Effect of Motor Control Exercise Combined With Laser Or TENS on Pain, Range of Motion, and Functional Disability on Obese Patients With Low Back Pain

The Low-level laser (LLL) pain-relief instrument RG-300IB (code E22), manufactured in China, was utilized for low-level laser therapy (LLLT) in Group A . The therapy employed a wavelength of 830 nm (near infrared) and involved careful skin contact hygiene at specified positions, 2.5 and 3.5 cm laterally from the spinous process (L4, L5, or S1) and one distal level segment. The laser operated at a repetition rate of 5,000, with a power density of 300 mW/cm2 and a power output of 10 mW. Each point received 3 J of energy, resulting in a density of 3 J/cm2, with four points. The spot size was 1 cm, and each point received a 30-second treatment. The energy was administered three times per week for four weeks

TENS Intelect Advanced device (Chattanooga, Mouguerre, France). The parameters for TENS stimulation included a frequency range of 60-80 Hz, a pulse width of 50-80 ms, and an intensity of 10-30 mA. Before commencing therapy, patients were provided information regarding the therapeutic approach and any potential adverse effects. During the procedure, two channels (four electrodes) were employed, with one set placed on the right and one on the left paraspinal muscles at the level of L2-L4. Active electrodes from the other channels were affixed 1.5 cm laterally to the spine, while passive electrodes were positioned 3 cm away. TENS therapy was utilized for 30 minutes in Group B, and the intensity of the pain and discomfort was adjusted to the patient's tolerance level.

Training in coordinated trunk muscle action, including decreasing overactive superficial muscles and independent activation of deep muscles (such as transversus abdominis and multifidus). Exercises for the pelvic floor muscles, controlling respiration, and regulating the position and movement of the spine were added to these exercises.