Electromyography in muscle activation lumbar region in a comparison between manual therapy and photobiomodulation associated with kinesiotherapy in individuals with low back pain

Abstract

Introduction: About 10 million people have low back pain (LBP) disability in Brazil, and several therapies are used to treat this condition, such as kinesiotherapy, manual therapy (MT) and photobiomodulation-PBM. Although studies have investigated the use of these methods in LBP, research seeking to evaluate the efficacy of the association between techniques is still needed. Objective: To evaluate the activation of the muscles lumbar region with the influence of PBM and MT associated with kinesiotherapy in the treatment of LBP. Methods: Twenty individuals with chronic LBP were randomly divided into two groups. The first group (MT) received vertebral mobilization associated with a kinesiotherapy exercise program, while the second group (830nm-PBM) received PBM associated with the exercise program, twice a week for 8 weeks. It was performed an evaluation of pain perceived by the visual analogic scale (VAS), lumbar disability by the Oswestry questionnaire, muscle strength by strain gauge and activation through surface electromyography, before and after the treatment protocol. EMG data analysis was performed by MatLab® software. The ANOVA two-way test was used (degree of significance p≤0.05), and the effects size by Hedge test. Results: Considering pain, the two groups presented a significant result (p<0.05). In muscle activation only the multifidus obtained different during side bridge (p<0.05) when compared intragroups. But none of the variables were different when evaluating intergroups. Conclusion: Both MT and PBM associated with kinesiotherapy for 8 weeks are effective in reducing pain, improving motor control and stability of the lumbar spine in patients with chronic LBP.