Effect of Motor Control Exercise and Transcutaneous Electrical Nerve Stimulation on Pain, Range of Motion, and Functional Disability of Obese Patients with Low Back Pain: Randomized Controlled Trial

Background: Low back pain (LBP) is a principal cause of disability, particularly among obese individuals. Hence, effective interventions are needed to cope pain and improve function in this population. Objective: To compare the effects of motor control exercise (MCE) combined with low-level laser therapy (LLLT) versus MCE combined with transcutaneous electrical nerve stimulation (TENS) on pain, range of motion (ROM), and functional disability in obese patients with LBP. Methods: This randomized controlled trial included (n= 60) obese patients with LBP, allocated into two groups. Group A received motor control exercise with LLLT, and Group B received MCE with TENS. Pain intensity was measured using the ‘Visual Analog Scale (VAS)’, lumbar ROM was assessed via the modified Schober test, and functional disability was evaluated using the Oswestry Disability Index (ODI). Measurements were taken before treatment and after a 4-week treatment period. Results: In Group A, ‘VAS scores decreased from M= 6.62, SD= 1.72 to M= 4.48, SD= 1.59; p.001.Lumbar flexion improved from M= 17.47, SD= 1.59 to M= 18.90, SD= 1.63; p.001. ODI scores decreased from M= 42.00, SD= 15.04 to M= 24.74, SD= 12.73; p.001’. In Group B, ‘VAS scores decreased from M= 7.27, SD= 1.57 to M= 5.27, SD= 1.57; p.001. Lumbar flexion improved from M= 17.10, SD= 0.92 to M= 18.93, SD= 0.98; p.001. The ODI score decreased from M= 49.18, SD= 14.12 to M= 20.22, SD= 12.15; p.001’. Concurrent significant improvements occurred in lumbar extension and side bending (right and left) in the both groups (p.001 for all comparisons). A mixed-design MANOVA was conducted to analyze the interaction between time (pre- and post-treatment) and group (Group A, Group B) on the dependent variables. The outcome was not a significant interaction effect, which indicates that the two treatments were equally effective: F(6, 53) = 0.45, p= 0.72, partial η²= 0.02. Conclusions: The combination of LLLT or TENS stimulation in patients with obesity-related low back pain did not affect the effects of MCE on ROM, functional impairment, and pain thresholds. Trial registration: NCT06545578