scholarly journals 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

2021 ◽  
Author(s):  
Maryse Fortin ◽  
Daniel Wolfe ◽  
Geoffrey Dover ◽  
Mathieu Boily
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Neuromuscular Electrical Stimulation ◽  
Low Back ◽  
Multifidus Muscle ◽  
Muscle Morphology ◽  
Secondary Outcomes ◽  
And Function ◽  
Subjective Reports

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

Ultrasonography of multifidus muscle morphology and function in ice hockey players with and without low back pain

2019 ◽  
Vol 37 ◽  
pp. 77-85 ◽  
Author(s):  
Maryse Fortin ◽  
Amanda Rizk ◽  
Stephane Frenette ◽  
Mathieu Boily ◽  
Hassan Rivaz
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Ice Hockey ◽  
Low Back ◽  
Multifidus Muscle ◽  
Muscle Morphology ◽  
Hockey Players ◽  
And Function

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.

McKenzie Method of Mechanical Diagnosis and Therapy was slightly more effective than placebo for pain, but not for disability, in patients with chronic non-specific low back pain: a randomised placebo controlled trial with short and longer term follow-up

2017 ◽  
Vol 52 (9) ◽  
pp. 594-600 ◽  
Author(s):  
Alessandra Narciso Garcia ◽  
Lucíola da Cunha Menezes Costa ◽  
Mark J Hancock ◽  
Fabrício Soares de Souza ◽  
Geórgia Vieira Freschi de Oliveira Gomes ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Treatment Effect ◽  
Controlled Trial ◽  
Low Back ◽  
End Of Treatment ◽  
Mckenzie Method ◽  
Secondary Outcomes

BackgroundThe McKenzie Method of Mechanical Diagnosis and Therapy (MDT) is one of the exercise approaches recommended by low back pain (LBP) guidelines. We investigated the efficacy of MDT compared with placebo in patients with chronic LBP.MethodsThis was a prospectively registered, two-arm randomised placebo controlled trial, with a blinded assessor. A total of 148 patients seeking care for chronic LBP were randomly allocated to either MDT (n=74) or placebo (n=74). Patients from both groups received 10 treatment sessions over 5 weeks. Patients from both groups also received an educational booklet. Clinical outcomes were obtained at the end of treatment (5 weeks) and 3, 6 and 12 months after randomisation. Primary outcomes were pain intensity and disability at the end of treatment (5 weeks). We also conducted a subgroup analysis to identify potential treatment effect modifiers that could predict a better response to MDT treatment.ResultsThe MDT group had greater improvements in pain intensity at the end of treatment (mean difference (MD) −1.00, 95% CI −2.09 to −0.01) but not for disability (MD −0.84, 95% CI −2.62 to 0.93). We did not detect between-group differences for any secondary outcomes, nor were any treatment effect modifiers identified. Patients did not report any adverse events.ConclusionWe found a small and likely not clinically relevant difference in pain intensity favouring the MDT method immediately at the end of 5 weeks of treatment but not for disability. No other difference was found for any of the primary or secondary outcomes at any follow-up times.Trial registration numberClinicalTrials.gov (NCT02123394)

The Relationship of Lumbar Multifidus Muscle Morphology to Previous, Current, and Future Low Back Pain

Spine ◽  
2014 ◽  
Vol 39 (17) ◽  
pp. 1417-1425 ◽  
Author(s):  
Jeffrey J. Hebert ◽  
Per Kjaer ◽  
Julie M. Fritz ◽  
Bruce F. Walker
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Multifidus Muscle ◽  
Muscle Morphology ◽  
Lumbar Multifidus ◽  
Relationship Of ◽  
The Relationship ◽  
Lumbar Multifidus Muscle

Secondary Outcomes from a Randomized Controlled Trial of Yoga for Veterans with Chronic Low-Back Pain

2019 ◽  
Vol 30 (1) ◽  
pp. 69-76
Author(s):  
Erik J. Groessl ◽  
Lin Liu ◽  
Laura Schmalzl ◽  
Douglas G. Chang ◽  
Adhana McCarthy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Chronic Low Back Pain ◽  
Military Veterans ◽  
Low Back ◽  
Delayed Treatment ◽  
Secondary Outcomes

