Effectiveness of Transcutaneous Neuromodulation on Abductor Muscles Electrical Activity in Subjects with Chronic Low Back Pain: A Randomized, Controlled, Crossover Clinical Trial

Abstract

Josep C Benítez-Martínez,1 Beatriz García-Haba,2 Samuel Fernández-Carnero,3,4 Daniel Pecos-Martin,3 Eleuterio A Sanchez Romero,4– 9 Francisco Selva-Sarzo,1,2 Juan Nicolás Cuenca-Zaldívar3,4,10,11 1Physiotherapy Faculty, University of Valencia, Valencia, 46010, Spain; 2Francisco Selva Physiotherapy Clinic, Valencia, 46008, Spain; 3Universidad de Alcalá, Facultad de Enfermería y Fisioterapia, Departamento de Fisioterapia, Grupo de Investigación en Fisioterapia y Dolor, Alcalá de Henares, 28801, Spain; 4Interdisciplinary Research Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea deMadrid, Villaviciosa de Odón, 28670, Spain; 5Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Spain; 6Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, 28670, Spain; 7Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, Santa Cruz de Tenerife, 38300, Spain; 8Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, Santa Cruz de Tenerife, 38300, Spain; 9Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), Madrid, 28009, Spain; 10Primary Health Center “El Abajón”, Las Rozas de Madrid, 28231, Spain; 11Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute - Segovia de Arana (IDIPHISA), Madrid, SpainCorrespondence: Eleuterio A Sanchez Romero; Francisco Selva-Sarzo, Email [email protected]; [email protected]: Non-specific chronic low back pain (NSCLBP) is a major cause of functional impairment, resulting in consequences like job absenteeism and reduced quality of life. Risk factors such as muscle weakness and tightness have been implicated. Electromagnetic fields have therapeutic effects on human tissue, including pain relief and muscle relaxation. This study aimed to examine the impact of a tape with magnetic particles (MPT) applied to the lumbar area on abductor muscle strength and surface electromyography (sEMG) of the Gluteus Medius and Tensor of the Fascia Lata muscles in individuals with NSCLBP.Methods: It was carried out a double-blind, randomized, controlled, crossover trial and with test retest, with 41 consecutive patients younger than 65 years who previously diagnosed with NSCLBP to assess the effect of a MPT over hip abductor muscle strength and activity. sEMG and force data were obtained during the Hip Stability Isometric Test (HipSIT). The HipSIT was used to assess the abduction strength using a hand-held dynamometer and sEMG. The HipSIT uses the maximum voluntary isometric contraction (MVIC). Four trials were recorded and the mean extracted for analysis. The tape was applied with either a MPT or a sham magnetic particle tape (SMPT) bilaterally without tension on from L1 to L5 paravertebral muscles.Results: The significant increase in the recruitment of fibers and the significant increase in the maximum voluntary contraction by applying MPT with respect to the SMPT, correspond to the increases in the Peak Force and the decrease in the time to reach the maximum force (peak time) of both muscles.Conclusion: Application of a MPT in patients with NSCLBP suggests an increase in muscle strength of the Gluteus Medius and Tensor Fascia Lata bilaterally during the HipSIT test. Lumbar metameric neuromodulation with MPT improves muscle activation of the hip musculature.Keywords: transcutaneous nerve stimulation, electromyography, low back pain

Keywords

• transcutaneous nerve stimulation
• electromyography
• low back pain.