Neuromuscular electrical stimulation for treating postpartum low back pain

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.

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

Clinical Medicine Insights Arthritis and Musculoskeletal Disorders ◽

10.1177/1179544119849570 ◽

2019 ◽

Vol 12 ◽

pp. 117954411984957 ◽

Cited By ~ 1

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.

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Therapeutic effectiveness of neuromuscular electrical stimulation for treating patients with chronic low back pain

Medicine ◽

10.1097/md.0000000000013197 ◽

2018 ◽

Vol 97 (48) ◽

pp. e13197 ◽

Cited By ~ 1

Author(s):

Peng Guo ◽

Jian-wei Wang ◽

An Tong

Keyword(s):

Electrical Stimulation ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Neuromuscular Electrical Stimulation ◽

Therapeutic Effectiveness ◽

Low Back

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Combined neuromuscular electrical stimulation with motor control exercise can improve lumbar multifidus activation in individuals with recurrent low back pain

Scientific Reports ◽

10.1038/s41598-021-94402-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sranya Songjaroen ◽

Panakorn Sungnak ◽

Pagamas Piriyaprasarth ◽

Hsing-Kuo Wang ◽

James J. Laskin ◽

...

Keyword(s):

Electrical Stimulation ◽

Low Back Pain ◽

Motor Control ◽

Back Pain ◽

Motor Performance ◽

Neuromuscular Electrical Stimulation ◽

Low Back ◽

Lumbar Multifidus ◽

Maximum Voluntary Isometric Contraction ◽

Control Exercise

AbstractMotor control exercise (MCE) is commonly prescribed for patients with low back pain. Although MCE can improve clinical outcomes, lumbar multifidus muscle (LM) activation remains unchanged. Neuromuscular electrical stimulation (NMES) can be used to re-activate motor units prior to MCE which should result in increased LM activation. Therefore, this study aimed to explore the immediate effects of NMES combined with MCE on LM activation and motor performance. Twenty-five participants without low back pain (NoLBP) and 35 participants with movement control impairment (MCI) were recruited. Participants with MCI were further randomized to combined NMES with MCE (COMB) or sham-NMES with MCE (MCE) group. Ultrasound imaging was used to measure LM thickness at rest, maximum voluntary isometric contraction (MVIC), and NMES with MVIC. These data were used to calculate LM activation. Quadruped rocking backward was used to represent motor performance. LM activation and motor performance were measured at baseline and after one-session of intervention. Results showed that both COMB and MCE groups had significantly lower (P < 0.05) LM activation compared with NoLBP group at baseline. Additionally, both COMB and MCE groups demonstrated significant improvement (P < 0.05) in motor performance while COMB group demonstrated significantly greater improvement (P < 0.05) in LM activation compared with MCE group. Individuals with MCI still have persisting LM activation deficit. Our key findings suggest that combined NMES and MCE may have better ability to improve LM activation in individuals with MCI. These findings would support the utility of NMES to induce a priming effect before MCE.

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