Trunk Muscle Training Augmented With Neuromuscular Electrical Stimulation Appears to Improve Function in Older Adults With Chronic Low Back Pain

Hicks, Gregory E.; Sions, Jaclyn Megan; Velasco, Teonette O.; Manal, Tara Jo

doi:10.1097/ajp.0000000000000348

Cited by 39 publications

(45 citation statements)

References 57 publications

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“…Few studies in the current literature address lumbopelvic stability exercises associated with the use of NMES in core stability muscles. Six previous studies evaluated the effectiveness of NMES in the therapeutic approach of low back pain (11)(12)(13)(14)(15)(16)(17). As a conclusion of this study, the results showed significant effects for CNG compared to the other intervention groups.…”

Section: Discussionsupporting

confidence: 52%

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Neuromuscular electrical stimulation associated with core stability exercises in nonspecific postural low back pain: a randomized clinical trial

Luz

Santos

Evaldt

et al. 2019

Muscle Ligaments and Tendons J

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Background. Low back pain is one of the most frequent causes of disability. Therapeutics programs have been used to promote muscle strengthening and lumbar stability. Methods. Randomized clinical trial with 30 female participants with chronic low back pain, divided into CORE Group (CG), NMES Group (NG), and CORE + NMES group (CNG). At the end of the intervention and six months later, the following were evaluated: pain level, functional status and disability, hamstring flexibility and evaluation of core stabilizing muscles. All groups received three weekly interventions for four weeks. Results. Pain level was significantly reduced in all study groups (p<0.05). The CNG Group significantly reduced pain at the end of the intervention compared to the NG Group (p<0.05). The Oswestry Disability Index decreased in all intervention groups; however, the CNG Group more significantly reduced the score compared to the other groups (p<0.05). Lumbopelvic stability tests showed that the CNG Group had a significantly higher stability than the CG Group and NG Group (p<0.05). Conclusion. Compared to the single use of CORE exercises or passive NMES, the association between NMES and CORE exercises resulted in greater analgesia, improved function, and greater lumbopelvic stability in patients with nonspecific low back pain.

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Section: Discussionsupporting

confidence: 52%

“…It is important to note that high-intensity NMES used for muscle strengthening can be very uncomfortable for many patients (11). (17). All protocols, including that of this study, used the maximum visible and comfortable contraction to the patient as stimulation intensity.…”

Section: Discussionmentioning

confidence: 99%

Neuromuscular electrical stimulation associated with core stability exercises in nonspecific postural low back pain: a randomized clinical trial

Luz

Santos

Evaldt

et al. 2019

Muscle Ligaments and Tendons J

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“…This secondary analysis included baseline participant data from a sample of community-dwelling, cognitively intact (Folstein Mini-Mental State Exam score ≥ 24) older adults with CLBP who were enrolled in a randomized preliminary trial;[17] CLBP participants were compared to a sample of older adults without CLBP. For this study, older adults were defined using the range 60–85 years.…”

Section: Methodsmentioning

confidence: 99%

Altered spatiotemporal characteristics of gait in older adults with chronic low back pain

et al. 2017

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Previous studies in older adults have identified that chronic low back pain (CLBP) is associated with slower gait speed. Given that slower gait speed is a predictor of greater morbidity and mortality among older adults, it is important to understand the underlying spatiotemporal characteristics of gait among older adults with CLBP. The purposes of this study were to determine (1) if there are differences in spatiotemporal parameters of gait between older adults with and without CLBP during self-selected and fast walking and (2) whether any of these gait characteristics are correlated with performance of a challenging walking task, e.g. stair negotiation. Spatiotemporal characteristics of gait were evaluated using a computerized walkway in 54 community-dwelling older adults with CLBP and 54 age- and sex-matched healthy controls. Older adults with CLBP walked slower than their pain-free peers during self-selected and fast walking. After controlling for body mass index and gait speed, step width was significantly greater in the CLBP group during the fast walking condition. Within the CLBP group, step width and double limb support time are significantly correlated with stair ascent/descent times. From a clinical perspective, these gait characteristics, which may be indicative of balance performance, may need to be addressed to improve overall gait speed, as well as stair-climbing performance. Future longitudinal studies confirming our findings are needed, as well as investigations focused on developing interventions to improve gait speed and decrease subsequent risk of mobility decline.

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“…22 To be included, volunteers with LBP had to have a pain intensity of ≥3/10 for ≥3 months. Older adult volunteers, ages 60-85 years, without LBP were concurrently recruited through community centers and advertisements.…”

Section: Methodsmentioning

confidence: 99%

Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

Sions

Coyle

Velasco

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Objective The purpose of this study was to determine if multifidi size and/or intramuscular fat were associated with self-reported and performance-based physical function in older adults with and without chronic LBP. Design Case-control study Setting Individuals participated in a standardized evaluation in a clinical laboratory and underwent magnetic resonance imaging (MRI) of the lumbar spine at a nearby facility. Patient Sample A volunteer sample of 106 community-dwelling older adults, aged 60-85 years, with (n=57) and without (n=49) chronic LBP were included in this secondary data analysis. Intervention Average right-left, L5 multifidi relative, i.e. total, cross-sectional area (rCSA); muscle-fat infiltration index (MFI), i.e. a measure of intramuscular fat; and relative muscle cross-sectional area (rmCSA), i.e. total CSA minus intramuscular fat CSA, were determined from MRIs. Linear regression modeling was performed with physical function measures as the dependent variables. Age, sex, and body mass index were entered as covariates. The main effects of L5 multifidi MFI and rmCSA, as well as their interaction with group assignment, were compared as independent variables. Main Outcome Measures Short Form-36 Health Survey Physical Functioning subscale (SF-36 PFS), Timed Up and Go (TUG), gait speed, and fast stair descent performance. Results Interaction terms between L5 multifidi MFI and group assignment were found to be significant contributors to the variance explained in all physical function measures (p≤.012). Neither the main effect, nor the interaction with group assignment for L5 multifidi rmCSA, significantly contributed to the variance explained in any of the physical function measures (p>.012). Conclusions Among older adults with chronic LBP of at least moderate intensity, L5 multifidi muscle composition, but not size, may help to explain physical function.

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Trunk Muscle Training Augmented With Neuromuscular Electrical Stimulation Appears to Improve Function in Older Adults With Chronic Low Back Pain

Cited by 39 publications

References 57 publications

Neuromuscular electrical stimulation associated with core stability exercises in nonspecific postural low back pain: a randomized clinical trial

Neuromuscular electrical stimulation associated with core stability exercises in nonspecific postural low back pain: a randomized clinical trial

Altered spatiotemporal characteristics of gait in older adults with chronic low back pain

Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

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