A COMPARISON BETWEEN STABILIZATION EXERCISES AND STABILIZATION EXERCISES SUPPLEMENTED WITH NEUROMUSCULAR ELECTRICAL STIMULATION IN PATIENTS WITH CHRONIC LOW BACK PAIN: A PHASE I RANDOMIZED CONTROLLED TRIAL

[摘要] Impaired motor control and atrophy of paraspinal muscles are commonly associated with chronic low back pain (LBP).Such impairments are treated with lumbar stabilization exercises aimed at creating muscular support for the lumbar spine, reducing pain and improving function.However, stabilization exercises are reported to have a limited long-term effect on pain and function.This limitation suggests that stabilization exercises alone may not activate the paraspinal muscles sufficiently.Thus, enhancement of the stabilization exercise effect on paraspinal muscle function may be warranted.The two aims of this study are: 1) to investigate the potential effectiveness of neuromuscular electrical stimulation (NMES) as a supplement to stabilization exercise in people with chronic LBP; and 2) to report on the tolerability of NMES when applied to paraspinal muscles.We conducted a phase I randomized controlled trial on 30 subjects with chronic LBP.Subjects were randomized into either a stabilization exercise group (n = 15) or a stabilization exercises plus NMES group (n = 15).Both groups received treatment twice a week for 6 weeks. Subjects were assessed pre- and post-treatment using the following outcome measures: the Modified Oswestry Disability Questionnaire (MODQ), the Numeric Pain Rating Scale (NPRS), the Fear-Avoidance Behavior Questionnaire, paraspinal muscle strength, and a NMES tolerability scale.Subjects in both group were followed up 4 weeks after the end of the last treatment and assessed with the MODQ and NPRS.The mixed analysis of variance shows that subjects in both groups significantly improved from baseline to post-intervention at 6 weeks on all outcome measures (p < .05).The improvements for the MODQ and NPRS were maintained at 4 weeks after the end of the intervention.There were no significant between-group differences (p > .05).All subjects in the stabilization plus NMES group found that the NMES was tolerable. This phase I trial suggests that the application of NMES on the paraspinal muscles is tolerable.Future trials are necessary to determine the NMES usefulness as a supplement to stabilization exercise in treating chronic LBP.

[发布机构] the University of Pittsburgh