Chronic Non-Specific Low Back Pain
Conditions
Keywords
Chronic low back pain, Core strengthening, Dynamic exercise, Traditional exercise, Physiotherapy, Lumbar stability, Rehabilitation
Brief summary
This research investigated the effectiveness of two different types of core strengthening exercises: dynamic versus traditional exercises. The participants comprised of individuals aged between 20-50 years, who have been suffering from chronic nonspecific low back pain for more than 12 weeks. The sample comprised of 70 participants, who were divided into two groups using random sampling. Group 1 performed dynamic core strengthening exercises, while Group 2 performed traditional core strengthening exercises. These two groups received routine physiotherapy, and were treated three times a week for a period of 8 weeks. The pain, back-related disability and assessment of lumbosacral stability was performed at the start and 8 weeks after the treatment using the Visual Analogue Scale, the Roland-Morris Disability Questionnaire and the Prone Instability Test, respectively. The aim of the study was to find out which of the two core strengthening exercise programs offered the participants more pain relief, and more improvement in lumbosacral stability and back-related disability.
Detailed description
Chronic non-specific low back pain can limit mobility and function in daily life. Core strengthening is often a component included in rehabilitation practices. Dynamic and traditional core strengthening methodologies can differ, however, their effectiveness when used in rehabilitation is comparably untested. The effects of dynamic and traditional core strengthening on pain, disability and lumbar stability were the primary focuses of this study. In this module, we describe results from an open-label, randomised, two-arm, parallel-group, superiority trial on 70 adults from the general population. An equal number of participants in the two arms of the study (dynamic versus traditional core strengthening) was also offered routine physiotherapy. Each intervention was delivered three times a week for eight weeks. All participants were assessed for pain, disability and lumbar stability at baseline and at week 8. The assessments used were the Visual Analogue Scale, the Roland-Morris Disability Questionnaire and the Prone Instability Test. Analyses were conducted to determine differences between the study arms and assess clinically meaningful changes.
Interventions
BEHAVIORALRoutine Physiotherapy
Routine physiotherapy included 10 minutes of lumbar heat application, static calf stretching, unilateral knee-to-chest exercise, pain-free straight-leg raises, and cross-leg stretching. This was provided prior to the scheduled core strengthening exercises.
BEHAVIORALDynamic Core Strengthening Exercises
Participants were required to maintain trunk stability while executing progressive alternate and opposite upper and lower limb movements. These exercises, done in a four-point kneeling position, were repeated in three sets of one-minute duration with one-minute interval rests. This treatment was applied three times a week for two months.
BEHAVIORALTraditional Core Strengthening Exercises
The participants performed progressive bridging and straight leg raising exercises. They performed each exercise in sets of three and rested for one minute between sets. This treatment was delivered three times a week for a duration of eight weeks.
Sponsors
University of Lahore
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
Considering the evident differences between the dynamic exercise and the traditional exercise programmes, the participants, treating physiotherapists, investigators, and outcome assessors, could not be masked. Thus, the study was an open-label, two-arm, parallel-group randomized clinical trial.
Intervention model description
This study was implemented as a two-arm, parallel-group, 1:1, randomised superiority trial. Dynamic core strengthening plus routine physiotherapy, and traditional core strengthening plus routine physiotherapy were the two alternatives offered to participants. There were 24 visits scheduled for all participants, due to the eight-week duration and frequency of three visits per week. Each therapy session was allotted 35 to 40 minutes.
Eligibility
Sex/Gender
ALL
Age
20 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Age between 20-50 * Chronic non-specific low back pain for more than 12 weeks * Male or female * Voluntary participation with a signed informed consent * Ability to follow instructions of the prescribed exercises
Exclusion criteria
* Low back pain with a specific cause (i.e. fracture, tumor, infection, or back pain due to other inflammatory diseases) * History of any spinal surgery * Presence of severe neurological deficits * Pregnancy * Presence of severe cardiovascular or systemic diseases * Cognitive impairment or inability to perform the prescribed exercises and follow instructions safely
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale | Baseline and week 8 | Pain intensity was scaled using a 10-centimeter Visual Analog Scale ranging from 0 (no pain) to 10 (extreme pain). Pain is linearly proportional to pain score, and so, change from baseline was assessed for week 8, and a pain score move in the direction of decreasing pain was considered a clinically significant score change in the direction of decreasing pain if the score decreased by at least 2 centimeters to the left on the scale. |
| Roland-Morris disability questionnaire | Baseline and week 8 | The 24-item Roland-Morris Disability Questionnaire was used for the evaluation of back-related disability with a score ranging from 0 to 24 with 24 indicating the highest disability. Roland-Morris scores from baseline to week 8 were analyzed for this study. It was determined a decrease of 3.5 or more points was clinically significant. |
| Prone instability test | Baseline and week 8 | Results were positive for lumbar instability or negative for lumbar stability based on the Prone Instability Test. Progressive changes in lumbar stability by way of test results taken at baseline and again at 8 weeks were examined. |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORWaqar ul Hassan, MS MSK
University of Lahore
Outcome results
None listed