Abstract Chronic low-back pain (cLBP) is a prevalent condition, and rates are higher among military veterans. cLBP is a persistent condition, and treatment options have either modest effects or a significant risk of side-effects, which has led to recent efforts to explore mind-body intervention options and reduce opioid medication use. Prior studies of yoga for cLBP in community samples, and the main results of a recent trial with military veterans, indicate that yoga can reduce back-related disability and pain intensity. Secondary outcomes from the trial of yoga with military veterans are presented here. In the study, 150 military veterans (Veterans Administration patients) with cLBP were randomized to either yoga or a delayed-treatment group receiving usual care between 2013 and 2015. Assessments occurred at baseline, 6 weeks, 12 weeks, and 6 months. Intent-to-treat analyses were conducted. Yoga classes lasting 60 minutes each were offered twice weekly for 12 weeks. Yoga sessions consisted of physical postures, movement, focused attention, and breathing techniques. Home practice guided by a manual was strongly recommended. The primary outcome measure was Roland-Morris Disability Questionnaire scores after 12 weeks. Secondary outcomes included pain intensity, pain interference, depression, fatigue, quality of life, self-efficacy, and medication usage. Yoga participants improved more than delayed-treatment participants on pain interference, fatigue, quality of life, and self-efficacy at 12 weeks and/or 6 months. Yoga participants had greater improvements across a number of important secondary health outcomes compared to controls. Benefits emerged despite some veterans facing challenges with attending yoga sessions in person. The findings support wider implementation of yoga programs for veterans, with attention to increasing accessibility of yoga programs in this population.

scholarly journals Effectiveness of workplace active rest programme on low back pain in office workers: a stepped-wedge cluster randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e040101
Author(s):  
Yamato Tsuboi ◽  
Tomohiro Oka ◽  
Kiyomasa Nakatsuka ◽  
Tsunenori Isa ◽  
Rei Ono
Keyword(s):  
Physical Activity ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Office Workers ◽  
Secondary Outcome ◽  
Low Back ◽  
Stepped Wedge ◽  
Cluster Randomised ◽  
Secondary Outcomes

ObjectiveThis study aimed to investigate the effectiveness of workplace active rest programme (WARP) on chronic low back pain (LBP) among office workers.DesignA closed cohort, stepped-wedge cluster randomised trial was conducted. The total duration of the study was 16 weeks (4 weeks for each step). Sequence allocation was randomised, but no one was blinded.SettingThis study was conducted in three offices in a Japanese electronics company. One office was for the administrative department, the others are for the engineering department.ParticipantsWe recruited 29 office workers with LBP greater than 3 months. LBP due to specific injury or disease was excluded. The median age was 38 years, and 26 (90%) were male. All participants completed the study.InterventionsIn the intervention phase, participants performed WARP comprising frequent stand-up and individualised brief exercise/physical activity during work. Physical therapists held an LBP workshop and developed tailor-made programmes before introducing WARP. We instructed participants to perform WARP at five timings during work. Control phase was set before the intervention and participants stayed as usual.Primary and secondary outcome measuresThe primary outcome was pain intensity of LBP assessed using the Brief Pain Inventory. The secondary outcomes were work productivity loss measured using the Work Limitations Questionnaire, LBP disability assessed using the Roland-Morris Disability Questionnaire, psychosocial subscale assessed using the STarT Back Screening Tool and physical activity measured using triaxial accelerometers. These outcomes were collected at baseline and at 4-month follow-up evaluation.ResultsIn the intention-to-treat analysis, WARP did not show any significant effects on pain intensity (β, 0.01; 95% CI −0.50 to 0.52) and on the secondary outcomes. The median adherence to WARP was 28.6% (IQR, 16.8–41.1), which was equal to 1.43 times per day. No adverse effect was observed.ConclusionsThe present study was unable to confirm the effectiveness of active rest in improving LBP. Hence, further study needs to investigate its effectiveness.Trial registration numberUMIN000033210.

scholarly journals Efficacy of the McKenzie Method in Patients With Chronic Nonspecific Low Back Pain: A Protocol of Randomized Placebo-Controlled Trial

2015 ◽  
Vol 95 (2) ◽  
pp. 267-273 ◽  
Author(s):  
Alessandra Narciso Garcia ◽  
Lucíola da Cunha Menezes Costa ◽  
Mark J. Hancock ◽  
Matheus Oliveira de Almeida ◽  
Fabrício Soares de Souza ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Low Back ◽  
Numerical Rating ◽  
Mckenzie Method ◽  
And Function

