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Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2022; 32(01): 27-37
DOI: 10.1055/a-1577-9849
Original Article

Does Neuromuscular Electrical Stimulation Have an Additive Effect on Disability, Pain and Abdominal and Lumbar Muscle Thickness in Chronic Low Back Pain? – A Randomized Controlled Double-Blind Study

Hat die neuromuskuläre Elektrostimulation eine additive Wirkung auf die Bewegungseinschränkung, die Schmerzintensität, die Lebensqualität und die Muskelkraft im Bauch- und Lendenbereich bei chronischen Rückenschmerzen? – Eine randomisierte, kontrollierte Doppelblindstudie
Ecenur Atli 
1   Physiotherapy and Rehabilitation, Bahcesehir University, Faculty of Health Sciences, Istanbul, Turkey
2   Physical Medicine and Rehabilitation Department, Koc University, Istanbul, Turkey
,
Dilber Karagozoglu Coskunsu
1   Physiotherapy and Rehabilitation, Bahcesehir University, Faculty of Health Sciences, Istanbul, Turkey
3   Physiotherapy and Rehabilitation, Fenerbahce University, Faculty of Health Sciences, Istanbul, Turkey
,
Zeynep Turan
2   Physical Medicine and Rehabilitation Department, Koc University, Istanbul, Turkey
,
Ozden Ozyemisci Taskiran
2   Physical Medicine and Rehabilitation Department, Koc University, Istanbul, Turkey
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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.

Zusammenfassung

Ziel Mit dieser Studie sollte die Wirkung der neuromuskulären Elektrostimulation (NMES) in Kombination mit Übungen zur Kräftigung der Rumpfmuskulatur bei Patienten mit chronischen Schmerzen der Lendenwirbelsäule untersucht werden.

Methoden Sechsunddreißig Patienten (Durchschnittsalter 33,6 ± 12,6 Jahre) mit chronischen Schmerzen der Lendenwirbelsäule wurden nach dem Zufallsprinzip einer vierwöchigen Therapie (12 Sitzungen) der NMES-Gruppe (NMES kombiniert mit Rumpfkräftigung) (n=18) oder der Kontrollgruppe (Schein-NMES und Rumpfkräftigung) (n=18) zugeteilt. Nach vier Wochen wurden dieselben Übungen als Heimübungsprogramm ohne NMES durchgeführt. Die Ergebnisse wurden anhand des Oswestry Disability Index (ODI), der visuellen Analogskala (VAS), des Nottingham Health Profile (NHP) und einer Ultraschalluntersuchung evaluiert. Mittels Ultraschalls wurden die Dicke des M. transversus abdominis, M. obliquus internus und externus sowie die Dicke und Fläche des lumbalen Multifidus-Muskels gemessen. Die Untersuchungen wurden zu Beginn der Studie sowie nach der vierten und achten Woche durchgeführt.

Ergebnisse In beiden Gruppen war die Veränderung der ODI-, VAS- und NHP-Werte der ersten Messung im Vergleich zu den Werten der vierten und achten Woche statistisch signifikant (p=0,001; p<0,01). Es gab in beiden Gruppen keine statistisch signifikanten Unterschiede bei den ODI-, VAS- und NHP-Werten zwischen der vierten und achten Woche (p>0,05). Keine der Ultraschall-Messungen der NMES- und der Kontrollgruppe zeigten eine statistisch signifikante Zunahme der drei seitlichen Bauchwandmuskeln und der Dicke und Fläche des Multifidus-Muskels (p>0,05).

Schlussfolgerungen Es konnte gezeigt werden, dass die neuromuskuläre Elektrostimulation (NMES) bei Patienten mit chronischen Rückenschmerzen durchgeführt werden kann, jedoch zeigte sich keine Wirkung auf die klinischen Ergebnisse, wenn zusätzlich zu Rumpfstabilisierungsübungen simultan eine neuromuskuläre Elektrostimulation durchgeführt wurde.

Key words

Low Back Pain - Electric Stimulation - Ultrasonography - Exercise Therapy - Chronic Pain

Schlüsselwörter

Rückenschmerzen - elektrische Stimulation - Ultraschall - Bewegungstherapie - chronischer Schmerz


Publication History

Received: 18 January 2021

Accepted: 06 July 2021

Article published online:
10 September 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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