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Trunk Muscle Training Augmented With Neuromuscular Electrical Stimulation Appears to Improve Function in Older Adults With Chronic Low Back Pain: A Randomized Preliminary Trial

Hicks, Gregory E. MPT, PhD; Sions, Jaclyn M. DPT, PhD; Velasco, Teonette O. DPT; Manal, Tara J. DPT

doi: 10.1097/AJP.0000000000000348
Original Articles
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Objectives: To assess the feasibility of a trial to evaluate a trunk muscle training program augmented with neuromuscular electrical stimulation (TMT+NMES) for the rehabilitation of older adults with chronic low back pain (LBP) and to preliminarily investigate whether TMT+NMES could improve physical function and pain compared with a passive control intervention.

Materials and Methods: We conducted a single-blind, randomized feasibility trial. Patients aged 60 to 85 years were allocated to TMT+NMES (n=31) or a passive control intervention (n=33), consisting of passive treatments, that is, heat, ultrasound, and massage. Outcomes assessed 3- and 6-month postrandomization included Timed Up and Go Test, gait speed, pain, and LBP-related functional limitation.

Results: Feasibility was established by acceptable adherence (≥80%) and attrition (<20%) rates for both interventions. Both groups had similar, clinically important reductions in pain of >2 points on a numeric pain rating scale during the course of the trial. But, only the TMT+NMES group had clinically important improvements in both performance-based and self-reported measures of function. In terms of the participants’ global rating of functional improvement at 6 months, the TMT+NMES group improved by 73.9% and the passive control group improved by 56.7% compared with baseline. The between-group difference was 17.2% (95% confidence interval, 5.87-28.60) in favor of TMT+NMES.

Discussion: It seems that a larger randomized trial investigating the efficacy of TMT+NMES for the purpose of improving physical function in older adults with chronic LBP is warranted.

Department of Physical Therapy, University of Delaware, Newark, DE

Supported by Award No. R21HD057274 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development, Bethesda, MD. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development or the National Institutes of Health. At the time of this work, G.E.H was also supported by K12HD055931 and J.M.S was supported by the Foundation for Physical Therapy: Promotion of Doctoral Studies I/II Scholarship. The authors declare no conflict of interest.

Reprints: Gregory E. Hicks, MPT, PhD, Department of Physical Therapy, University of Delaware, 540 S. College Ave, Newark, DE 19716 (e-mail: ghicks@udel.edu).

Received May 19, 2015

Received in revised form January 22, 2016

Accepted December 27, 2015

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