Wolfe Daniel, Rosenstein Brent, Fortin Maryse
Department Health Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada.
PERFORM Centre, Concordia University, Montreal, QC H4B 1R6, Canada.
J Clin Med. 2023 Jul 14;12(14):4680. doi: 10.3390/jcm12144680.
Chronic low back pain (CLBP) affects paraspinal muscle size, quality (e.g., fatty infiltration), range of motion (ROM), and strength. Although transcutaneous electrotherapies are used to treat CLBP, their effects on paraspinal-related outcomes are not fully known. The aim of this systematic review and meta-analysis was to assess the overall effect of transcutaneous electrotherapies on trunk/lumbar ROM, paraspinal muscle morphology, and trunk muscle function (including strength and endurance) in CLBP patients. A systematic search of four databases and two study registers was conducted between 1 February 2022 and 15 September 2022. Two reviewers were responsible for screening and data extraction. Of the 3939 independent records screened, 10 were included in the systematic review and 2 in the meta-analysis. The results suggest there is limited evidence that both EMS and EMS exercise are superior to passive and active controls, respectively, for improving trunk muscle endurance. There is limited evidence that neither TENS nor mixed TENS are superior to controls for improving trunk muscle endurance. There is limited evidence that NMES is superior to passive controls for improving trunk muscle strength. The effect of transcutaneous electrotherapy on the other investigated outcomes was inconclusive. Future transcutaneous electrotherapy studies should focus on paraspinal-based outcomes that are under-studied.
慢性下腰痛（CLBP）会影响椎旁肌的大小、质量（如脂肪浸润）、活动范围（ROM）和力量。尽管经皮电疗法用于治疗CLBP，但其对椎旁相关结果的影响尚不完全清楚。本系统评价和荟萃分析的目的是评估经皮电疗法对CLBP患者躯干/腰椎ROM、椎旁肌形态和躯干肌肉功能（包括力量和耐力）的总体影响。在2022年2月1日至2022年9月15日期间对四个数据库和两个研究登记处进行了系统检索。两名评审员负责筛选和数据提取。在筛选的3939条独立记录中，10条纳入系统评价，2条纳入荟萃分析。结果表明，仅有有限的证据表明，与被动和主动对照相比，电刺激肌肉疗法（EMS）和EMS运动分别在改善躯干肌肉耐力方面更具优势。仅有有限的证据表明，经皮电刺激神经疗法（TENS）和混合TENS在改善躯干肌肉耐力方面并不优于对照。仅有有限的证据表明，神经肌肉电刺激（NMES）在改善躯干肌肉力量方面优于被动对照。经皮电疗法对其他研究结果的影响尚无定论。未来经皮电疗法的研究应关注那些研究不足的基于椎旁的结果。
