Repetitive peripheral magnetic neurostimulation of multifidus muscles combined with motor training influences spine motor control and chronic low back pain.
OBJECTIVE
The study tested whether combining repetitive peripheral magnetic stimulation (RPMS) and motor training of the superficial multifidus muscle (MF) better improved the corticomotor control of spine than training alone in chronic low back pain (CLBP).


METHODS
Twenty-one participants with CLBP were randomly allocated to [RPMS+training] and [Sham+training] groups for three sessions (S1-S3) over a week where MF was stimulated before training (volitional contraction). Training was also home-practiced twice a day. Changes were tested at S1 and S3 for anticipatory postural adjustments (APAs) of MF and semi-tendinosus (ST), MF EMG activation, cortical motor plasticity (transcranial magnetic stimulation) and pain/disability.


RESULTS
The RPMS group showed immediate decrease of pain at S1, then improvement of MF activation, ST APA, M1 facilitation, and pain/disability at S3. Changes were larger when brain excitability was lower at baseline. Disability index remained improved one month later.


CONCLUSIONS
Combining RPMS with training of MF in CLBP impacted motor planning, MF and lumbopelvic spine motor control and pain/disability one week after the onset of protocol. Brain plasticity might have favoured motor learning and improved daily lumbopelvic spine control without pain generation.


CONCLUSIONS
Clinically, RPMS impacted the function by improving the gains beyond those reached by training alone in CLBP.
Research Center of CHU de Québec, Neuroscience Division, Clinical Neuroscience and Neurostimulation Laboratory, Quebec City, Qc, Canada.
Hugo
H
Massé-Alarie
Research Center of CHU de Québec, Neuroscience Division, Clinical Neuroscience and Neurostimulation Laboratory, Quebec City, Qc, Canada.
Louis-David
LD
Beaulieu
McGill University, Constance-Lethbridge Rehabilitation Center-CRIR, Montreal, Qc, Canada.
Richard
R
Preuss
Research Center of CHU de Québec, Neuroscience Division, Clinical Neuroscience and Neurostimulation Laboratory, Quebec City, Qc, Canada; Dept of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Qc, Canada. Electronic address: cyril.schneider@rea.ulaval.ca.
Cyril
C
Schneider
D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000628:therapy*; D055909:Magnetic Field Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology; D009119:Muscle Contraction; D064170:Paraspinal Muscles / Q000294:innervation* / Q000502:physiology; D011187:Posture
APA; Chronic low back pain; M1 excitability; Magnetic neurostimulation; Motor training; Paravertebral muscles