The Effects of EMS-Combined Body Awareness Exercises on Non-Specific Low Back Pain

Low back pain is one of the most prevalent musculoskeletal conditions worldwide and is a leading cause of disability and reduced quality of life. Non-specific low back pain (NSLBP), which has no identifiable underlying pathology, accounts for the majority of low back pain cases and often requires a multidisciplinary rehabilitation approach.

Body awareness-based exercises aim to improve postural control, movement quality, and the individual's perception of bodily sensations, and have been shown to be beneficial in chronic pain management. Electrical muscle stimulation (EMS) is a non-invasive modality that enhances neuromuscular activation and may support functional recovery when combined with exercise interventions.

The purpose of this study is to investigate the effects of EMS-combined body awareness exercises on pain intensity, functional disability, and body awareness in individuals with non-specific low back pain. Participants will be randomly assigned to either an intervention group receiving EMS-assisted body awareness training or a control group receiving standard body awareness exercises. Outcome measures will be assessed before and after the intervention period.

This study aims to provide evidence on whether the addition of EMS to body awareness-based rehabilitation leads to superior clinical outcomes compared to body awareness exercises alone in individuals with non-specific low back pain.

Study Overview

• Status: Not yet recruiting
• Conditions: Low Back Pain
• Intervention / Treatment: Behavioral: EMS-Assisted Body Awareness Exercises; Behavioral: Exercises

Detailed Description

This study is designed as a randomized controlled trial investigating the effectiveness of combining electrical muscle stimulation (EMS) with body awareness-based exercises in individuals with non-specific low back pain. The study will be conducted in an outpatient physiotherapy setting and will include adult participants diagnosed with non-specific low back pain according to clinical criteria.

Participants will be randomly allocated into two groups: an experimental group receiving EMS-assisted body awareness exercises and a control group receiving body awareness exercises alone. Both groups will participate in a structured rehabilitation program focusing on posture, movement quality, breathing, and proprioceptive awareness. The intervention will be delivered by trained physiotherapists under standardized conditions.

Electrical muscle stimulation will be applied to the lumbar and related trunk muscles during selected exercise components in the experimental group, with stimulation parameters adjusted according to participant tolerance and safety guidelines. The control group will perform the same exercise protocol without EMS application.

Primary outcomes will include pain intensity and functional disability, assessed using validated self-report questionnaires. Secondary outcomes will include body awareness levels and movement-related functional measures. Assessments will be conducted at baseline and after completion of the intervention period.

This study aims to determine whether the integration of EMS into a body awareness-based rehabilitation program provides additional benefits in pain reduction, functional improvement, and body awareness compared to body awareness exercises alone in individuals with non-specific low back pain.

• Study Type: Interventional
• Enrollment (Estimated): 72
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Aged between 18 and 65 years
• Diagnosed with non-specific low back pain for at least 3 months
• Pain intensity of ≥4 on the Numeric Rating Scale (NRS)
• Ability to understand and follow exercise instructions
• Willingness to participate in the study and provide written informed consent

Exclusion Criteria:

• Specific causes of low back pain (e.g., disc herniation with neurological deficit, spinal stenosis, spondylolisthesis, fracture, infection, tumor)
• History of spinal surgery within the last 12 months
• Known neurological disorders affecting movement or sensation
• Diagnosed rheumatological or inflammatory diseases (e.g., ankylosing spondylitis, rheumatoid arthritis)
• Pregnancy
• Presence of cardiac pacemaker or implanted electronic devices (contraindication for EMS)
• Severe osteoporosis or other conditions contraindicating exercise
• Current participation in another structured physiotherapy or rehabilitation program
• Cognitive impairment or psychiatric conditions limiting cooperation with the protocol

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: EMS-Assisted Body Awareness Exercise Group; Participants in this group will receive a structured body awareness-based exercise program combined with electrical muscle stimulation (EMS). EMS will be applied to the lumbar and related trunk muscles during selected exercise components in order to enhance neuromuscular activation and sensorimotor integration. The intervention will be delivered by trained physiotherapists under standardized clinical conditions.	Behavioral: EMS-Assisted Body Awareness Exercises; This intervention consists of a body awareness-based rehabilitation program supported by electrical muscle stimulation. EMS will be applied to the lumbar and trunk muscles during selected exercises to facilitate muscle activation, improve postural control, and enhance sensorimotor awareness. The exercise program will include postural alignment, breathing regulation, controlled movement patterns, and proprioceptive training.; Behavioral: Exercises; This intervention consists of a structured body awareness-based exercise program focusing on postural control, breathing, movement quality, and proprioceptive awareness. Exercises will be performed without any electrical stimulation and will be supervised by trained physiotherapists
Active Comparator: Exercise Group; Participants in this group will receive the same structured body awareness-based exercise program without electrical muscle stimulation. The program will focus on posture, breathing, movement quality, and proprioceptive awareness, and will be delivered by trained physiotherapists under standardized clinical conditions.	Behavioral: Exercises; This intervention consists of a structured body awareness-based exercise program focusing on postural control, breathing, movement quality, and proprioceptive awareness. Exercises will be performed without any electrical stimulation and will be supervised by trained physiotherapists

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functional Disability	Functional disability will be evaluated using the Oswestry Disability Index (ODI), which assesses the impact of low back pain on daily activities such as walking, sitting, standing, and lifting. Higher scores indicate greater levels of disability.	Baseline (Week 0) and Week 8
Pain intensity	Pain intensity will be assessed using the Numeric Rating Scale (NRS), where participants rate their current low back pain intensity on an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). The NRS is a valid and reliable tool for measuring pain in individuals with musculoskeletal conditions. Time Frame: Baseline and post-intervention (after completion of the intervention period)	Baseline (Week 0) and Week 8

Collaborators and Investigators

• Sponsor: Recep Tayyip Erdogan University
• Collaborators: İstanbul Yeni Yüzyıl Üniversitesi

Study record dates

Study Major Dates

• Study Start (Estimated): February 1, 2026
• Primary Completion (Estimated): May 1, 2026
• Study Completion (Estimated): June 1, 2026

Study Registration Dates

• First Submitted: January 31, 2026
• First Submitted That Met QC Criteria: February 6, 2026
• First Posted (Actual): February 13, 2026

Study Record Updates

• Last Update Posted (Actual): February 13, 2026
• Last Update Submitted That Met QC Criteria: February 6, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Low Back Pain; Body Awareness; Electrical Muscle Stimulation
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Back Pain; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Low Back Pain; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Exercise
• Other Study ID Numbers: 2026/01-1795

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared publicly in order to protect participant privacy and confidentiality. The dataset contains sensitive health-related information, and data sharing is restricted in accordance with ethical approval and data protection regulations.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No