Effects of core stability with dynamic stretching in addition to routine physical therapy in patients with chronic low back pain: a randomized controlled trial
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Abstract
OBJECTIVE: To evaluate the effects of core stability with dynamic stretching along with routine physical therapy in patients with chronic low back pain (CLBP).
METHODS: This randomized controlled trial at Government Mian Munshi Hospital, Lahore, Pakistan, enrolled 48 participants with CLBP. After obtaining consent, participants were randomly assigned through lottery method to Group-A (routine physical therapy) or Group-B (routine physical therapy plus core stability exercises and dynamic stretching). Pain, range of motion (ROM), and physical disability were evaluated at pretreatment, and at 2nd, 4th, and 6th weeks post-treatment using Numeric Pain Rating Scale (NPRS), a goniometer, and Oswestry Disability Index (ODI), respectively.
RESULTS: Baseline characteristics were comparable between groups. Group-A had a mean age of 37.42±3.96 years and a mean BMI of 23.05±3.83 kg/m². Group-B had a mean age of 41.67±4.86 years and a mean BMI of 23.58±3.28 kg/m². In Group-A, the NPRS scores improved from 5.00 (4.00-7.00) to 4.00 (2.00-5.00) (p <0.001), and ODI scores improved from 40.0 (24.0-48.0) to 34.0 (14.0-35.0) (p <0.001). Flexion improved from 49.88 ± 6.955 to 53.79 ± 6.750 (p <0.001). In Group-B, the NPRS scores improved from 6.00 (4.00-7.00) to 2.80 (1.60-4.00) (p <0.001), and ODI scores improved from 46.0 (35.0-50.0) to 21.0 (30.1-28.0) (p <0.001). Flexion improved from 43.46±7.718 to 57.92±1.840 (p <0.001).
CONCLUSION: Integrating core stability exercises and dynamic stretching alongside routine physical therapy significantly improved pain intensity, physical disability, and ROM in patients with CLBP. These findings emphasize the potential benefits of these modalities as valuable adjuncts in managing CLBP.
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References
Popescu A, Lee H. Neck pain and lower back pain. Med Clin North Am 2020;104(2):279-92. https://doi.org/10.1016/j.mcna.2019.11.003
Malik KM, Nelson AM, Chiang TH, Imani F, Khademi SH. The specifics of non-specific low back pain: re-evaluating the current paradigm to improve patient outcomes. Anesth Pain Med 2022;12(4). https://doi.org/10.5812/aapm-131499
Delport E. The perspectives of Occupational Health Nurse Practitioners, employed at a National Retail Company in South Africa, regarding their management of employees with Low Back Pain. 2022. [Accessed on: January 20, 2024]. Available from URL: https://scholar.sun.ac.za/server/api/core/bitstreams/13de7c9a-22d8-42a2-90ed-632102dfb734/content
Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ, Ostelo RW, Guzman J, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ 2015;350:h444. https://doi.org/10.1136/bmj.h444
Wahyuni W, Kurnia NE. The effectiveness of core stability exercises on pain in patients with low back pain: a meta-analysis. Phys Ther J Indones 2023;4(1):85-90. https://doi.org/10.51559/ptji.v4i1.86
Frizziero A, Pellizzon G, Vittadini F, Bigliardi D, Costantino C. Efficacy of core stability in non-specific chronic low back pain. J Funct Morphol Kinesiol 2021;6(2):37. https://doi.org/10.3390/jfmk6020037
Chan EWM, Adnan R, Azmi R. Effectiveness of core stability training and dynamic stretching in rehabilitation of chronic low back pain patient. Malays J Mov Health Exerc 2019;8(1):1-13. http://dx.doi.org/10.15282/mohe.v8i1.210
Isa ILM, Teoh SL, Nor NHM, Mokhtar SA. Discogenic low back pain: anatomy, pathophysiology and treatments of intervertebral disc degeneration. Int J Mol Sci 2022;24(1):208. https://doi.org/10.3390/ijms24010208
