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Vol. 23. Issue 6.
Pages 506-515 (01 November 2019)
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Vol. 23. Issue 6.
Pages 506-515 (01 November 2019)
Original Research
DOI: 10.1016/j.bjpt.2018.10.003
Stabilization exercises combined with neuromuscular electrical stimulation for patients with chronic low back pain: a randomized controlled trial
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Muhammad Alrwailya,b,
Corresponding author
muhammad.alrwaily@hsc.wvu.edu

Corresponding author at: Division of Physical Therapy, School of Medicine, West Virginia University, PO Box 9226, Health Sciences Center South, Morgantown, WV 26506, United States.
, Michael Schneiderc, Gwendolyn Sowad, Michael Timkoa,c, Susan L. Whitneyc,e, Anthony Delittoc
a Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, WV, United States
b Department of Physical Therapy, King Fahad Specialist Hospital, Dammam, Saudi Arabia
c Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
d Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
e Department of Physical Therapy, School of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
Highlights

  • Electrical stimulation was tolerable in patients with chronic low back pain.

  • Stabilization exercises with NMES did not add clinical benefit for the CLBP.

  • Because of the small sample; clinicians should interpreting the results cautiously.

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Figures (1)
Tables (12)
Table 1. Baseline characteristics and demographics.
Table 2. Descriptors of intensity (sensory) and discomfort (affective) aspects of electrical stimulation.
Table 3. Electrical stimulation ratings of sensory (intensity) and affective (discomfort) aspects at baseline and final session.
Table 4. Outcome measures scores for each group over time.
Abdominal bracing exercises (non-weight bearing)
Abdominal bracing exercises (weight bearing)
Side support exercises
Quadruped exercises
Abdominal bracing exercises (non-weight bearing)
Abdominal bracing exercises (weight bearing)
Side support exercises
Quadruped exercises
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Abstract
Background

One proposed mechanism of chronic low back pain might be paraspinal muscle impairment. Commonly, this impairment is treated with stabilization exercises. However, the effect size of stabilization exercises has been previously reported to be small.

Design

Randomized controlled trial.

Objective

To investigate the clinical benefit of using neuromuscular electrical stimulation as a supplement to stabilization exercises in patients with chronic low back pain.

Methods

Thirty participants with chronic low back pain were randomized into a stabilization exercise only group (n=15) or a stabilization exercise plus neuromuscular electrical stimulation group (n=15). The stabilization exercises included abdominal, side support, and quadruped exercises. The neuromuscular electrical stimulation was applied to the lumbar paraspinal muscles for 20min each session. Both groups received their respective interventions twice a week for 6 weeks. Participant eligibility for inclusion was age between 18 and 60 years, body mass index ≤34, chronic low back pain ≥3 months, Numeric Pain Rating Scale ≥3, Modified Oswestry Disability Questionnaire score ≥20 and ability to understand English. Outcome measurements were self-reported neuromuscular electrical stimulation tolerability scale, Modified Oswestry Disability Questionnaire, Numeric Pain Rating Scale, Fear-Avoidance Beliefs Questionnaire and paraspinal muscle strength.

Results

The neuromuscular electrical stimulation was reported to be tolerable. There were no significant between-group differences on any of the outcome measures (p>0.05).

Conclusions

The application of neuromuscular electrical stimulation on the paraspinal muscles was reported to be tolerable. Supplementing stabilization exercises with neuromuscular electrical stimulation did not offer any additional clinical benefit for the chronic low back pain patients.

Keywords:
Chronic low back pain
Stabilization exercises
Electrical stimulation
Muscle activation
Paraspinal muscles
Motor control exercises

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