LBP
Conditions
Keywords
Exercise therapy, LBP, Disability
Brief summary
Background: Low back pain (LBP) is a leading cause of disability, often requiring primary care management. Objective: To compare the effectiveness of isometric versus isotonic exercise programs for LBP. Methods: Sixty adults with LBP were randomly assigned to two groups. Group A (n=30) performed isometric exercises, infrared therapy, and TENS. Group B (n=30) performed isotonic exercises with the same adjunct therapies. Pain (VAS), disability (MODI), and abdominal endurance were measured pre- and post-intervention. Keywords: Exercise therapy; low back pain; disability evaluation
Detailed description
Group-Specific Exercise Protocols: * Isometric Exercise Group (IEG): This group performed a circuit of three core-stabilizing isometric exercises, each held for 10 seconds with brief rest intervals, for 5 complete repetitions. The exercises included: (a) Isometric Curl-Up, (b) Side Bridge, and (c) Bird Dog. The total dedicated exercise time was approximately 20 minutes per session. * Isotonic Exercise Group (ITG): This group performed a circuit of three dynamic, strength-oriented isotonic exercises, each completed for 10 repetitions. The exercises included: (a) Bent Knee Sit-Up, (b) Cross Curl-Up, and (c) Prone Back Extension. The total dedicated exercise time was also approximately 20 minutes per session. All exercises were selected and adapted from previously published rehabilitation protocols for CLBP \[13\]. Adjunctive Therapies (Common to Both Groups): 1. Infrared (IR) Therapy: A standard therapeutic infrared lamp was positioned 50 cm from the participant's lumbar spine at a 90-degree angle. Heat was applied for 15 minutes per session to promote muscle relaxation and local blood flow. 2. Transcutaneous Electrical Nerve Stimulation (TENS): Electrodes were placed over the painful lumbar area. A low-frequency (\<10 Hz) TENS unit was applied for 20 minutes per session. The analgesic mechanism of TENS is well-documented, involving the modulation of pain pathways via opioid and noradrenergic receptors in the central nervous system \[16\]. Both groups received a standardized four-week intervention program, consisting of three supervised sessions per week, totaling 12 sessions. Each 55-minute session included adjunctive therapies common to both groups, followed by the specific exercise protocol.
Interventions
OTHERIsometric exercises
• Isometric Exercise Group (IEG): This group performed a circuit of three core-stabilizing isometric exercises, each held for 10 seconds with brief rest intervals, for 5 complete repetitions. The exercises included: (a) Isometric Curl-Up, (b) Side Bridge, and (c) Bird Dog. The total dedicated exercise time was approximately 20 minutes per session.
OTHERIsotonic exercises
• Isotonic Exercise Group (ITG): This group performed a circuit of three dynamic, strength-oriented isotonic exercises, each completed for 10 repetitions. The exercises included: (a) Bent Knee Sit-Up, (b) Cross Curl-Up, and (c) Prone Back Extension. The total dedicated exercise time was also approximately 20 minutes per session. All exercises were selected and adapted from previously published rehabilitation protocols for CLBP \[13\].
Sponsors
Palestine Ahliya University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Intervention model description
Group A: Isometric Exercises Group B: Isotonic Exercises
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 60 years; * Diagnosis of non-specific CLBP, defined as pain localized between the lower rib margin and the gluteal folds persisting for more than three months; * Self-reported pain intensity score between 40 mm and 80 mm on a 100-mm Visual Analogue Scale (VAS), indicating moderate to severe pain; * Pain experienced on at least three days in the month preceding enrollment, with documented interference in daily activities; * A formal referral for physiotherapy management.
Exclusion criteria
* The presence of "red flag" pathologies (e.g., spinal tumor, infection, fracture); - Neurological signs or symptoms suggestive of radiculopathy or myelopathy; * a history of spinal surgery or epidural steroid injections within the previous 12 months; * Systemic inflammatory diseases (e.g., rheumatoid arthritis) or major neurological disorders; * Pregnancy; * Receipt of physiotherapy for low back pain within the last six months; * Current use of non-steroidal anti-inflammatory drugs (NSAIDs) or inability to refrain from their use during the study period; * Any diagnosed psychiatric condition.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| VAS | 4 WEEKS | Measured using a 100-mm Visual Analogue Scale , where 0 mm represents "no pain" and 100 mm represents "the worst pain imaginable." Participants marked a point on the line corresponding to their current pain level. The Arabic version of the VAS has been validated as a reliable and responsive tool for pain assessment in clinical populations \[17\]. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| MODI | 4WEEKS | This self-administered questionnaire contains 10 items addressing various aspects of daily life (e.g., pain intensity, personal care, lifting, walking). Each item is scored from 0 to 5, with the total sum converted to a percentage (0-100%); higher scores indicate greater disability. The MODI is a gold-standard tool with demonstrated high reliability, validity, and sensitivity to clinical change in patients with low back pain \[18\]. |
| Muscular Endurance | 4WWEKS | Assessed via a standardized Abdominal Endurance Test. Participants were instructed to hold a partial curl-up position (trunk elevated at 30° from the plinth) for as long as possible while maintaining proper form. The time in seconds until failure was recorded. This test is a validated and reliable measure of core muscular endurance, a key component of lumbar stability \[19\]. |
Countries
Palestinian Territories
Outcome results
None listed