Effect of high voltage pulsed current on pain and strength of back muscles in patients with back problems: a randomized controlled study

Öz

Purpose: The aim of this study was to evaluate the effectiveness of high voltage pulsed current on back extension muscle strengthening and pain. Materials and methods: Forty two
patients with back pain syndrome participated in this study. Twenty one patients (mean age 43.62±14.46 years) formed the control group in which hot packs, ultrasound, TENS and
exercise program including strengthening and stretching exercises were given. Besides these modalities, high voltage pulsed current and exercise program including strengthening and
stretching exercises were given to the study group consisting of 21 patients (mean age 43.81±12.32 years). Results: The difference between within-group parameters was found statistically significant (p<0.05). Multifidus muscle cross sectional area, abdominal muscle strength, flexibility and endurance of back extension muscles were higher in the study group when compared with the control group. However, the difference was not statistically significant (p>0.05). Alleviation in pain level and decrease in Oswestry disability index scores was found
statistically significant in the study group when compared with the control group (p<0.05). Conclusion: It was concluded that high voltage pulsed current with exercise is not effective in
increasing muscle strength, however it can help to reduce pain and can provide ease in activities of daily living. 

Anahtar Kelimeler

• Back pain
• Electric stimulation therapy
• Muscle strength

Bel problemli hastalarda yüksek voltaj kesikli akımın ağrı ve bel kas kuvvetine etkisi: rastgele kontrollü çalışma

Öz

Amaç: Çalışmamız, yüksek voltaj kesikli akımın, ağrı ve bel ekstansör kaslarının kuvvetlendirilmesindeki etkinliğinin belirlenmesi amacıyla planlandı. Gereç ve yöntem: Bel ağrısı şikayetiyle başvuran, toplam 42 birey çalışmaya dahil edildi. Bu bireylerden yaşları 19 ile 68 arasında değişen (ortalama yaş 43.62±14.46 yıl) ve kontrol grubunu oluşturan toplam 21 bireye sıcak yastık, ultrason ve TENS ile birlikte kuvvetlendirme ve germe egzersizleri verildi. Yaşları 27 ile 65 arasında değişen (ortalama yaş 43.81±12.32 yıl) ve çalışma grubunu oluşturan toplam 21 bireye ise sıcak yastık, ultrason, TENS ve yüksek voltaj kesikli akım ile birlikte kuvvetlendirme ve germe egzersizleri verildi. Sonuçlar: Tedavi sonrasında yapılan değerlendirmelerde, her iki grubun parametrelerinde anlamlı düzelmeler belirlendi (p0.05). Çalışma grubunun ağrı şiddeti ve Oswestry fonksiyonel kısıtlılık puanlarındaki düzelme oranının kontrol grubuna göre istatistiksel olarak daha fazla olduğu saptandı (p

Anahtar Kelimeler

• Bel ağrısı
• Elektrik stimulasyon tedavisi
• Kas kuvveti

Kaynakça

1. Basmajian JV, De Luca CJ. Muscle Alive: Their Function Revealed by Electromyography. Baltimore: Williams and Wilkins; 1985.
2. Wallwork TL, Stanton WR, Freke M, et al. The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle. Man Ther. 2009;14:496-500.
3. Smeets RJ. Do lumbar stabilising exercises reduce pain and disability in patients with recurrent low back pain? Aust J Physiother. 2009;55:138.
4. Danneels LA, Vanderstraeten GG, Cambier DC, et al. Effects of three different training modalities on the cross sectional area of the lumbar multifidus muscle in patients with chronic low back pain. Br J Sports Med. 2001;35:186-191.
5. Wong RA. High voltage versus low voltage electrical stimulation. Force of induced muscle contraction and perceived discomfort in healthy subjects. Phys Ther. 1986;66:1209-1214.
6. Jackson A, Hettinga DM, Mead J, et al. Using consensus methods in developing clinical guidelines for exercise in managing persistent low back pain. Physiotherapy. 2009;95:302-311.
7. Otman S, Demirel H, Sade A. Tedavi Hareketlerinde Temel Değerlendirme Prensipleri. Ankara: HÜ Fizik Tedavi ve Reh YO Yayınları, 1995.
8. Ertekin C. Ağrının Nöroanatomisi ve Nörofizyolojisi. Yegül, İ. (Ed). Ağrı ve Tedavisi. İzmir: Yapım Matbaacılık; 1983:1-17.

9. Tamer K. Sporda Fiziksel-Fizyolojik Performansın Ölçülmesi ve Değerlendirilmesi. Ankara: Türkerler Kitabevi, 1995.
10. Yakut E, Duger T, Oksuz C, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine 2004;29:581-585.
11. Gundersen HJ, Bendtsen TF, Korbo L, et al. Some new simple and efficient stereological methods and their use in pathological research and diagnosis. APMIS. 1988;96:379-394.
12. http://www.bmls.com/products/products.php (01.12.2009).
13. Hyun JK, Lee JY, Lee SJ, et al. Asymmetric atrophy of multifidus muscle in patients with unilateral lumbosacral radiculopathy. Spine. 2007;32:E598- E602.
14. Kader DF, Wardlaw D, Smith FW. Correlation between the MRI changes in the lumbar multifidus muscles and leg pain. Clin Radiol. 2000;55:145-149.
15. Cornwall J, Haris JA, Mercer SR. The lumbar multifidus muscle and patterns of pain. Man Ther. 2006;11:40-45.
16. Hides J, Gilmore C, Stanton W, et al. Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects. Man Ther. 2008;13:43-49.
17. Hides JA, Richardson CA, Jull GA. Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine. 1996;21:2763-2769.
18. Belavy D, Hides JA, Wilson J, et al. Resistive simulated weightbearing exercise with whole body vibration reduces lumbar spine deconditioning in bed-rest. Spine. 2008;33:E121-E131.
19. Chahade WH, Battistella LR, Biasoli MC. Low back pain (LBP): physical therapy approach. Temas de Reumatologia Clinica. 2001;2:24-32.
20. Jemmet RS. Rehabilitation of lumbar multifidus dysfunction in low back pain: strengthening versus a motor re-education model. Br J Sports Med. 2003;37:91-94.
21. Kofotolis N, Eleftherios K. Effect of two 4-week proprioceptive neuromuscular facilitation programs on muscle endurance, flexibility, and functional performance in women with chronic low back pain. Phys Ther. 2006;86:1001-1012.
22. Mohr T, Carlson B, Sulentic C, et al. Comparison of isometric exercise and high volt galvanic stimulation on quadriceps femoris muscle strength. Phys Ther. 1985;65:606-609.
23. Yakut E, Kırdı N, Yakut Y. Yüksek voltaj elektrik stimülasyonu ve izometrik egzersizin quadriceps femoris kas kuvveti ve uyluk çevre ölçümüne etkilerinin karşılaştırılması. Romatoloji ve Tıbbi Rehabilitasyon Dergisi. 1999;10:35-39.