Background The McKenzie method is widely used as an active intervention in the treatment of patients with nonspecific low back pain. Although the McKenzie method has been compared with several other interventions, it is not yet known whether this method is superior to placebo in patients with chronic low back pain. Objective The purpose of this trial is to assess the efficacy of the McKenzie method in patients with chronic nonspecific low back pain. Design An assessor-blinded, 2-arm, randomized placebo-controlled trial will be conducted. Setting This study will be conducted in physical therapy clinics in São Paulo, Brazil. Participants The participants will be 148 patients seeking care for chronic nonspecific low back pain. Intervention Participants will be randomly allocated to 1 of 2 treatment groups: (1) McKenzie method or (2) placebo therapy (detuned ultrasound and shortwave therapy). Each group will receive 10 sessions of 30 minutes each (2 sessions per week over 5 weeks). Measurements The clinical outcomes will be obtained at the completion of treatment (5 weeks) and at 3, 6, and 12 months after randomization. The primary outcomes will be pain intensity (measured with the Pain Numerical Rating Scale) and disability (measured with the Roland-Morris Disability Questionnaire) at the completion of treatment. The secondary outcomes will be pain intensity; disability and function; kinesiophobia and global perceived effect at 3, 6, and 12 months after randomization; and kinesiophobia and global perceived effect at completion of treatment. The data will be collected by a blinded assessor. Limitations Therapists will not be blinded. Conclusions This will be the first trial to compare the McKenzie method with placebo therapy in patients with chronic nonspecific low back pain. The results of this study will contribute to better management of this population.

scholarly journals THU0566 THE EFFECT OF KINESIO-TAPING ON CHRONIC NONSPECIFIC LOW BACK PAIN: PRELIMINARY RESULTS OF A DOUBLE BLINDED RANDOMIZED CLINICAL TRIAL.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 524.1-525
Author(s):  
I. Aachari ◽  
K. Samia ◽  
T. Latifa ◽  
T. Fatima Zahrae ◽  
S. Afilal ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Placebo Group ◽  
Back Pain ◽  
Randomized Clinical Trial ◽  
Clinical Characteristics ◽  
Functional Disability ◽  
Low Back ◽  
Kinesio Taping ◽  
Secondary Outcomes

Background:The technique of Kinesio-Taping is a method of adhesive bandage exerting traction on the skin which would favorably influence the muscular and articular systems by reducing the pressure exerted on the subcutaneous mechanoreceptors thus reducing pain and muscle tension.Objectives:The aim of this study is to assess the effectiveness of Kinesio-Taping in the short and medium term on pain and function in patients with chronic nonspecific low back pain compared to a placebo.Methods:We conducted a double-blind, two-arm randomized clinical trial. The study should include a total of 70 patients randomized into 2 groups: Kinesio-Taping (n = 35) and control group (n = 35). To this date we have included 46 patients.All patients receives four I-shaped adhesive strips arranged in a star-like shape and applied to the most painful region of the lower back with a tension between 25% to 30% in the taping group. The placebo group received a taping procedure with no tension.Taping is applied three times (at baseline, fourth and eighth day). Patients are assessed at baseline, on day 14 and at 4 weeks by the Arabic version of the Oswestry Physical and Functional Disability Index (ODI) which is the primary outcome. The secondary outcomes are the assessment of pain and functional disability according to the visual analog scale (VAS) evaluated on a scale of 0 to 10, as well as Rolland-Morris score.Results:Both groups were comparable at baseline concerning the demographical and clinical characteristics (P > 0.05) (table 1). The result of repeated measures ANOVA showed a significant change in ODI score and in VAS for pain and functional disability as well as Rolland-Morris score in both groups. Using the ANCOVA, controlling for pre-test scores, a significant difference was found between the two groups (table 2).Table 1. Clinical characteristics of study population.Conclusion:Our clinical trial offers preliminary evidence on the superiority of Kinesio-Taping in the treatment chronic back pain compared to placebo concerning the reduction of pain and disability. Thus, it can be used as a complementary method in chronic non-specific low back pain.Table 2. Primary and secondary outcomes in the Kinesio-Taping and placebo group.Disclosure of Interests:None declared

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