Stabilization exercises combined with neuromuscular electrical stimulation for patients with chronic low back pain: a randomized controlled trial
- PMID: 30482602
- PMCID: PMC6849075
- 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
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; Electrical stimulation; Motor control exercises; Muscle activation; Paraspinal muscles; Stabilization exercises.
Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.
Figures
Similar articles
-
Effects of Neuromuscular Electrical Stimulation Adjunct to Lumbar Stabilization Exercises on Multifidus Muscle Thickness, Pain, Disability, and Psychosocial Status in Patients With Chronic Low Back Pain.Am J Phys Med Rehabil. 2025 Sep 1;104(9):800-808. doi: 10.1097/PHM.0000000000002715. Epub 2025 Feb 12. Am J Phys Med Rehabil. 2025. PMID: 39938065 Clinical Trial.
-
The Effect of 2 Different Exercise Programs on Pain Intensity and Muscle Dimensions in Patients With Chronic Low Back Pain: A Randomized Controlled Trial.J Manipulative Physiol Ther. 2018 Feb;41(2):102-110. doi: 10.1016/j.jmpt.2017.03.011. Epub 2017 Jul 21. J Manipulative Physiol Ther. 2018. PMID: 28739019 Clinical Trial.
-
Recovery of the lumbar multifidus muscle size in chronic low back pain patients by strengthening hip abductors: A randomized clinical trial.J Bodyw Mov Ther. 2021 Apr;26:147-152. doi: 10.1016/j.jbmt.2020.12.035. Epub 2020 Dec 30. J Bodyw Mov Ther. 2021. PMID: 33992236 Clinical Trial.
-
The Effectiveness of Hollowing and Bracing Strategies With Lumbar Stabilization Exercise in Older Adult Women With Nonspecific Low Back Pain: A Quasi-Experimental Study on a Community-based Rehabilitation.J Manipulative Physiol Ther. 2018 Jan;41(1):1-9. doi: 10.1016/j.jmpt.2017.06.012. Epub 2017 Dec 16. J Manipulative Physiol Ther. 2018. PMID: 29254626 Review.
-
Core Stability Exercise Versus General Exercise for Chronic Low Back Pain.J Athl Train. 2017 Jan;52(1):71-72. doi: 10.4085/1062-6050-51.11.16. Epub 2016 Nov 16. J Athl Train. 2017. PMID: 27849389 Free PMC article. Review.
Cited by
-
Disability reduction following a lumbar stabilization exercise program for low back pain: large vs. small improvement subgroup analyses of physical and psychological variables.BMC Musculoskelet Disord. 2024 May 4;25(1):358. doi: 10.1186/s12891-024-07480-4. BMC Musculoskelet Disord. 2024. PMID: 38704535 Free PMC article.
-
The Impact of Neuromuscular Stimulation on the Rehabilitation Outcomes of Patients Following Joint Replacement Surgery: A Systematic Review and Meta-Analysis.Iran J Public Health. 2025 May;54(5):928-938. doi: 10.18502/ijph.v54i5.18628. Iran J Public Health. 2025. PMID: 40765774 Free PMC article. Review.
-
Comparative effectiveness of electroacupuncture VS neuromuscular electrical stimulation in the treatment of chronic low back pain in active-duty personals: A single-center, randomized control study.Front Neurol. 2022 Sep 13;13:945210. doi: 10.3389/fneur.2022.945210. eCollection 2022. Front Neurol. 2022. PMID: 36176555 Free PMC article.
-
Combined neuromuscular electrical stimulation with motor control exercise can improve lumbar multifidus activation in individuals with recurrent low back pain.Sci Rep. 2021 Jul 20;11(1):14815. doi: 10.1038/s41598-021-94402-2. Sci Rep. 2021. PMID: 34285318 Free PMC article. Clinical Trial.
-
Soft-Tissue Mobilization and Pain Neuroscience Education for Chronic Nonspecific Low Back Pain with Central Sensitization: A Prospective Randomized Single-Blind Controlled Trial.Biomedicines. 2023 Apr 23;11(5):1249. doi: 10.3390/biomedicines11051249. Biomedicines. 2023. PMID: 37238919 Free PMC article.
References
-
- McGill S. 2nd ed. Human Kinetics; Champaign, IL: 2007. Low Back Disorders: Evidence-Based Prevention and Rehabilitation.
-
- Richaedson C., Hodges P., Hides J. Churchill Livingstone; Edinburgh: 2004. Therapeutic Exercise for Lumbopelvic Stabilization.
-
- Cholewicki J., Greene H.S., Polzhofer G.K., Galloway M.T., Shah R.A., Radebold A. Neuromuscular function in athletes following recovery from a recent acute low back injury. J Orthop Sports Phys Ther. 2002;32(11):568–575. - PubMed
-
- Cholewicki J., Silfies S.P., Shah R.A. Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine (Phila Pa 1976) 2005;30(23):2614–2620. - PubMed
-
- Radebold A., Cholewicki J., Panjabi M.M., Patel T.C. Muscle response pattern to sudden trunk loading in healthy individuals and in patients with chronic low back pain. Spine (Phila Pa 1976) 2000;25(8):947–954. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical