Effects of Neuromuscular Electrical Stimulation Adjunct to Lumbar Stabilization Exercises on Multifidus Muscle Thickness, Pain, Disability, and Psychosocial Status in Patients With Chronic Low Back Pain.

Abstract

Objectives: The aims of the study were to assess the effects of neuromuscular electrical stimulation combined with lumbar stabilization exercises on lumbar multifidus muscle thickness, disability, pain, depression, anxiety, and fear-avoidance beliefs in patients with chronic low back pain and to examine the correlation between ultrasound and magnetic resonance imaging of the lumbar multifidus.

Design: Forty patients aged 18-65 yrs were randomized into two groups: group 1: exercise and group 2: exercise + neuromuscular electrical stimulation. The participants underwent 15-session electrical stimulation and/or exercise (3 d/wk). All outcome measures assessed at baseline, posttreatment, and 3 mos after. Multifidus cross-sectional area on magnetic resonance imaging was measured only at baseline.

Results: Multifidus thickness increased, and pain decreased significantly in both groups, more prominent in group 2. Disability, depression, and fear-avoidance beliefs scores significantly decreased in both groups, while anxiety decreased only in group 1. Both magnetic resonance and ultrasound measurements demonstrated excellent interrater reliability and statistically significant correlations.

Conclusions: Both groups improved in terms of pain, disability, psychological status, and muscle thickness. Neuromuscular electrical stimulation adjunct to lumbar stabilization exercises demonstrated enhanced effectiveness in increasing lumbar multifidus thickness.