Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, WV, United States; Department of Physical Therapy, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States.
Braz J Phys Ther. 2019 Nov-Dec;23(6):506-515. doi: 10.1016/j.bjpt.2018.10.003. Epub 2018 Oct 18.
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.
Randomized controlled trial.
To investigate the clinical benefit of using neuromuscular electrical stimulation as a supplement to stabilization exercises in patients with chronic low back pain.
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.
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).
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.
慢性下腰痛的一个可能发病机制是脊柱旁肌肉损伤。通常，这种损伤采用稳定化锻炼来治疗。然而，稳定化锻炼的效果大小先前已被报道为较小。
随机对照试验。
研究在慢性下腰痛患者中使用神经肌肉电刺激作为稳定化锻炼的补充治疗的临床益处。
30 名慢性下腰痛患者被随机分为仅接受稳定化锻炼组（n=15）或稳定化锻炼加神经肌肉电刺激组（n=15）。稳定化锻炼包括腹部、侧支撑和四足运动。神经肌肉电刺激应用于腰部脊柱旁肌肉，每次 20 分钟，每周 2 次，共 6 周。纳入研究的参与者符合以下标准：年龄在 18 至 60 岁之间，体重指数≤34，慢性下腰痛≥3 个月，数字疼痛评分量表≥3，改良 Oswestry 残疾问卷评分≥20，且能够理解英语。结局测量包括自我报告的神经肌肉电刺激耐受性量表、改良 Oswestry 残疾问卷、数字疼痛评分量表、恐惧回避信念问卷和脊柱旁肌肉力量。
神经肌肉电刺激被报告为可耐受。在任何结局测量上，组间均无显著差异（p＞0.05）。
在脊柱旁肌肉上应用神经肌肉电刺激被报告为可耐受。将神经肌肉电刺激补充到稳定化锻炼中并未为慢性下腰痛患者提供任何额外的临床益处。
