Effects of different neuromuscular electrical stimulation techniques applied to the multifidus muscle on the kinematics of the spine, pelvis, and hip during sit-to-stand in individuals with chronic nonspecific Low back pain

Duygu Yılmaz Uras; Nazif Ekin Akalan; Shavkat Nadir Kuchimov; Demet Tekdöş Demircioğlu; Tüzün Fırat

doi:10.1080/09638288.2026.2614294

Effects of different neuromuscular electrical stimulation techniques applied to the multifidus muscle on the kinematics of the spine, pelvis, and hip during sit-to-stand in individuals with chronic nonspecific Low back pain

Disabil Rehabil. 2026 Jan 13:1-14. doi: 10.1080/09638288.2026.2614294. Online ahead of print.

Authors

Duygu Yılmaz Uras¹, Nazif Ekin Akalan^{2

3}, Shavkat Nadir Kuchimov^{2

3

4}, Demet Tekdöş Demircioğlu⁵, Tüzün Fırat¹

Affiliations

¹ Faculty of Physical Therapy and Rehabilitation, Department of Musculoskeletal Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
² Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul Kultur University, Istanbul, Turkey.
³ Motion Analysis Center, Istanbul Kultur University, Istanbul, Turkey.
⁴ Instute of Biomedical Engineering, Bogazici University, Istanbul, Türkiye.
⁵ Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul Aydin University, Istanbul, Turkey.

PMID: 41530991
DOI: 10.1080/09638288.2026.2614294

Abstract

Purpose: To investigate the effects of two neuromuscular electrical stimulation (NMES) techniques applied to the lumbar multifidus on spine, pelvis, and hip kinematics during sit-to-stand (STS) in individuals with chronic nonspecific low back pain (CNLBP).

Methods: Twenty-two individuals with CNLBP were randomized into conventional NMES (CNMES; n = 11) or functional NMES (FNMES; n = 11) groups. A control group of ten healthy individuals was included for comparison. The CNMES group received stimulation in the prone position without voluntary contraction, whereas the FNMES group received stimulation during STS. Interventions were delivered three times weekly for eight weeks. Kinematic parameters were assessed using optoelectronic motion capture, and pain and disability using the Visual Analog Scale and Oswestry Disability Index.

Results: At baseline, CNLBP groups showed reduced range of motion and angular velocity during the flexion phase of STS. After the intervention, the FNMES group demonstrated significant improvements in spine, pelvis, and hip kinematics (p < 0.05), while only spine angular velocity improved in the CNMES group. Both NMES groups demonstrated significant reductions in pain and disability levels (p < 0.05).

Conclusion: FNMES was more effective than CNMES in improving movement patterns during the flexion phase of STS, demonstrating its potential as a phase-specific rehabilitation approach for individuals with CNLBP.

Keywords: Low back pain; electric stimulation; hip; kinematics; pelvis; spine.

Plain language summary

In individuals with chronic nonspecific low back pain (CNLBP), the kinematic alterations observed in the spine, pelvis, and hip joints during the sit-to-stand (STS) should be taken into consideration in both assessment and treatment planning.Neuromuscular electrical stimulation (NMES) applied synchronously with functional activity is more effective than conventional application in improving hip kinematics during the flexion phase of the STS.Rehabilitation professionals should integrate NMES synchronized with functional activity into rehabilitation programs to improve movement kinematics in individuals with CNLBP who are able to perform the STS independently.