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The goal of this randomized controlled trial, is to investigate the effect of functional NMES and conventional NMES applied to the lumbar multifidus muscle on body kinematic and kinetic values during the sit-to-stand in individuals with non-specific low back pain. Our study will include 24 participants between the ages of 18-65. Which physiotherapy intervention will be applied to the participants will be determined by the block randomization method, using a table of random numbers. After randomization; NMES to the participants' lumbar multifidus muscle during physiotherapy intervention will be applied in two groups; In the first group, NMES will be applied with the conventional technique during prone position and in the second group, NMES will be applied with the functional technique during the sit-to-stand activity. Evaluations will be made twice for each participant- before and after the intervention. During the evaluation, data regarding the change in body kinetics and kinematics of individuals during the sit-to-stand activity will be recorded with a Vicon camera system. For secondary outcome measures, a visual analog scale will be used to evaluate pain, the Roland Morris Disability Questionnaire and the Oswestry Disability Index will be used to evaluate functional status, and the Tampa Kinesiophobia Scale will be used to evaluate fear-avoidance behavior.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Functional Neuromuscular Electrical Stimulation Group | Experimental | Functional NMES involves stimulating the lumbar multifidus muscle while the individual performs a sit-to-stand activity. |
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| Conventional Neuromuscular Electrical Stimulation Group | Experimental | Conventional NMES intervention involves only stimulating the lumbar multifidus muscle while the individual is in the prone position, and the individual will not reveal any voluntary contraction during stimulation. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Functional Neuromuscular Electrical Stimulation | Other | The functional NMES technique involves the application of electrical stimulation during functional activity. In our study, in the functional neuromuscular electrical simulation group, neuromuscular electrical stimulation will be applied to the lumbar multifidus muscle while individuals perform the activity of standing up from sitting. |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in kinematics of the Lumbar Spine and Hip During sit-to-stand activity | With kinematic analysis, the mean, minimum and maximum range of motion of the lumbar spine and hip joint during the sit-to-stand activity will be evaluated and recorded in degrees using the vicon motion capture system (Vicon, 6xVantage 5 Cameras 5MP@420FPS, 2xVue Video Cameras). | Baseline and first week after 8-week intervention |
| Changes in ground reaction force during sit-to-stand activity | Ground reaction force will be evaluated using force plates (2xAMTI force plates). | Baseline and first week after 8-week intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Hip and Lumbar spine range of motion | Hip and Lumbar spine range of motion will be evaluated using goniometer and recorded in degrees. | Baseline and first week after 8-week intervention |
| Shortness of the hip flexor, knee flexor and plantar flexor muscles |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hacettepe University | Ankara | Turkey (Türkiye) |
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| Conventional Neuromuscular Electrical Stimulation | Other | The conventional neuromuscular electrical simulation technique, electrical stimulation is applied without the individual performing voluntary contractions. In our study, conventional NMES will be applied to the lumbar multifidus muscle with the individual lying in the prone position and the individual will not elicit any voluntary contractions during the simulation. |
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Shortness of the hip flexor, knee flexor and plantar flexor muscles will be evaluated by Thomas test, popliteal angle hamstring test and ankle dorsiflexion ROM measurements, respectively. Results will be recorded in degrees. |
| Baseline and first week after 8-week intervention |
| Beighton test | The Beighton test is a screening technique for hypermobility. The test is a nine-point scale and requires the performance of 5 maneuvers. | Baseline and first week after 8-week intervention |
| Visual analogue scale | Visual analog scale will be used to evaluate pain. The visual analog scale consists of a single 10 cm line used to evaluate pain intensity. Patients will be asked to mark the severity of their pain at rest, during activity and during night. | Baseline and first week after 8-week intervention |
| Oswestry Disability Index | Oswestry Disability Index will be used to evaluate the degree of loss of function. Higher values represent greater disability. | Baseline and first week after 8-week intervention |
| Roland-Morris Disability Questionnaire | Roland-Morris Disability Questionnaire will be used to evaluate functional disabilities. Higher values represent greater disability. | Baseline and first week after 8-week intervention |
| Tampa Kinesiophobia Scale | Tampa Kinesiophobia Scale will be used to evaluate fear of movement/reinjury. Higher values represent greater kinesiophobia. | Baseline and first week after 8-week intervention |
| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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