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Motor control training compared with transcutaneous electrical nerve stimulation in patients with disc herniation with associated radiculopathy: a randomized controlled trial [with consumer summary]
Franca FJR, Callegari B, Ramos LAV, Burke TN, Magalhaes MO, Comachio J, Carvalho Silva APMC, Almeida GPL, Marques AP
American Journal of Physical Medicine & Rehabilitation 2019 Mar;98(3):207-214
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The aim of the study was to compare the effectiveness of motor control training and transcutaneous electrical nerve stimulation in relieving pain, reducing functional disability, and improving transversus abdominis activation in patients with lumbar disc herniation with associated radiculopathy. DESIGN: This is a randomized controlled trial. METHODS: Forty patients diagnosed with lumbar disc herniation were randomly divided into two groups: motor control training group (n = 20) and transcutaneous electrical nerve stimulation group (n = 20). INTERVENTIONS: The motor control training group and transcutaneous electrical nerve stimulation group attended 60 mini sessions twice a week for 8 wks, totaling to 16 sessions. MAIN OUTCOME MEASURES: The main outcome measures are pain, functional disability, and transversus abdominis activation capacity. RESULTS: Differences between both groups were observed after 8 wks, favoring the motor control training group. Motor control training was more effective than transcutaneous electrical nerve stimulation in relieving pain (mean difference 3.3 points, 95% confidence interval 2.12 to 4.48), reducing functional disability (mean difference 8.4 points, 95% confidence interval 5.44 to 11.36), improving the quality of pain (mean difference 17 points, 95% confidence interval 7.93 to 26.07), sensory quality of pain (mean difference 10.3 points, 95% confidence interval 5.55 to 15.05), and transversus abdominis activation (mean difference 1.5 points, 95% confidence interval 0.90 to 2.10). CONCLUSIONS: The results suggest that motor control training is more effective than transcutaneous electrical nerve stimulation with respect to relieving pain, reducing functional disability, and improving transversus abdominis activation in patients with lumbar disc herniation.

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