Effectiveness of Ergon Technique with Neuromuscular Electrical Stimulation in Addition to Routine Physical Therapy on Pain and Functional Mobility in Patients with Non Specific Chronic Low Back Pain

Purpose of this study was to investigate the effectiveness of Ergon technique with neuromuscular electrical stimulation (NMES) on pain and functional mobility in patients with chronic low back pain (CLBP).

Two-center, parallel group, concealed, double blind, randomized controlled trial of 50 participants.

1) Physical Therapy Department, University of Lahore Teaching Hospital. 2) University Physical Therapy and Rehabilitation Clinic, University of Lahore. Participant, and outcome assessor blinded.

Both adult males and females; 18 - 60 years of age diagnosed with chronic low back pain (CLBP) duration 3 months or greater and BMI less than 30 were included. Participants were excluded if they have positive nerve root tension signs or neurological deficit. Suffered from any spinal tumor or infection, spinal fracture. Contraindications to Ergon technique and NMES (e.g. skin allergy/wound). Previous experience with myofascial therapy or a history of rehabilitation treatment for back pain within the preceding 1 month.

In group 1 Progression of Ergon Technique from basic to advance using multiple strokes on lower back especially paraspinal muscles, multifidus and transverse abdominis(TrA) for a duration of minimum 10 mins as per patient requirement. The NMES electrodes were placed on multifidus and TrA for 20 mins. Same protocol of physical therapy as in group 2 except for TENS because of NMES protocol. In group 2 Lumbar mobility, stabilisation and strengthening exercises, aerobic exercises, hams stretching, Hot pack, TENS (20 mins) (Continuous mode) The treatment was provided for 1 hour, 3 days per week on alternate basis, for 4 weeks (12 sessions).

Modified oswestry disability questionnaire was used to assess functional mobility. Numeric pain rating scale was used for pain.

The study was designed to be a parallel group randomized controlled trial. After baseline assessment, eligible patients were randomly assigned (in a 1:1 ratio) Ergon + NMES + routine physical therapy (ERGON intervention group) or routine physical therapy (control group). Computer generated randomization assignments designed by an independent statistician and randomization was done by one of the research team member who was not involved in patient recruitment or assessment or data analysis. Randomization is without stratification, with the use of permuted-block randomization; the randomization assignments were kept in opaque, sealed envelopes and unsealed by a researcher after baseline testing.

After randomisation, study participants were only informed about the content of their allocated programme by their therapist, remaining unaware of the intervention in the other group. Patient information stated that the study purpose was to evaluate the effects of exercise and physical therapy interventions on chronic low back pain, without specifying that one of the programmes was considered a control intervention. Information about the details of both programmes was not provided except for similarities across both groups (exercise regime). Both programmes were personalised to the patient’s abilities to ensure all eligible patients could complete the programme. Outcome assessors were masked to group allocation. Patients were instructed not to talk about the content of their exercise programme during the post intervention visit and could contact their therapist in case of any problems during trial participation. Moreover, if two or more study participants were in the clinic/hospital at the same time, they were assign to different treatment areas without any opportunity to observe each other or their treatment times were rearranged to prevent unintended crossover.

IPD, study protocol, statistical analysis plan, informed consent form and clinical study report will be shared for primary and secondary outcome measure with interested research after considering the ethics and confidentiality.

Data will be available after 6 months of publication for 3 consecutive years.

Data will only be shared with individual researcher and academic researchers working in movement disorders. Data will not be shared for any commercial purposes/businesses for any reasons.

Data can be used under confidentiality and ethics.

Data can be obtained by emailing at haiderullah@live.com. Mobile number 0092 331 4127210

Simple email can do this. But this can take up to 4 weeks.