Verification of an optimized stimulation point on the abdominal wall for transcutaneous neuromuscular electrical stimulation for activation of deep lumbar stabilizing muscles

Baek, Seung Ok; Cho, Hee Kyung; Jung, Gil Su; Son, Su Min; Cho, Yun Woo; Ahn, Sang Ho

doi:10.1016/j.spinee.2014.02.016

Cited by 11 publications

(14 citation statements)

References 22 publications

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“…In addition to conventional rehabilitation, all three groups underwent their targeted interventions for 30 minutes each day, 5 days per week for 3 weeks. The CME program and the location of NMES attachment in abdominal and back muscles were similar to those reported in recently published trials [ 6 , 11 ].…”

Section: Methodssupporting

confidence: 75%

Comparison Between Neuromuscular Electrical Stimulation to Abdominal and Back Muscles on Postural Balance in Post-stroke Hemiplegic Patients

et al. 2018

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ObjectiveTo compare the effects of neuromuscular electrical stimulation (NMES) to abdominal muscles and back muscles on postural balance in post-stroke hemiplegic patients.MethodsThirty post-stroke hemiplegic patients were prospectively enrolled and randomly assigned to one of the three groups: core muscle-strengthening exercise (CME) with NMES to abdominal muscles (group A), CME with NMES to back muscles (group B), and CME alone (group C). All subjects underwent their targeted interventions for 30 minutes each day, 5 days per week for 3 weeks under a conventional stroke rehabilitation program. Subjects were evaluated using Korean version of Berg Balance Scale (K-BBS), Trunk Impairment Scale (TIS), Korean version of Modified Barthel Index (K-MBI), Weight Distribution Index (WDI), and Stability Index (SI) just before and 3 weeks after intervention.ResultsChanges in K-BBS (p<0.05) and TIS (p<0.05) were significantly higher in group A (18.5±8.10, 6.6±1.90) and group B (19.9±5.44, 7.0±2.26) than in group C (8.4±4.14, 3.1±0.99). However, K-MBI, WDI, and SI failed to show any significant difference. No significant difference in all outcomes was observed between groups A and B.ConclusionThe effect of NMES to the abdominal muscles was similar to the effect on back muscles in terms of postural balance. This finding indicated that the NMES to the abdominal muscles may be an alternative for post-stroke hemiplegic patients contraindicated for NMES to the back muscles. Additional studies investigating the effects of NMES on abdominal and back muscles are needed.

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Section: Methodssupporting

confidence: 75%

Comparison Between Neuromuscular Electrical Stimulation to Abdominal and Back Muscles on Postural Balance in Post-stroke Hemiplegic Patients

et al. 2018

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“…Several studies have reported that NMES effectively activates the deep lumbar stabilizing muscles 23 , 24 , 27 , 28 ) . Coghlan et al 23 ) demonstrated a significant increase in TrA thickness during belt-type NMES of healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

“…Baek et al 28 ) reported that 20 healthy subjects showed significant thickness increases in LM, TrA and OI during NMES of the lumbar paraspinal region, and Baek et al. 27 ) reported 20 healthy subjects showed significant TrA and OI thickness increases during NMES applied to the abdominal wall. Our results are in agreement with these results and suggest that NMES could be used to train the deep lumbar stabilizing muscles of patients with LDK.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, significant thickness changes in LM muscles were found during abdominal wall stimulation (protocol A). This thickness change may be the result of an indirect tensile effect of the lumbar fascia straining during contraction of the abdominal muscles 27 , 28 ) . Baek et al 27 ) reported LM muscle activation without lumbar region activation during NMES applied to the abdominal wall of healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

“…This thickness change may be the result of an indirect tensile effect of the lumbar fascia straining during contraction of the abdominal muscles 27 , 28 ) . Baek et al 27 ) reported LM muscle activation without lumbar region activation during NMES applied to the abdominal wall of healthy subjects. Baek et al 28 ) also reported TrA and OI activations during NMES applied to the lumbar region without abdominal wall stimulation in healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

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The effects of transcutaneous neuromuscular electrical stimulation on the activation of deep lumbar stabilizing muscles of patients with lumbar degenerative kyphosis

