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

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.

The effects of whole-body muscle stimulation on body composition and strength parameters: A PRISMA systematic review and meta-analysis

“…[39] Among the 26 studies included, 11 have been conducted with women only [16,20,[35][36][37][38][39][42][43][44][45] and 7 were only with men. [13,26,41,[46][47][48][49][50] Two interventions have been performed in patients with chronic low back pain, [34,51] 4 in people with sarcopenia and obese, [20,39,46,52] 4 in pre-and post-menopausal women [43][44][45]53] and 1 in older people with osteoarthritis. [38] Two studies have worked with athletes.…”

“…However, 5 working groups used a maximum impulse tolerance appro ach. [35,38,39,48] and a single article worked the stimulus intensity between 80 and 100 mA. [21] It remains important to note that none of the studies reported negative side effects of WB-EMS applications Table 3.…”

Whole Body Vibration Improves Brain and Musculoskeletal Health by Modulating the Expression of Tissue-Specific Markers: FNDC5 as a Key Regulator of Vibration Adaptations

“…WBV effects have also been extensively documented at the musculoskeletal level, suggesting among the main benefits are an increase in bone mineral density and muscle mass and strength, as well as improved motor performance and general health [ 11 , 12 ]. Furthermore, WBV is currently used as a preventive tool for several diseases, such as osteoporosis, sarcopenia, and chronic low back pain, as well as for improving muscle function and joint stability [ 13 , 14 , 15 ]. In this context, we recently investigated the effects of WBV on skeletal muscle in a group of 12-month-old mice by light and electron microscopy, observing significant variations depending on the vibratory training protocol used [ 16 ].…”

Spatial Distribution of Muscular Effects of Acute Whole-Body Electromyostimulation at the Mid-Thigh and Lower Leg—A Pilot Study Applying Magnetic Resonance Imaging

“…Depending on the stimulation setting, NMES-as the underlying technology of WB-EMS application-has an impact on deeper muscle groups/layers [2], possibly contributing to the positive effects of WB-EMS on low back pain [7][8][9]. The neuro-muscular principle of (N)EMS is to predominately activate motor neuron axons or intramuscular axonal branches [10], which in turn stimulate the corresponding muscle fibers, allowing innervation of muscles along the neural tracts.…”