title: Activations of deep lumbar stabilizing muscles by transcutaneous neuromuscular electrical stimulation of lumbar paraspinal regions.
abstract: OBJECTIVE
  To investigate changes in lumbar multifidus (LM) and deep lumbar stabilizing abdominal muscles (transverse abdominis [TrA] and obliquus internus [OI]) during transcutaneous neuromuscular electrical stimulation (NMES) of lumbar paraspinal L4-L5 regions using real-time ultrasound imaging (RUSI).
  
  
  METHODS
  Lumbar paraspinal regions of 20 healthy physically active male volunteers were stimulated at 20, 50, and 80 Hz. Ultrasound images of the LM, TrA, OI, and obliquus externus (OE) were captured during stimulation at each frequency.
  
  
  RESULTS
  The thicknesses of superficial LM and deep LM as measured by RUSI were greater during NMES than at rest for all three frequencies (p<0.05). The thicknesses in TrA, OI, and OE were also significantly greater during NMES of lumbar paraspinal regions than at rest (p<0.05).
  
  
  CONCLUSIONS
  The studied transcutaneous NMES of the lumbar paraspinal region significantly activated deep spinal stabilizing muscle (LM) and the abdominal lumbar stabilizing muscles TrA and OI as evidenced by RUSI. The findings of this study suggested that transcutaneous NMES might be useful for improving spinal stability and strength in patients having difficulty initiating contraction of these muscles.
authors.affiliation: Department of Rehabilitation Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Seung Ok
authors.initials: SO
authors.lastname: Baek
authors.affiliation: Department of Rehabilitation Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Ahn
authors.affiliation: Department of Anesthesia, University of Kansas School of Medicine, Wichita, KS, USA.
authors.forename: Rodney
authors.initials: R
authors.lastname: Jones
authors.affiliation: Department of Physical Medicine and Rehabilitation, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Cho
authors.affiliation: Medical Devices Clinical Trial Center, Yeungnam University, Daegu, Korea.
authors.forename: Gil Su
authors.initials: GS
authors.lastname: Jung
authors.affiliation: Department of Rehabilitation Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Yun Woo
authors.initials: YW
authors.lastname: Cho
authors.affiliation: Department of Rehabilitation Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Hyeong Jun
authors.initials: HJ
authors.lastname: Tak
keywords: Lumbar multifidus; Lumbar stabilizing muscle; Real-time ultrasound imaging; Transcutaneous neuromuscular electrical stimulation; Transverse abdominis