Kulig K, Powers CM, Landel RF, Chen H, Fredericson M, Guillet M, et al. Segmental lumbar mobility in individuals with low back pain: in vivo assessment during manual and self-imposed motion using dynamic MRI. BMJ Musculoskelet Disord 2007;8:1-10. https://doi.org/10.1186/1471-2474-8-8
Woods K, Bishop P, Jones E. Warm-up and stretching in the prevention of muscular injury. Sports Med 2007;37(12):1089-99. https://doi.org/10.2165/00007256-200737120-00006
Hodges PW, Danneels L. Changes in structure and function of the back muscles in low back pain: different time points, observations, and mechanisms. J Orthops Sports Phys Ther 2019;49(6):464-76. https://doi.org/10.2519/jospt.2019.8827
Seif HE, Alenazi A, Hassan SM, Kachanathu SJ, Hafez AR. The effect of stretching hamstring, gastrocnemius, iliopsoas and back muscles on pain and functional activities in patients with chronic low back pain: a randomized clinical trial. Open J Ther Rehabil 2015;3(04):139-45. http://dx.doi.org/10.4236/ojtr.2015.34019
Büyükturan B, Şaş S, Kararti C, Büyükturan ÖJMS, Practice. The effects of combined sternocleidomastoid muscle stretching and massage on pain, disability, endurance, kinesiophobia, and range of motion in individuals with chronic neck pain: A randomized, single-blind study. Musculoskelet Sci Pract 2021;55:102417. https://doi.org/10.1016/j.msksp.2021.102417
Krause F, Niederer D, Banzer W, Vogt L. Medical exercise and physiotherapy modes and frequency as predictors for a recurrence of chronic non-specific low back pain. J Back Musculoskelet Rehabil 2021;34(4):665-70. https://doi.org/10.3233/bmr-200149
Waqqash E, Adnan R, Md Yusof S, Sulaiman N, Ismail SI, editors. Efficacy of core stability exercise and muscular stretching on chronic low-back pain. Proceedings of the International Colloquium on Sports Science, Exercise, Engineering and Technology 2014 (ICoSSEET 2014); 2014:431-9. http://dx.doi.org/10.1007/978-981-287-107-7_45
Baard ML, Pietersen J, van Rensburg SJ. Interventions for chronic low back pain: whole body vibration and spinal stabilisation. S Afr J Sports Med 2011;23(2):35-9. https://doi.org/10.17159/2078-516X/2011/v23i2a343
Bibi M, Shah A. Comparing the efficacy of core stability exercises and conventional physical therapy in the management of lower back pain: a randomized controlled trial. Northwest J Med Sci 2023;2(1)13-7.
Brayjani SJ, Daneshmandi H. A review of the effect of core stability exercises on pain and functional disability in people with non-specific chronic low back pain. J Paramed sci Rehabil 2021;10(1):108-18. https://doi.org/10.22038/jpsr.2021.54766.2209
Nambi G, Abdelbasset WK, Alqahtani BA, Alrawaili SM, Abodonya AM, Saleh AK. Isokinetic back training is more effective than core stabilization training on pain intensity and sports performances in football players with chronic low back pain: a randomized controlled trial. Medicine (Baltimore) 2020;99(21):e20418. https://doi.org/10.1097/md.0000000000020418
Sengul YS, Yilmaz A, Kirmizi M, Kahraman T, Kalemci OJ. Effects of stabilization exercises on disability, pain, and core stability in patients with non-specific low back pain: A randomized controlled trial. Work 2021;70(1):99-107. https://doi.org/10.3233/wor-213557
Buttagat V, Techakhot P, Wiriya W, Mueller M, Areeudomwong P. Effectiveness of traditional Thai self-massage combined with stretching exercises for the treatment of patients with chronic non-specific low back pain: A single-blinded randomized controlled trial. J Bodyw Mov Ther 2020;24(1):19-24. https://doi.org/10.1016/j.jbmt.2019.03.017