Efficacy of core stabilization program and conventional exercises in low back pain

Authors

  • Arvind Kumar Department of Physical Medicine and Rehab, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Vivek Gupta Institute of Paramedical Sciences, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Mansoor A. Khan Department of Physical Medicine and Rehab, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Harshika Srivastava Department of Physical Medicine and Rehab, King George’s Medical University, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20233466

Keywords:

Core stabilization exercise, Nonspecific chronic low back pain, Routine physical therapy exercise, Ultrasound

Abstract

Background: Patients experiencing low back pain (LBP) often benefit from therapeutic exercise. These exercises can retrain trunk muscles and improve spinal stability and sensory integration. Consequently, we aimed to compare the efficacy of a core stabilization program and conventional exercises in low back pain.

Methods: This prospective, comparative study comprised 192 subjects aged 20-60 with nonspecific chronic low back pain (NSLBP). Core stabilization or usual physical therapy activities were randomly assigned to groups C or R. Both treatment groups received TENS and ultrasound therapy. Pretreatment, second, fourth, and sixth-week post-treatment outcomes were documented using a visual analogue scale (VAS).

Results: Both groups were female-dominated. Height, weight, and BMI were comparable. At baseline, group C had a mean VAS score (5.69±1.80), while group R had (5.52±1.42). P value 0.4684 indicates no significant difference between exercise groups. At the final assessment, group C had a considerably (p<0.0001*) lower mean VAS score (2.96±0.39) than group R (3.89±0.98). Group C had a substantially higher mean VAS score change from baseline to the final evaluation (-2.73±0.51) than group R (-1.18±0.79).

Conclusions: Core stabilization exercise is more effective than routine physical therapy exercise in terms of greater reduction in pain in chronic NSLBP.

References

Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968-74.

Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arth Rheum. 2012;64(6):2028-37.

Shetty GM, Jain S, Thakur H, Khanna K. Prevalence of low back pain in India: a systematic review and meta-analysis. Work. 2022;(Preprint):1-24.

Deyo RA, Weinstein JN. Low back pain. N Engl J Med. 2001;344(5):363-70.

Ehrlich GE. Low back pain. Bull World Health Organ. 2003;81(9):671–6.

Tong MH, Mousavi SJ, Kiers H, Ferreira P, Refshauge K, van Dieën J. Is there a relationship between lumbar proprioception and low back pain? A systematic review with meta-analysis. Archives of physical medicine and rehabilitation. 2017;98(1):120-36.

Brumagne S, Diers M, Danneels L, Moseley GL, Hodges PW. Neuroplasticity of sensorimotor control in low back pain. J Orthop Sports Phys Ther. 2019;49(6):402-14.

Hides JA, Stokes MJ, Saide MJ, Jull GA, Cooper DH. Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine. 1994;19(2):165-72.

Vleeming A, Schuenke MD, Danneels L, Willard FH. The functional coupling of the deep abdominal and paraspinal muscles: the effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia. J Anat. 2014;225(4):447-62.

França FR, Burke TN, Hanada ES, Marques AP. Segmental stabilization and muscular strengthening in chronic low back pain-a comparative study. Clinics. 2010;65(10):1013-7.

Shamsi M, Sarrafzadeh J, Jamshidi A, Arjmand N, Ghezelbash F. Comparison of spinal stability following motor control and general exercises in nonspecific chronic low back pain patients. Clin Biomech. 2017;48:42-8.

Schaeffer RL, Mendenhall W, Ott L. Elementary Survey Sampling. 4th edn. Duxbury Press: Belmont, California; 1990.

Shetty GM, Jain S, Thakur H, Khanna K. Prevalence of low back pain in India: A systematic review and meta-analysis. Work. 2022;73(2):429-52.

Kelly A. The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J. 2001;18(3):205-7.

Areeudomwong P, Puntumetakul R, Jirarattanaphochai K, Wanpen S, Kanpittaya J, Chatchawan U, et al. Core stabilization exercise improves pain intensity, functional disability and trunk muscle activity of patients with clinical lumbar instability: a pilot randomized controlled study. J Phys Ther Sci. 2012;24(10):1007-12.

Koumantakis GA, Watson PJ, Oldham JA. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther. 2005;85(3):209-25.

O’Sullivan PB, Phyty GD, Twomey LT, Allison GT. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997;22(24):2959-67.

Cholewicki J, Juluru K, Radebold A, Panjabi MM, McGill SM. Lumbar spine stability can be augmented with an abdominal belt and/or increased intra-abdominal pressure. Eur Spine J. 1999;8:388-95.

Costa LO, Maher CG, Latimer J, Hodges PW, Herbert RD, Refshauge KM, et al. Motor control exercise for chronic low back pain: a randomized placebo-controlled trial. Phys Ther. 2009;89(12):1275-86.

Hlaing SS, Puntumetakul R, Khine EE, Boucaut R. 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. BMC Musculoskel Disord. 2021;22(1):1-3.

Kong YS, Jang GU, Park S. The effects of prone bridge exercise on the Oswestry disability index and proprioception of patients with chronic low back pain. J Phys Ther Sci. 2015;27(9):2749-52.

Byström MG, Rasmussen-Barr E, Grooten WJ. Motor control exercises reduces pain and disability in chronic and recurrent low back pain: a meta-analysis. Spine. 2013;38(6):E350-8.

Downloads

Published

2023-10-31

How to Cite

Kumar, A., Gupta, V., Khan, M. A., & Srivastava, H. (2023). Efficacy of core stabilization program and conventional exercises in low back pain. International Journal Of Community Medicine And Public Health, 10(11), 4298–4302. https://doi.org/10.18203/2394-6040.ijcmph20233466

Issue

Section

Original Research Articles