo Manal ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Muscle Activity ◽  
Neuromuscular Electrical Stimulation ◽  
Low Back ◽  
High Tolerance ◽  
Multifidus Muscle ◽  
Thickness Change

Study design: Cross-sectional study. Background: Neuromuscular electrical stimulation (NMES) is an effective tool for stimulating multifidus muscle contractions. Ultrasound imaging (USI) is valid and reliable for quantifying multifidus activity represented by percent thickness change from a resting to contracted state. Thus, USI may be used to help determine optimal NMES intensity. Objectives: To explore NMES intensity effects on multifidus thickening in adults with chronic low back pain (CLBP). Methods: Sixty patients with CLBP participated. L4/5 multifidus ultrasound images were obtained and percent thickness change from a resting to a contracted state was determined at baseline with a limb lift and during NMES application. During NMES, the examiner recorded the intensity, in milliampere, when the multifidus first started to thicken as observed with USI. The examiner also recorded the NMES intensity that resulted in no further multifidus thickening (ie, high-tolerance group) or, in cases where maximal thickening was not observed, the NMES intensity of the submaximal contraction (ie, low-tolerance group). Differences between participants with high versus low NMES tolerance were evaluated. Results: During NMES, the multifidus began thickening at a higher intensity for the high-tolerance group (n = 39), that is, 34 mA, compared with the low-tolerance group (n = 21), that is, 32 mA ( P = .001). A greater mean intensity in the high-tolerance group, that is, 62 mA, as compared to 45 mA in the low-tolerance group, resulted in a larger percent thickness change, that is, 30.89% compared to 20.60%, respectively ( P < .001). Conclusions: Results provide clinicians with NMES intensity targets to facilitate multifidus muscle thickening, which provides insight into muscle activity.

Comparison of Selective Local and Global Muscle Thicknesses in Females with and without Chronic Low Back Pain

2018 ◽  
Vol 20 (3) ◽  
pp. 197-204 ◽  
Author(s):  
Mahnaz Aboufazeli ◽  
Mohammad Akbari ◽  
Ali Ashraf Jamshidi ◽  
Mohammad Saleh Jafarpisheh
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Healthy Subjects ◽  
Muscle Thickness ◽  
Gluteus Medius ◽  
Transversus Abdominis ◽  
Low Back ◽  
Lumbar Multifidus ◽  
Sample Test

Background. Chronic low back pain (LBP) leads to long-term physical and psychological problems and may result in acute deterioration of the pain. It is hypothesized that size changes in selected limb and pelvis muscles during contracting movements are different between healthy individuals and LBP patients. Materials and methods. A case-control study including two groups of 30 female participants with and without LBP symptoms was designed. Participants were 20-45 years old (36.7±6.7, healthy subjects; 34.6±6.2 LBP subjects). Ultrasonography was used to estimate the thicknesses of the quadratus lumborum (QL), gluteus medius (GMed), transversus abdominis (TrA) and lumbar multifidus (MF). Thickness changes of the muscles in a submaximal contracting position compared to the rest position were measured. Statistical analysis included an independent t-test to determine the significance of differences, and the Kolmogrov-Smirnov two-sample test to evaluate the normality and reliability. Results. All muscles increased their thickness during contractions. The average increase in LBP subjects was lower than in the healthy subjects. The smaller increase in the muscle thickness of GMed in the LBP group may suggest a weakness because of imbalance in the GMed muscle of LBP patients. Conclusions. 1. Ultrasonography of local and global muscles is an appropriate device for clinical diagnosis of LBP. 2. Strengthening TrA, MF, and GMed muscles for pain prevention is effective in the prevention and treatment of LBP.

Changes in Muscle Thickness After Exercise and Biofeedback in People With Low Back Pain

2014 ◽  
Vol 23 (4) ◽  
pp. 307-318 ◽  
Author(s):  
Shandi L. Partner ◽  
Mark Alan Sutherlin ◽  
Shellie Acocello ◽  
Susan A. Saliba ◽  
Eric M. Magrum ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Muscle Thickness ◽  
Transversus Abdominis ◽  
Group Differences ◽  
Low Back ◽  
Lateral Abdominal Wall ◽  
Percent Change ◽  
Before And After

Context:Individuals with low back pain (LBP) have reduced function of the transversus abdominis (TrA) and lumbar multifidus (LM) muscles. Biofeedback during exercise may increase the ability to contract the TrA and LM muscles compared with exercise alone.Objective:To compare TrA preferential activation ratio (PAR) and the percent change in LM-muscle thickness in patients with LBP history before and after exercise with or without biofeedback.Design:Controlled laboratory study.Setting:University research laboratory.Patients:20 LBP individuals, 10 exercise alone and 10 exercise with biofeedback.Interventions:Patients were allotted to tabletop exercises in isolation or tabletop exercises with visual, auditory, and tactile biofeedback.Main Outcome Measures:TrA PAR and percent change in LM-muscle thickness.Results:There were no differences between groups at baseline (all P > .05). Nonparametric statistics showed decreased resting muscle thickness for total lateral abdominal-wall muscles (P = .007) but not TrA (P = .410) or LM (P = .173). Percent TrA thickness increased from table to standing positions before (P = .006) and after exercise (P = .009). TrA PAR increased after exercise (pre 0.01 ± 0.02, post 0.03 ± 0.04, P = .033) for all patients and for exercise with biofeedback (pre 0.02 ± 0.01, post 0.03 ± 0.01, P = .037) but not for exercise alone (pre 0.01 ± 0.02, post 0.02 ± 0.05, P = .241). No group differences were observed for TrA PAR before (exercise 0.01 ± 0.02, exercise with biofeedback 0.02 ± 0.01, P = .290) or after exercise (exercise 0.02 ± 0.05, exercise with biofeedback 0.03 ± 0.01, P = .174). There were no group differences in LM percent change before exercise (P = .999) or after exercise (P = .597). In addition, no changes were observed in LM percent change as a result of exercise among all participants (P = .391) or for each group (exercise P = .508, exercise with biofeedback P = .575).Conclusion:TrA PAR increased after a single session of exercises, whereas no thickness changes occurred in LM.

