Efficacy of the addition of interferential current to Pilates method in patients with low back pain: a protocol of a randomized controlled trial

Yuri Rafael dos Santos Franco, Richard Eloin Liebano, Katherinne Ferro Moura, Naiane Teixeira Bastos de Oliveira, Gisela Cristiane Miyamoto, Matheus Oliveira Santos, Cristina Maria Nunes Cabral, Yuri Rafael dos Santos Franco, Richard Eloin Liebano, Katherinne Ferro Moura, Naiane Teixeira Bastos de Oliveira, Gisela Cristiane Miyamoto, Matheus Oliveira Santos, Cristina Maria Nunes Cabral

Abstract

Background: Chronic low back pain is one of the four most common diseases in the world with great socioeconomic impact. Supervised exercise therapy is one of the treatments suggested for this condition; however, the recommendation on the best type of exercise is still unclear. The Pilates method of exercise is effective in reducing pain and disability in these patients, as well as the analgesia promoted by interferential current. Currently, the literature lacks information on the efficacy of the association of these two techniques in the short- and medium-term than performing one of the techniques isolated. The objective of this study will be to evaluate the efficacy of adding interferential current to the Pilates method exercises for the treatment of patients with chronic nonspecific low back pain in the short- and medium-term.

Methods/design: This study will be a randomized controlled trial with two arms and blinded evaluator, conducted at an outpatient Physical Therapy Department in Brazil. Patients with nonspecific chronic low back pain and pain equal to or greater than 3 in the Pain Numerical Rating Scale (0/10) will be randomly assigned to one of two groups: Group with active interferential current + Pilates (n = 74) will be submitted to the active interferential current associated to the modified Pilates exercises, and Group with sham interferential current + Pilates (n = 74) will be submitted to the sham interferential current associated with the modified Pilates exercises during 18 sessions. The outcomes pain intensity, pressure pain threshold, general and specific disability, global perceived effect and kinesiophobia will be evaluated by a blinded assessor at baseline, six weeks and six months after randomization.

Discussion: Because of the study design, blinding of the participants and the therapists involved in the study will not be possible. The results of this study could contribute to the process of clinical decision- making for the improvement of pain and disability in participants with nonspecific chronic low back pain.

Trial registration: ClinicalTrials.gov NCT01919268.

