Comparative Efficacy of Motor control exercise and surface EMG guided exercises in low back pain with lumbar radiculopathy - A single blinded Randomized Clinical Trial

Pain, Muscle weakness, and postural instability are very common causes of long-term disability related to low back pain with Lumbar radiculopathy worldwide. The incidence of low back pain is estimated between 13% to 31%, and among them,12%-40% of patients with low back pain experience radicular symptoms. Improvement of postural stability and motor control are important predictor for improving the quality of life and functional independence among patients with low back pain with Lumbar radiculopathy. Various approaches are implemented in physiotherapy to improve the patient’s symptoms with low back pain and Lumbar radiculopathy. Motor control and EMG-guided exercises greatly enhance postural control and functional independence by enhancing muscle strength and awareness of muscle actions through audio-visual feedback.

Purpose of study : The purpose of the study is to find out the efficacy of motor control exercise (MCE) and surface EMG-guided exercise to reduce disability and improve the quality of life in patients with low back pain with Lumbar radiculopathy and compare the efficacy of these 2 different techniques.

Methodology: Patients who were referred with complaints of low back pain with radiculopathy were assessed for eligibility. A brief screening of patients was performed using an SLR (straight leg raise) test to confirm a lumbar disc herniation. According to the inclusion-exclusion criteria, 50 patients were selected, among them 16 patients were excluded by not meeting the criteria (n=9), and declined to participate(n= 7). 34 patients were randomly divided into two groups (n=17) to compare the efficacy of motor control exercise and surface EMG-guided exercise. 6 patients from Group B discontinued from mid-intervention, Group A (n= 17) was received motor control exercise, and Group B (n=11) received EMG-guided exercise. Treatment was provided for 3 sessions /week for a total of 4 weeks.

Statistical Analysis: The statistical analysis was conducted using SPSS software version 30.0. The primary analysis used descriptive statistics to analyse the demographic data. Homogeneity of the groups was checked using the Shapiro-Wilk test. Pre (baseline) and post (after 4 weeks) intervention data. Student t-tests were used for the inter-group and within-group data analysis. The level of significance was considered at p<0.05.

Result: The results of the within-group analysis showed significant results with a significant mean difference (p<0.05) in all the outcomes of both Group A and Group B, except for hip adductor strength in Group B. Between-group comparisons revealed no significant differences with a mean difference (p>0.05) between Group A and Group B. Both interventions demonstrated that 4 weeks of intervention results in a similar level of effectiveness in managing low back pain with lumbar radiculopathy. Therefore, the null hypothesis is accepted in this study.