GSPP Penn Therapy and Fitness, Philadelphia, PA.
School of Biomedical Engineering Science and Health Systems, Drexel University, Philadelphia, PA, USA.
Physiother Theory Pract. 2020 Apr;36(4):516-523. doi: 10.1080/09593985.2018.1488908. Epub 2018 Jun 28.
Lumbar multifidus impairments are associated with low back pain (LBP), with sustained impairments thought to contribute to recurrence and chronicity of pain. Ability to regain muscle function can be challenging. While neuromuscular electrical stimulation (NMES) may aid in muscle function recovery, validity of its ability to selectively recruit the lumbar multifidus and provide adequate dosage for muscle overload has not been demonstrated. Near infrared spectroscopy (NIRS) can be used to determine muscle selectivity and overload during NMES and offers advantages over electromyography (EMG), which is affected by electrical interference. : The aim of this study was to determine the ability of NMES to activate and overload the lumbar multifidus in isolation. EMG and NIRS were collected over the trunk extensors during standardized movements followed by delivery of NMES in 10 healthy participants. NIRS was used to determine the ability of NMES to selectively recruit the lumbar multifidus at the L5 region relative to other trunk extensors. EMG and NIRS data were then entered into a linear regression model to predict muscle activity during NMES relative to the standardized movements. : There was a significant correlation ( = 0.81, < 0.001) between EMG and NIRS in the lumbar multifidus. There was significantly greater activation of lumbar multifidus compared to lumbar erector spinae using specific NMES electrode placement ( < 0.001). NMES can preferentially activate lumbar multifidus with potential to provide a therapeutic overload to these muscles in healthy participants. It may be a promising intervention for individuals with LBP.
腰部多裂肌损伤与下腰痛(LBP)有关,持续的损伤被认为是疼痛复发和慢性化的原因。恢复肌肉功能可能具有挑战性。虽然神经肌肉电刺激(NMES)可能有助于肌肉功能的恢复,但尚未证明其能够有选择性地募集腰部多裂肌并提供足够的超负荷剂量来恢复肌肉功能。近红外光谱(NIRS)可用于确定 NMES 期间的肌肉选择性和超负荷,并且相对于受电干扰影响的肌电图(EMG)具有优势。本研究旨在确定 NMES 单独激活和超负荷孤立腰部多裂肌的能力。在 10 名健康参与者进行标准运动后,收集躯干伸肌的 EMG 和 NIRS,并进行 NMES 治疗。NIRS 用于确定 NMES 在 L5 区域相对于其他躯干伸肌有选择性地募集腰部多裂肌的能力。然后,将 EMG 和 NIRS 数据输入线性回归模型,以预测 NMES 期间相对于标准运动的肌肉活动。EMG 和 NIRS 在腰部多裂肌中呈显著相关(r=0.81,p<0.001)。使用特定的 NMES 电极放置,与腰部竖脊肌相比,腰部多裂肌的激活明显更大(p<0.001)。NMES 可以有选择地激活腰部多裂肌,有可能为健康参与者的这些肌肉提供治疗性超负荷。对于下腰痛患者来说,这可能是一种很有前途的干预措施。