References

    1. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl 2):S192–S300. doi: 10.1007/s00586-006-1072-1.
    1. Waddell G. The Back Pain Revolution. 2. Edinburgh: Churchill Livingstone; 2004.
    1. Costa LCM, Maher CG, McAuley JH, Hancock MJ, Herbert RD, Refshauge KM, Henschke N. Prognosis for patients with chronic low back pain: inception cohort study. BMJ. 2009;339:b3829. doi: 10.1136/bmj.b3829.
    1. Costa LCM, Maher CG, Hancock MJ, McAuley JH, Herbert RD, Costa LO. The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ. 2012;184:E613–E624. doi: 10.1503/cmaj.111271.
    1. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, Woolf A, Vos T, Buchbinder R. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64:2028–2037. doi: 10.1002/art.34347.
    1. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basáñez MG, Baxter A, Bell ML, Benjamin EJ, Bennett D, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–2196. doi: 10.1016/S0140-6736(12)61729-2.
    1. Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J. 2008;8:8–20. doi: 10.1016/j.spinee.2007.10.005.
    1. Delitto A, George SZ, Van Dillen LR, Whitman JN, Sowa G, Shekelle P, Denninger TR, Godges JJ. Low back pain. J Orthop Sports Phys Therapy. 2012;42:A1–57. doi: 10.2519/jospt.2012.42.4.A1.
    1. Wells C, Kolt GS, Marshall P, Hill B, Bialocerkowski A. The effectiveness of pilates exercise in people with chronic low back pain: a systematic review. PLoS One. 2014;9:e100402. doi: 10.1371/journal.pone.0100402.
    1. Correa JB, Costa LO, de Oliveira NT, Sluka KA, Liebano RE. Effects of the carrier frequency of interferential current on pain modulation in patients with chronic nonspecific low back pain: a protocol of a randomised controlled trial. BMC Musculoskelet Disord. 2013;14:195. doi: 10.1186/1471-2474-14-195.
    1. Facci LM, Nowotny JP, Tormem F, Trevisani VF. Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial. Sao Paulo Med J. 2011;129:206–216.
    1. Lara-Palomo IC, Aguilar-Ferrandiz ME, Mataran-Penarrocha GA, Saavedra-Hernandez M, Granero-Molina J, Fernandez-Sola C, Castro-Sanchez AM. Short-term effects of interferential current electro-massage in adults with chronic non-specific low back pain: a randomized controlled trial. Clin Rehabil. 2013;27:439–449. doi: 10.1177/0269215512460780.
    1. Zambito A, Bianchini D, Gatti D, Viapiana O, Rossini M, Adami S. Interferential and horizontal therapies in chronic low back pain: a randomized, double blind, clinical study. Clin Exp Rheumatol. 2006;24:534–539.
    1. Fuentes J, Armijo-Olivo S, Funabashi M, Miciak M, Dick B, Warren S, Rashiq S, Magee DJ, Gross DP. Enhanced therapeutic alliance modulates pain intensity and muscle pain sensitivity in patients with chronic low back pain: an experimental controlled study. Phys Ther. 2014;94:477–489. doi: 10.2522/ptj.20130118.
    1. Zambito A, Bianchini D, Gatti D, Rossini M, Adami S, Viapiana O. Interferential and horizontal therapies in chronic low back pain due to multiple vertebral fractures: a randomized, double blind, clinical study. Osteoporos Int. 2007;18:1541–1545. doi: 10.1007/s00198-007-0391-3.
    1. Palmer ST, Martin DJ, Steedman WM, Ravey J. Alteration of interferential current and transcutaneous electrical nerve stimulation frequency: effects on nerve excitation. Arch Phys Med Rehabil. 1999;80:1065–1071. doi: 10.1016/S0003-9993(99)90062-X.
    1. Johnson MI, Tabasam G. A single-blind placebo-controlled investigation into the analgesic effects of interferential currents on experimentally induced ischaemic pain in healthy subjects. Clin Physiol Funct Imaging. 2002;22:187–196. doi: 10.1046/j.1475-097X.2002.00416.x.
    1. Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150:971–979. doi: 10.1126/science.150.3699.971.
    1. Solano LR, Sanhueza CA, Carter BM, Bianchi LD, Riedemann GP. Electroanalgesia en el síndrome de dolor lumbar agudo: efectividad comparativa de TIF versus TENS: estudio preliminar/Electro-analgesia in the low back pain syndrome: comparative effectiveness of TIF versus TENS: preliminary study. Rev Chil Reumatol. 2006;22:5.
    1. Werners R, Pynsent PB, Bulstrode CJ. Randomized trial comparing interferential therapy with motorized lumbar traction and massage in the management of low back pain in a primary care setting. Spine. 1999;24:1579–1584. doi: 10.1097/00007632-199908010-00012.
    1. Zaniewska R, Okurowska-Zawada B, Kulak W, Domian K. Analysis of quality of life in patiens with low back pain after receiving transcutaneous electrical nerve stimulation (TENS) Med Pr. 2012;63:295–302.
    1. George SZ, Wittmer VT, Fillingim RB, Robinson ME. Comparison of graded exercise and graded exposure clinical outcomes for patients with chronic low back pain. J Orthop Sports Phys Ther. 2010;40:694–704. doi: 10.2519/jospt.2010.3396.
    1. Ostelo RW, de Vet HC. Clinically important outcomes in low back pain. Best Pract Res Clin Rheumatol. 2005;19:593–607. doi: 10.1016/j.berh.2005.03.003.
    1. Carvalho T, Nóbrega ACL, Lazzoli JK, Magni JRT, Rezende L, Drummond FA, Oliveira MAB, Rose EH, Araújo CGS, Teixeira JAC. Posição oficial da Sociedade Brasileira de Medicina do Esporte: atividade física e saúde. Rev Bras Med Esporte. 1996;2:79–81.
