Methods: This study involved 29 patients (age range 25-58 years) randomized into 2 groups: the segmental stabilization group (n = 15), who received stabilization exercises on the transversus abdominis (TrA) and lumbar multifidus muscles; and the TENS group (n = 14), who received electrotherapy. Groups underwent 16 sessions, for 60 minutes, twice per week, and they were evaluated before and after intervention. Pain was measured using a visual analog scale, functional disability using the Oswestry Disability Index, muscle activation and fatigue with electromyography, and patients’ ability to contract the TrA with a pressure biofeedback unit. Analyses within and between groups were performed.
Results: The stabilization group improved lumbar multifidus fatigue (median frequency [MF] initial [P = .002], MF final [P < .001], MF slope [P = .001], and resistance time [P < .001]), ability to contract the TrA (P < .001), pain (P < .001), and functional disability (P < .001). TENS only was effective for pain (P = .012).
Conclusion: Although it relieved pain, TENS was not effective as a single treatment to prevent fatigue, increase TrA contraction, and reduce functional disability in herniated disk patients. Stabilization exercises alone improved all measured outcomes.
Author keywords: Muscle Fatigue; Abdominal Muscles; Transcutaneous Electrical Nerve Stimulation; Intervertebral Disk Displacement
Author affiliations: LAVR: Campus Binacional of Oiapoque, Federal University of Amapá, Oiapoque, Amapá, Brazil; BC:Laboratory of Human Movement Studies, Department of Physical Therapy and Occupational Therapy, Institute of Health Sciences, Federal University of Pará, Belém, Pará, Brazil; FJRF, TNB, APMCCES, JC, APM: Department of Physical, Speech, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; MOM: Laboratory of Human Movement Studies, Department of Physical Therapy and Occupational Therapy, Institute of Health Sciences, Federal University of Pará, Belém, Pará, Brazil; GPLA: Department of Physical Therapy, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
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