Affiliations: [a] Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daemyung-Dong, Nam-Gu, Daegu, Korea | [b] Department of Physical Medicine and Rehabilitation, College of Medicine, Catholic University, Daegu, Korea | [c] Research Institute of Medical Engineering, Yeungnam University, Daegu, Korea | [d] Department of Anesthesia, University of Kansas School of Medicine, Wichita, KS, USA
Correspondence:
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Corresponding author: Sang Ho Ahn, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyung-Dong, Nam-Gu, Daegu 705-717, Korea. Tel.: +82 53 620 3268; OPD: +82 53 620 3450; Fax: +82 53 625 3508; E-mail:[email protected]
Abstract: BACKGROUND: Transcutaneous neuromuscular electrical stimulation (NMES) is
known to stimulate contraction of deep lumbar stabilizing muscles. OBJECTIVE: The purpose of this study was to investigate changes in deep
lumbar stabilizing muscle thickness during transcutaneous NMES on specific
abdominal wall and paraspinal regions. METHODS: Thirty patients with low back pain (LBP) were recruited. Three
sessions were preformed: Session 1: NMES on abdominal wall, Session 2: NMES
on lumbar paraspinal area, and Session 3: concurrent NMES on abdominal wall
and lumbar paraspinal area. Real time ultrasound imaging (RUSI) of three
abdominal stabilizing muscles; transverse abdominis (TrA), obliquus internus
(OI), obliquus externus (OE) muscles and one posterior stabilizer, the
lumbar multifidus muscles (LM) was captured. RESULTS: All studied muscles of TrA, OI, OE, and LM were found to have
significant thickness increases during all three sessions compared to
resting state (p < 0.05). Thicknesses changes of TrA, OI, and LM were
significant during simultaneous NMES of both abdominal wall and lumbar
paraspinal regions (Session 3) (p < 0.05). CONCLUSIONS: Our results indicate that concurrent NMES on abdominal wall and
lumbar paraspinal area is most effective to maximally activate deep lumbar
stabilizers. Rehabilitative efforts for patients with LBP may benefit from
simultaneous transcutaneous NMES of abdominal and lumbar regions.
Keywords: Neuromuscular electrical stimulation, lumbar stabilizing muscle, real time ultrasound imaging, low back pain
