The goal of this randomized controlled trial, is to investigate the effect of functional NMES and conventional NMES applied to the lumbar multifidus muscle on body kinematic and kinetic values during the sit-to-stand in individuals with non-specific low back pain. Our study will include 24 participants between the ages of 18-65. Which physiotherapy intervention will be applied to the participants will be determined by the block randomization method, using a table of random numbers. After randomization; NMES to the participants' lumbar multifidus muscle during physiotherapy intervention will be applied in two groups; In the first group, NMES will be applied with the conventional technique during prone position and in the second group, NMES will be applied with the functional technique during the sit-to-stand activity. Evaluations will be made twice for each participant- before and after the intervention. During the evaluation, data regarding the change in body kinetics and kinematics of individuals during the sit-to-stand activity will be recorded with a Vicon camera system. For secondary outcome measures, a visual analog scale will be used to evaluate pain, the Roland Morris Disability Questionnaire and the Oswestry Disability Index will be used to evaluate functional status, and the Tampa Kinesiophobia Scale will be used to evaluate fear-avoidance behavior.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
24
The functional NMES technique involves the application of electrical stimulation during functional activity. In our study, in the functional neuromuscular electrical simulation group, neuromuscular electrical stimulation will be applied to the lumbar multifidus muscle while individuals perform the activity of standing up from sitting.
The conventional neuromuscular electrical simulation technique, electrical stimulation is applied without the individual performing voluntary contractions. In our study, conventional NMES will be applied to the lumbar multifidus muscle with the individual lying in the prone position and the individual will not elicit any voluntary contractions during the simulation.
Hacettepe University
Ankara, Turkey (Türkiye)
Changes in kinematics of the Lumbar Spine and Hip During sit-to-stand activity
With kinematic analysis, the mean, minimum and maximum range of motion of the lumbar spine and hip joint during the sit-to-stand activity will be evaluated and recorded in degrees using the vicon motion capture system (Vicon, 6xVantage 5 Cameras 5MP@420FPS, 2xVue Video Cameras).
Time frame: Baseline and first week after 8-week intervention
Changes in ground reaction force during sit-to-stand activity
Ground reaction force will be evaluated using force plates (2xAMTI force plates).
Time frame: Baseline and first week after 8-week intervention
Hip and Lumbar spine range of motion
Hip and Lumbar spine range of motion will be evaluated using goniometer and recorded in degrees.
Time frame: Baseline and first week after 8-week intervention
Shortness of the hip flexor, knee flexor and plantar flexor muscles
Shortness of the hip flexor, knee flexor and plantar flexor muscles will be evaluated by Thomas test, popliteal angle hamstring test and ankle dorsiflexion ROM measurements, respectively. Results will be recorded in degrees.
Time frame: Baseline and first week after 8-week intervention
Beighton test
The Beighton test is a screening technique for hypermobility. The test is a nine-point scale and requires the performance of 5 maneuvers.
Time frame: Baseline and first week after 8-week intervention
Visual analogue scale
Visual analog scale will be used to evaluate pain. The visual analog scale consists of a single 10 cm line used to evaluate pain intensity. Patients will be asked to mark the severity of their pain at rest, during activity and during night.
Time frame: Baseline and first week after 8-week intervention
Oswestry Disability Index
Oswestry Disability Index will be used to evaluate the degree of loss of function. Higher values represent greater disability.
Time frame: Baseline and first week after 8-week intervention
Roland-Morris Disability Questionnaire
Roland-Morris Disability Questionnaire will be used to evaluate functional disabilities. Higher values represent greater disability.
Time frame: Baseline and first week after 8-week intervention
Tampa Kinesiophobia Scale
Tampa Kinesiophobia Scale will be used to evaluate fear of movement/reinjury. Higher values represent greater kinesiophobia.
Time frame: Baseline and first week after 8-week intervention
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