    1. Ozcan J, Ward AR, Robertson VJ. A comparison of true and premodulated interferential currents. Arch Phys Med Rehabil. 2004;85:409–415. doi: 10.1016/S0003-9993(03)00478-7.
    1. Pantaleao MA, Laurino MF, Gallego NL, Cabral CM, Rakel B, Vance C, Sluka KA, Walsh DM, Liebano RE. Adjusting pulse amplitude during transcutaneous electrical nerve stimulation (TENS) application produces greater hypoalgesia. J Pain. 2011;12:581–590. doi: 10.1016/j.jpain.2010.11.001.
    1. Curnow D, Cobbin D, Wyndham J, Boris Choy ST. Altered motor control, posture and the pilates method of exercise prescription. J Bodyw Mov Ther. 2009;13:104–111. doi: 10.1016/j.jbmt.2008.06.013.
    1. Gladwell V, Head S, Haggar M, Beneke R. Does a program of pilates improve chronic non-specific low back pain. J Sport Rehabil. 2006;15:14.
    1. da Luz Jr MA, Costa LO, Fuhro FF, Manzoni AC, de Oliveira NT, Cabral CM. Effectiveness of mat pilates or equipment-based Pilates in patients with chronic non-specific low back pain: a protocol of a randomised controlled trial. BMC Musculoskelet Disord. 2013;14:16. doi: 10.1186/1471-2474-14-16.
    1. Latey P. The Pilates method: history and philosophy. J Bodyw Mov Ther. 2001;5:275–282. doi: 10.1054/jbmt.2001.0237.
    1. Miyamoto GC, Costa LO, Galvanin T, Cabral CM. Efficacy of the addition of modified Pilates exercises to a minimal intervention in patients with chronic low back pain: a randomized controlled trial. Phys Ther. 2013;93:310–320. doi: 10.2522/ptj.20120190.
    1. Costa LO, Maher CG, Latimer J, Ferreira PH, Ferreira ML, Pozzi GC, Freitas LM. Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best? Spine. 2008;33:2459–2463. doi: 10.1097/BRS.0b013e3181849dbe.
    1. Turk DC, Melzack R. Handbook of Pain Assessment. 2. New York: The Guilford Press; 2001.
    1. Meeus M, Roussel NA, Truijen S, Nijs J. Reduced pressure pain thresholds in response to exercise in chronic fatigue syndrome but not in chronic low back pain: an experimental study. J Rehabil Med. 2010;42:884–890. doi: 10.2340/16501977-0595.
    1. Schenk P, Laeubli T, Klipstein A. Validity of pressure pain thresholds in female workers with and without recurrent low back pain. Eur Spine J. 2007;16:267–275. doi: 10.1007/s00586-006-0124-x.
    1. Arendt-Nielsen L, Nie H, Laursen MB, Laursen BS, Madeleine P, Simonson OH, Graven-Nielsen T. Sensitization in patients with painful knee osteoarthritis. Pain. 2010;149:573–581. doi: 10.1016/j.pain.2010.04.003.
    1. O'Neill S, Kjaer P, Graven-Nielsen T, Manniche C, Arendt-Nielsen L. Low pressure pain thresholds are associated with, but does not predispose for, low back pain. Eur Spine J. 2011;20:2120–2125. doi: 10.1007/s00586-011-1796-4.
    1. Venancio RC, Pelegrini S, Gomes DQ, Nakano EY, Liebano RE. Effects of carrier frequency of interferential current on pressure pain threshold and sensory comfort in humans. Arch Phys Med Rehabil. 2013;94:95–102. doi: 10.1016/j.apmr.2012.08.204.
    1. Costa LO, Maher CG, Latimer J, Ferreira PH, Pozzi GC, Ribeiro RN. Psychometric characteristics of the Brazilian-Portuguese versions of the functional rating index and the Roland Morris disability questionnaire. Spine. 2007;32:1902–1907. doi: 10.1097/BRS.0b013e31811eab33.
    1. Nusbaum L, Natour J, Ferraz MB, Goldenberg J. Translation, adaptation and validation of the Roland-Morris questionnaire–Brazil Roland-Morris. Braz J Med Biol Res. 2001;34:203–210. doi: 10.1590/S0100-879X2001000200007.
    1. Roland M, Morris R. A study of the natural history of back pain. part I: development of a reliable and sensitive measure of disability in low-back pain. Spine. 1983;8:141–144. doi: 10.1097/00007632-198303000-00004.
    1. Feinstein A. Clinimetrics. New Haven: Yale University Press; 1987.
    1. Stratford P, Gill C, Westaway M, Binkley J. Assessing disability and change on individual patients: a report of a patient specific measure. Physiother Can. 1995;47:5. doi: 10.3138/ptc.47.4.258.
    1. de Souza FS, Marinho Cda S, Siqueira FB, Maher CG, Costa LO. Psychometric testing confirms that the Brazilian-Portuguese adaptations, the original versions of the Fear-Avoidance Beliefs Questionnaire, and the Tampa Scale of Kinesiophobia have similar measurement properties. Spine. 2008;33:1028–1033. doi: 10.1097/BRS.0b013e31816c8329.
    1. Siqueira FB, Teixeira-Salmela LF, Magalhães LC. Análise das propriedades psicométricas da versão brasileira da Escala Tampa de Cinesiofobia. Acta Ortop Bras. 2007;15:6. doi: 10.1590/S1413-78522007000100004.
    1. Miller R, Kori S, Todd D. The tampa scale: a measure of kinesiophobia. Clin J Pain. 1991;7:2. doi: 10.1097/00002508-199103000-00053.
    1. Miyamoto GC, Costa LOP, Cabral CMN. Efficacy of the Pilates method for pain and disability in patients with chronic nonspecific low back pain: a systematic review with meta-analysis. Braz J Phys Ther. 2013;17:517–532. doi: 10.1590/S1413-35552012005000127.
    1. Fuentes JP, Armijo Olivo S, Magee DJ, Gross DP. Effectiveness of interferential current therapy in the management of musculoskeletal pain: a systematic review and meta-analysis. Phys Ther. 2010;90:1219–1238. doi: 10.2522/ptj.20090335.
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