Efficacy of capacitive and resistive transfer of energy (TECAR) therapy with therapeutic exercises in individuals with chronic mechanical low back pain

This study is carried to out to find the effectiveness of capacitive and resistive electric transfer (TECAR) therapy combined with back exercise on individauals with chronic mechanical low back pain.Capacitive and resistive electric transfer (TECAR) therapy is a physical treatment modality used to treat pain in several musculoskeletal disorders. It is classified as a type of diathermy. It use very high-frequency electromagnetic waves to increase heat in deep tissues of the body. Among the various methods of diathermy, TECAR therapy is considered the most convenient and safe as it has few limitations concerning the treatment area and does not cause excessive heat generation between the skin and the electrode.It helps in regulating the ionic activity inside and outside the cell. The energy causes a stream of ions with excessively rapid electrical oscillations will lead to permeabilization of the plasma membrane. It can open large number of ion channels, effectively help ions through the membrane channel for transmembrane movement, so that the positive and negative ion exchange of cells to normal, so as to achieve cell repair. It has two modes, capacitive mode and resistive modeIt offers various frequencies 300 KHZ to 1 MHZ. The higher the frequency, the more concentric and more superficial. The lower the frequency is, the more diffuse and deeper.448 KHz approx is known to be the most appropriate frequency to regulate the activities of the ions. The capacitive mode works with an isolated electrode that concentrates most of the electric changes close to the electrode. In this way, it works on superficial and water-based tissues such as muscles, blood and lymphatic vessels. On the contrary, the resistive modality works with a non-isolated electrode: electric charges can penetrate the superficial tissues and reach deeper structures such as tendons, ligaments, bones and cartilages. Mechanical back pain refers to any sort of back pain caused by inserting abnormal stress and strain on muscles of the backbone. Mechanical back pain arises from dangerous habits, like poor posture, poorly designed seating, and incorrect bending and lifting motions. Back endurance exercises has evidence in enhancing muscle reactivation and reconditioning. There is emerging evidence to suggest that endurance training of the low-back extensors and core stability exercises in patients with LBP can be effective in reducing pain, disability, and work loss, and improving fatigue threshold and physical performance.Total 40 subjects will be taken for the study where the subjects will be divided into 2 groups of 20 subjects each. Numeric pain rating scale (NPRS), Roland-Morris Disability Questionnaire (RMDQ), Modified Schober’s Test will be used to select the subjects for chronic mechanical low back pain. Group A will be given TECAR along with therapeutic back exercises and group B will be given only therapeutic back exercises. On group A, TECAR therapy with both capacitive and resistive modes to be given. Capacitive mode with dynamic  electrode will be given for 5 minutes and resistive static electrode will be given for 15 minutes for alternate days for 4 weeks. Exercises to be done for 30 minutes 1 set each for 10 repetitions and 10 seconds hold. Exercises includes bridging , clamshells , tummy tuck in, core stabilization with physio ball.After  4 weeks of treatment program, the patients will be reassessed on the basis of pain rating of NPRS and disability rating on the Rolland Morris Disability Questionnaire.