Transcutaneous neuromuscular electrical stimulation applied to optimal points on the lower abdomen and lumbar paraspinal region changes gait parameters in patients with lumbar degenerative kyphosis.

Abstract

Lumbar degenerative kyphosis (LDK) is characterized by sagittal imbalance resulting from degenerative loss of lumbar lordosis. The ability of transcutaneous neuromuscular electrical stimulation (NMES) to activate deep lumbar stabilizing muscles has been demonstrated. The aim of this study was to evaluate the effects of transcutaneous NMES applied to optimal points on the lower abdomen and lumbar paraspinal region on gait problems in patients with lumbar degenerative kyphosis (LDK). Twenty-one patients with lumbar degenerative kyphosis underwent three walking sessions in the following order; walking for 5 minutes without NMES, walking with NMES on the lumbar multifidus (LM) only, and walking with NMES on both LM and transverse abdominis (TrA)/obliquus internus (OI). Differences in gait parameters at the commencement and completion of each of the three sessions were evaluated by gait analysis. During the 5-minute walk with NMES applied to the LM or to the LM and TrA/OI, participants showed lesser increases in spine forward tilt, pelvic anterior tilt, and external foot progression angle, and a lesser decrease in hip internal rotation than when walking without NMES (P< 0.05). In addition, with NMES, patients showed less decrement in gait velocity and stride length at walk completion than patients walking without NMES (P< 0.05). However, in the comparison between walks with NMES applied to the LM and walks with NMES applied to the LM and TrA/OI, we could not find any significant difference in changes of gait parameters (p> 0.05). Transcutaneous NMES applied at optimal points on the lower abdomen and back could provide a means of treating gait problems caused by a stooped trunk in LDK patients.