The Effect of Traditional Bridging or Suspension-Exercise Bridging on Lateral Abdominal Thickness in Individuals With Low Back Pain

2012 ◽  
Vol 21 (2) ◽  
pp. 151-160 ◽  
Author(s):  
Rebecca J. Guthrie ◽  
Terry L. Grindstaff ◽  
Theodore Croy ◽  
Christopher D. Ingersoll ◽  
Susan A. Saliba
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Muscle Thickness ◽  
Transversus Abdominis ◽  
Minimal Detectable Change ◽  
Abdominal Muscles ◽  
Low Back ◽  
Time Interaction ◽  
Contraction Ratio

Context:Individuals with low back pain (LBP) are thought to benefit from interventions that improve motor control of the lumbopelvic region. It is unknown if therapeutic exercise can acutely facilitate activation of lateral abdominal musculature.Objective:To investigate the ability of 2 types of bridging-exercise progressions to facilitate lateral abdominal muscles during an abdominal drawing-in maneuver (ADIM) in individuals with LBP.Design:Randomized control trial.Setting:University research laboratory.Participants:51 adults (mean ± SD age 23.1 ± 6.0 y, height 173.6 ± 10.5 cm, mass 74.7 ± 14.5 kg, and 64.7% female) with LBP. All participants met 3 of 4 criteria for stabilization-classification LBP or at least 6 best-fit criteria for stabilization classification.Interventions:Participants were randomly assigned to either traditional-bridge progression or suspension-exercise-bridge progression, each with 4 levels of progressive difficulty. They performed 5 repetitions at each level and were progressed based on specific criteria.Main Outcome Measures:Muscle thickness of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) was measured during an ADIM using ultrasound imaging preintervention and postintervention. A contraction ratio (contracted thickness:resting thickness) of the EO, IO, and TrA was used to quantify changes in muscle thickness.Results:There was not a significant increase in EO (F1,47 = 0.44, P = .51) or IO (F1,47 = .30, P = .59) contraction ratios after the exercise progression. There was a significant (F1,47 = 4.05, P = .05) group-by-time interaction wherein the traditional-bridge progression (pre = 1.55 ± 0.22; post = 1.65 ± 0.21) resulted in greater (P = .03) TrA contraction ratio after exercise than the suspension-exercise-bridge progression (pre = 1.61 ± 0.31; post = 1.58 ± 0.28).Conclusion:A single exercise progression did not acutely improve muscle thickness of the EO and IO. The magnitude of change in TrA muscle thickness after the traditional-bridging progression was less than the minimal detectable change, thus not clinically significant.

scholarly journals Pain Catastrophizing Is Related to Static Postural Control Impairment in Patients with Nonspecific Chronic Low Back Pain: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Chanjuan Zhang ◽  
Zhou Zhang ◽  
Yuelong Li ◽  
Chenyang Feng ◽  
Haiqi Meng ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Postural Control ◽  
Chronic Low Back Pain ◽  
Pain Catastrophizing ◽  
Transversus Abdominis ◽  
Voluntary Activation ◽  
Control Group ◽  
Low Back ◽  
Eyes Closed

Purpose. Pain catastrophizing may contribute to the altered trunk muscle activity in patients with nonspecific chronic low back pain (NSCLBP). It is unclear if pain catastrophizing influences static postural control in patients with NSCLBP. This study aimed to investigate the relationship between pain catastrophizing and static postural control in NSCLBP patients. Methods. Sixty-eight participants with NSCLBP and 40 healthy participants were recruited. Postural control was assessed by the sway area and the sway length of the center of pressure (COP) during balance tests. Pain catastrophizing in participants with NSCLBP was assessed by the Pain Catastrophizing Scale (PCS). Bilateral transversus abdominis (TrA) activation was evaluated by ultrasound imaging-measured percent change in muscle thickness. Associations between COP parameter and PCS/subscales of PCS were examined by multiple linear regression (MLR). Results. Our results observed a larger COP sway area in NSCLBP group under eyes-closed condition p < 0.001 and a lower level of voluntary activation of the bilateral TrA p < 0.001 , compared with the healthy control group. The MLR analyses revealed that the COP area sway under eyes-closed condition was significantly associated with the PCS score/helplessness score of PCS, voluntary activation of the left TrA, and age in participants with NSCLBP (β = 0.222/0.236, 0.341/0.344, and 0.328/0.325; p = 0.045 / 0.033 , 0.002, and 0.004, resp.). Conclusions. Static postural control was associated with pain catastrophizing, voluntary activation of TrA, and age in participants with NSCLBP. This indicated that pain catastrophizing may affect postural control and should be considered when interpreting balance test results and managing NSCLBP.

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