Comparison of the effects of two intensities of transcutaneous electrical nerve stimulation on muscle endurance in individuals with nonspecific low back pain: preliminary randomized trial

Pavanate, Vanessa; Aguiar, Thiago Pereira; Contezini, Luiza Roberta; Marcolino, Alexandre Márcio; Barbosa, Rafael Inácio; Haupenthal, Alessandro; Lima, Kelly Mônica Marinho e

doi:10.63231/2595-0118.20250038-pt

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ORIGINAL ARTICLE • BrJP 8 • 2025 • https://doi.org/10.63231/2595-0118.20250038-en linkcopy

Comparison of the effects of two intensities of transcutaneous electrical nerve stimulation on muscle endurance in individuals with nonspecific low back pain: preliminary randomized trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES Transcutaneous electrical nerve stimulation (TENS) is used as low back pain (LBP) treatment, enabling pain control and better muscle endurance. The intensity of “strong but comfortable” has been described as more effective but it is not always tolerated by all patients in clinical practice. To date, no studies have been found comparing two intensities of TENS to increase exercise tolerance in the same session. Therefore, this study aims to compare the effects of low and high intensities (LI and HI, respectively) on muscular endurance and, secondarily, on pain, kinesiophobia and disability in individuals with non-specific LBP.

METHODS This is a randomized and double-blinded clinical trial. Sixteen individuals were divided into LI (n =7) and HI (n = 9) groups. The Numerical Rating Scale (NRS), Oswestry Disability Index, supine bridge test, and TAMPA scale were used to collect data regarding pain, disability, muscle resistance, and kinesiophobia, respectively.

RESULTS An increase in muscular endurance and a temporary reduction in pain were observed in both groups post-intervention (p<0.05). No significant differences exist between time and groups (p>0.05) regarding kinesiophobia. Oswestry scale (disability) demonstrated lower values in follow-up compared to baseline.

CONCLUSION TENS improved muscular endurance performance in both groups. One session of TENS applied in high and low intensities reduced pain in patients with nonspecific low back pain. At follow-up, kinesiophobia did not change compared with baseline, but disability was reduced in both groups.

Keywords:
Analgesia; Kinesiophobia; Low Back Pain; Physical Endurance; Transcutaneous Electrical Nerve Stimulation

HIGHLIGHTS

Only one TENS session promotes an increase in muscle resistance of trunk stabilizers

Muscular endurance performance has a good correlation with high intensity group

Only one TENS session made possible to reduce the pain in high and low intensity

Disability reduced in high and low intensities at follow-up compared to baseline

Kinesiophobia did not change at follow-up compared to baseline

Groups	Low intensity	High intensity
Number of voluntaries (n)	7	9
Gender	n= 4 men	n= 5 men
Gender	n = 3 women	n= 4 women
Age (years)	27.57 ± 6.45	23.89 ± 3.48
Weight (Kg)	86.71 ± 8.75	73.78 ± 18.20
Height (m)	1.74 ± 0.06	1.66 ± 0.08
Time of pain complaint	More than 3 months: n=4	More than 3 months: n=7
Time of pain complaint	Less than 3 months: n=3	Less than 3 months: n=2

Outcomes	Mean ± SD	Mean difference	95% coefficient interval	Effect size (Hedgess’ g)
NRS HI	2.00 ± 1.73	-0.66	-2.81 to 1.47	0.77
NRS LI	1.33 ± 1.55	-0.66	-2.81 to 1.47	0.77
R HI [s]	68.00 ± 67,55	-2.00	-36.23 to 32.23	0.03
R LI [s]	66.00 ± 64,42	-2.00	-36.23 to 32.23	0.03
D HI [%]	16.00 ± 16.22	2.33	-6.679 to 11.35	0.13
D LI [%]	18.33 ± 18.72	2.33	-6.679 to 11.35	0.13

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Sociedade Brasileira para o Estudo da Dor Av. Conselheiro Rodrigues Alves, 937 Cj2 - Vila Mariana, CEP: 04014-012, São Paulo, SP - Brasil, Telefones: , (55) 11 5904-2881/3959 - São Paulo - SP - Brazil
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[1] NRS: Numerical Rating Scale; R: Resistance; D: Disability; HI: high intensity; LI: low intensity; all these values cited are from the post-TENS (NRS values are from the post 2).