Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial

Abstract Background Therapeutic exercises are used in clinical practice for patients with low back pain (LBP). Core stabilization exercises can retrain the important function of local trunk muscles and increase the accuracy of the sensory integration process for stability of the spine in individuals with LBP. The aim of this study was to compare the effects of two different exercise regimes, Core stabilization exercises (CSE) and Strengthening exercise (STE), on proprioception, balance, muscle thickness and pain-related outcomes in patients with subacute non-specific low back pain (NSLBP). Methods Thirty-six subacute NSLBP patients, [mean age, 34.78 ± 9.07 years; BMI, 24.03 ± 3.20 Kg/m2; and duration of current pain, 8.22 ± 1.61 weeks], were included in this study. They were randomly allocated into either CSE (n = 18) or STE groups (n = 18). Exercise training was given for 30 min, three times per week, for up to 4 weeks. Proprioception, standing balance, muscle thickness of transversus abdominis (TrA) and lumbar multifidus (LM), and pain-related outcomes, comprising pain, functional disability and fear of movement, were assessed at baseline and after 4 weeks of intervention. Results The CSE group demonstrated significantly more improvement than the STE group after 4 weeks of intervention. Improvements were in: proprioception [mean difference (95% CI): − 0.295 (− 0.37 to − 0.2), effect size: 1.38, (p < 0.001)], balance: single leg standing with eyes open and eyes closed on both stable and unstable surfaces (p < 0.05), and percentage change of muscle thickness of TrA and LM (p < 0.01). Although both exercise groups gained relief from pain, the CSE group demonstrated greater reduction of functional disability [effect size: 0.61, (p < 0.05)] and fear of movement [effect size: 0.80, (p < 0.01)]. There were no significant adverse effects in either type of exercise program. Conclusion Despite both core stabilization and strengthening exercises reducing pain, core stabilization exercise is superior to strengthening exercise. It is effective in improving proprioception, balance, and percentage change of muscle thickness of TrA and LM, and reducing functional disability and fear of movement in patients with subacute NSLBP. Trial registration Thai Clinical Trial Registry (TCTR20180822001; August 21, 2018).

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Core Stabilization Exercise on the Lumbar Lordosis and Pelvic Inclination Among Chronic Nonspecific Low Back Pain Patients

Journal of Spine Practice (JSP) ◽

10.18502/jsp.v1i1.9778 ◽

2021 ◽

pp. 18

Author(s):

Leo R Athinaraj Antony Soundararajan

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Inclination Angle ◽

Functional Disability ◽

Low Back ◽

Stabilization Exercise ◽

Core Stabilization ◽

Pelvic Inclination ◽

Core Stabilization Exercise

Introduction: Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders and it is documented that >90% of the cases have no defined cause for pain, called nonspecific low back pain (NSLBP). Alteration in the joint position, abnormal posture, and impaired muscle recruitment may result in recurrent CLBP. Lumbar lordosis (LL) provides strength against the compressive forces of gravity and it also protects the posterior spinal ligament and acts as a shock absorber for vertical forces. Increased LL is considered as a reason for radiculopathy, facet pain, and postural pain. Spinal posture and pelvic position were analyzed and documented as altered in CLBP patients. Anatomically, the anterior and posterior tilt of the back and pelvis by the force of different muscles can alter the spinal curvature. Posterior pelvic tilt in a standing position can decrease the LL. The pelvic inclination is related to the lumbar curve, and both are related to the performance and length of the back and abdominal muscles. Therefore, in this study, we aimed to evaluate the effect of core stabilization exercise on pain intensity, functional disability, LL, and pelvic inclination in NSLBP. Methodology: A total of 63 patients aged between 20 and 60 years who met the selection criteria were included. All participants gave their written consent to participate in this study. Demographic data such as age, weight, height, and duration of the back pain were documented. Patients were asked to report their pain using the Visual Analogue Scale (VAS) and Disability in Roland Morris Disability Questionnaire (RMDQ). Exclusion criteria were participants with musculoskeletal disorders (osteoarthritis and rheumatoid arthritis) and a history of previous fractures and systemic diseases. DIERS Formetric 4D spine and posture analyzer were used to assess spinal alignment using the light-optical scanning method on the back of patient in standing position. Angle of LL: the angle formed by the apex of LL and the T12 and L5 spinous processes. Pelvic tilt is the orientation of the pelvis in respect to the thighbones and the rest of the body. Core stabilization exercises were given for 30 min, five days a week, for 12 sessions. Pre- and posttest values were documented and analyzed. Result: In this experimental study, we used Pearson’s correlation coefficient to find the correlation between LL and pelvic inclination angle and found a strong positive correlation (r = 0.76; P = 0.001). The study showed that core stabilization exercise for 12 weeks’ duration had statistically significant reduction in the pain intensity (p < 0.01), functional disability (p < 0.002), LL (p < 0.05), and pelvic inclination angle (p < 0.05) among patients with chronic NSLBP. Conclusion: From this research, we conclude that core stabilization exercises decrease the pain intensity, functional disability, LL, and pelvic inclination angle in patients with chronic NSLBP. Thus, evaluation of the lumbar curvature and pelvic inclination, and designing the appropriate exercise is recommended in the management of NSLBP.

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Effect of Core Stabilization Exercise for Non-Specific Low Back Pain among Athletes

International Journal of Clinical Inventions and Medical Science ◽

10.36079/lamintang.ijcims-0301.171 ◽

2021 ◽

Vol 3 (1) ◽

pp. 18-25

Author(s):

Mohd Yusof Baharuddin ◽

Muhammad Hafiz Kudri ◽

Siti Noor Azza Aminudin

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Relief ◽

Functional Disability ◽

Exercise Group ◽

Low Back ◽

Stabilization Exercise ◽

Core Stabilization ◽

General Exercise ◽

Core Stabilization Exercise

This study aimed to analyze the effect of core stabilization exercise compared to general exercise for non-specific low back pain among athletes. There were 16 athletes with non-specific low back pain participated in this study. They were divided randomly into two groups after the screening process: core stabilization exercise group (CSG) and general exercise group (GEG). They were required to finish three sessions per week for six weeks. The pre-test and post-test were recorded using the Numeric Rating Scale (NRS) and Oswestry Low Back Pain Disability Questionnaire (ODQ). The study revealed that the core stabilization exercise group is influential and has significant pain relief (p=0.000) and disability reduced (p=0.001) compared to the general exercise group after six weeks of intervention. This study demonstrated that core stabilization exercise is effective in reducing pain relief and reduce functional disability. Thus, prescribing core stabilization exercise may be beneficial to be used as therapeutic exercises for patients who suffer low back pain as it relieves pain and reduces functional disability.

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