Similar Pain Intensity Reductions and Trunk Strength Improvements Following Whole-Body Electromyostimulation vs. Whole-Body Vibration vs. Conventional Back-Strengthening Training in Chronic Non-specific Low Back Pain Patients: A Three-Armed Randomized Controlled Trial.

Florian Micke,Heinz Kleinöder,Nicolas Wirtz,Ulrike Dörmann,Lars Donath,Wolfgang Kemmler,Matthias Kohl,Anja Weissenfels,Simon Von Stengel

doi:10.3389/fphys.2021.664991

Abstract

The aim of this multicenter trial was to compare the effects of whole-body electromyostimulation (WB-EMS) and whole-body vibration (WBV) with conventional back-strengthening training (CT) on changes in mean back pain intensity (MPI) and trunk strength in patients suffering from chronic non-specific low back pain (CNLBP). Two-hundred and forty CNLBP patients (40–70 years; 62% female) were randomly assigned to three intervention arms (WB-EMS: n = 80 vs. WBV: n = 80 vs. CT: n = 80). All training intervention programs were performed for 12 weeks in their usual commercial training setting. Before and during the last 4 weeks of the intervention, MPI was recorded using a 4-week pain diary. Additionally, maximal isometric trunk extension and -flexion strength was assessed on the BackCheck® machine. A moderate but significant decrease of MPI was observed in all groups (WB-EMS: 29.7 ± 39.1% (SMD 0.50) vs. WBV: 30.3 ± 39.3% (SMD 0.57) vs. CT: 30.5 ± 39.6% (SMD 0.59); p < 0.001). Similar findings were observed for maximal isometric strength parameters with a significant increase in all groups (extension: WB-EMS: 17.1 ± 25.5% vs. WBV: 16.2 ± 23.6% vs. CT: 21.6 ± 27.5%; p < 0.001; flexion: WB-EMS: 13.3 ± 25.6% vs. WBV: 13.9 ± 24.0% vs. CT: 13.9 ± 25.4%; p < 0.001). No significant interaction effects for MPI (p = 0.920) and strength parameters (extension: p = 0.436; flexion: p = 0.937) were observed. WB-EMS, WBV, and CT are comparably effective in improving MPI and trunk strength. However, training volume of WB-EMS was 43 or 62% lower, compared with CT and WBV.

Highlights

With a global lifetime prevalence of 38.9%, low back pain is considered one of the most impactful health issues worldwide (Hoy et al, 2012)
The attendance rate was high for all groups (WB-EMS: 92.0 ± 7.2%; whole-body vibration (WBV): 91.0 ± 7.0%; conventional back-strengthening training (CT): 88.0 ± 8.0%)
There was a significant decline in all groups [whole-body electromyostimulation (WB-EMS): 29.7 ± 39.1% (SMD 0.50) vs. WBV: 30.3 ± 39.3% (SMD 0.57) vs. CT: 30.5 ± 39.6% (SMD 0.59); p < 0.001]

Summary

Introduction

With a global lifetime prevalence of 38.9%, low back pain is considered one of the most impactful health issues worldwide (Hoy et al, 2012). Low back pain serves as a multifactorial disease with different underlying etiologies (e.g., lifestyle and social demographic factors, occupational factors, psychological factors, age, and gender; Manchikanti et al, 2014). Those factors create substantial disease burden on a personal, community, and financial level (Rapoport et al, 2004). There is a large amount of studies focusing on conventional training programs and the reduction of low back pain. Beside a variety of effective exercise-based training regimen, strength training has been shown to reduce pain intensity and improve physical function of patients with chronic non-specific low back pain (CNLBP). Time-efficient and effective training programs that can be performed by less active and possibly fearavoidance individuals are needed to keep patients regularly and sustainably active

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Discussion

Conclusion