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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 GE, Sions JM, Velasco TO, Manal TJ
The Clinical Journal of Pain 2016 Oct;32(10):898-906
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 to 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.

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