Kim

Jung

et al. 2016

J Phys Ther Sci

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[Purpose] To investigate the effectiveness of three different neuromuscular electrical stimulation (NMES) protocols for the deep lumbar stabilizing muscles of patients with lumbar degenerative kyphosis (LDK). [Subjects and Methods] Twenty patients with LDK were recruited. Three stimulation protocols were investigated: stimulation of the abdominal muscles (protocol A); stimulation of the lumbar muscles (protocol B); and simultaneous stimulation of the abdominal and lumbar muscles (protocol A+B). Images of the obliquus externus (OE), obliquus internus (OI), transversus abdominis (TrA), and lumbar multifidus (LM) muscles were captured by real-time ultrasound imaging (RUSI). [Results] The thickness of LM was significantly greater during stimulation than at rest for all three protocols. Thicknesses of the abdominal muscles (TrA, OI, and OE) were significantly greater during stimulation than at rest for protocols A and A+B. Thickness increases in LM were significantly greater during protocols B and A+B, but not during protocol A. Thickness increases in the abdominal muscles (TrA, OI, and OE) were significantly greater during protocols A and A+B, but not during protocol B. [Conclusion] NMES can significantly activate the deep lumbar stabilizing muscles of patients with LDK. Protocol A+B of NMES is recommended to aid postural correction and low back pain (LBP) in patients with LDK.

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Inconsistent descriptions of lumbar multifidus morphology: A scoping review

Hofste

Soer

Hermens

et al. 2020

BMC Musculoskelet Disord

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Background: Lumbar multifidus (LM) is regarded as the major stabilizing muscle of the spine. The effects of exercise therapy in low back pain (LBP) are attributed to this muscle. A current literature review is warranted, however, given the complexity of LM morphology and the inconsistency of anatomical descriptions in the literature. Methods: Scoping review of studies on LM morphology including major anatomy atlases. All relevant studies were searched in PubMed (Medline) and EMBASE until June 2019. Anatomy atlases were retrieved from multiple university libraries and online. All studies and atlases were screened for the following LM parameters: location, imaging methods, spine levels, muscle trajectory, muscle thickness, cross-sectional area, and diameter. The quality of the studies and atlases was also assessed using a five-item evaluation system. Results: In all, 303 studies and 19 anatomy atlases were included in this review. In most studies, LM morphology was determined by MRI, ultrasound imaging, or drawingsparticularly for levels L4-S1. In 153 studies, LM is described as a superficial muscle only, in 72 studies as a deep muscle only, and in 35 studies as both superficial and deep. Anatomy atlases predominantly depict LM as a deep muscle covered by the erector spinae and thoracolumbar fascia. About 42% of the studies had high quality scores, with 39% having moderate scores and 19% having low scores. The quality of figures in anatomy atlases was ranked as high in one atlas, moderate in 15 atlases, and low in 3 atlases. Discussion: Anatomical studies of LM exhibit inconsistent findings, describing its location as superficial (50%), deep (25%), or both (12%). This is in sharp contrast to anatomy atlases, which depict LM predominantly as deep muscle. Within the limitations of the self-developed quality-assessment tool, high-quality scores were identified in a majority of studies (42%), but in only one anatomy atlas. Conclusions: We identified a lack of standardization in the depiction and description of LM morphology. This could affect the precise understanding of its role in background and therapy in LBP patients. Standardization of research methodology on LM morphology is recommended. Anatomy atlases should be updated on LM morphology.

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Verification of an optimized stimulation point on the abdominal wall for transcutaneous neuromuscular electrical stimulation for activation of deep lumbar stabilizing muscles

Cited by 11 publications

References 22 publications

Comparison Between Neuromuscular Electrical Stimulation to Abdominal and Back Muscles on Postural Balance in Post-stroke Hemiplegic Patients

Comparison Between Neuromuscular Electrical Stimulation to Abdominal and Back Muscles on Postural Balance in Post-stroke Hemiplegic Patients

The effects of transcutaneous neuromuscular electrical stimulation on the activation of deep lumbar stabilizing muscles of patients with lumbar degenerative kyphosis

Inconsistent descriptions of lumbar multifidus morphology: A scoping review

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