A COMPARISON BETWEEN STABILIZATION EXERCISES AND STABILIZATION EXERCISES SUPPLEMENTED WITH NEUROMUSCULAR ELECTRICAL STIMULATION IN PATIENTS WITH CHRONIC LOW BACK PAIN: A PHASE I RANDOMIZED CONTROLLED TRIAL

Impaired motor control and atrophy of paraspinal muscles are commonly associated with chronic low back pain (LBP). Such impairments are treated with lumbar stabilization exercises aimed at creating muscular support for the lumbar spine, reducing pain and improving function. However, stabilization exercises are reported to have a limited long-term effect on pain and function. This limitation suggests that stabilization exercises alone may not activate the paraspinal muscles sufficiently. Thus, enhancement of the stabilization exercise effect on paraspinal muscle function may be warranted. The two aims of this study are: 1) to investigate the potential effectiveness of neuromuscular electrical stimulation (NMES) as a supplement to stabilization exercise in people with chronic LBP; and 2) to report on the tolerability of NMES when applied to paraspinal muscles. We conducted a phase I randomized controlled trial on 30 subjects with chronic LBP. Subjects were randomized into either a stabilization exercise group (n = 15) or a stabilization exercises plus NMES group (n = 15). Both groups received treatment twice a week for 6 weeks. Subjects were assessed pre- and post-treatment using the following outcome measures: the Modified Oswestry Disability Questionnaire (MODQ), the Numeric Pain Rating Scale (NPRS), the Fear-Avoidance Behavior Questionnaire, paraspinal muscle strength, and a NMES tolerability scale. Subjects in both group were followed up 4 weeks after the end of the last treatment and assessed with the MODQ and NPRS. The mixed analysis of variance shows that subjects in both groups significantly improved from baseline to post-intervention at 6 weeks on all outcome measures (p .05). All subjects in the stabilization plus NMES group found that the NMES was tolerable. This phase I trial suggests that the application of NMES on the paraspinal muscles is tolerable. Future trials are necessary to determine the NMES usefulness as a supplement to stabilization exercise in treating chronic LBP

Assessing Physical Therapy Knowledge amongst the New Graduates in Saudi Arabia: Competency Examination across the Nation

Given the increasing demand for more trained physical therapists in providing care to patients in Saudi Arabia, it has become vital to adequately assess individual physical therapy graduate academic learning and performance. Therefore, the present study aimed at evaluating the knowledge and skills of Saudi PT graduates. A competency examination adapted from a practice test that is commercially available and simulates the National Physical Therapy Examination (NPTE) was conducted. Out of 398 Saudi physical therapists that were approached with the examination link, 149 PT graduates consented to the study. Seventy questions were randomly selected by two individuals familiar with the content of PT programs in the United States and Saudi Arabia. The content outline of the selected questions followed the NPTE recommendations for body systems and non-systems. Each question was multiple choice with four answers. The examination was distributed electronically. Each participant was given 90 min to complete the examination. The passing score was set at 55%. Out of 149, only 6six (4.02%) participants passed the examination with an average passing score of 67% (range: 56–96%). In the primary domains of body systems, the score was highest in the endocrine domain (55.1%), followed by the integumentary (42.18%) and the neurology (40.9%) domains. In the non-system, participants had the highest score in the professionalism domain (89.8%). The highest mean knowledge score was obtained in the field of assessment (38.57%). PT graduates from Saudi Arabia performed poorly in the examination, demonstrating weak domain knowledge and skills