Effectiveness of Core Stabilization Exercise and Routine Exercise Therapy in Treatment of Chronic Nonspecific Low Back Pain: A Randomized Controlled Clinical Trial

Abstract

Introduction: Low back pain (LBP) is one of the most primary complaint with which the patients consults their physical therapist. This is a frequent problem faced by the majority of people at some point in their lifetime. Economic burden of LBP is very considerable. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is a lack of research data and literature in effectiveness of different exercise therapies for chronic nonspecific low back pain in this part of world. Objective: This study was designed to compare the effectiveness of specific stabilization exercises with routine physical therapy exercises provided in patients with nonspecific chronic nonspecific low back pain. Methodology: This was a single blinded randomized controlled trial conducted at the department of physical therapy, Orthopedic and Spine Institute, Johar Town, Lahore in which 120 subjects with nonspecific chronic low back pain were recruited. Subjects with the age between 20 to 60 years and primary complaint of chronic low back pain were recruited after their informed consent. Subjects with spinal pathology, systemic illness or any other red flag signs were excluded from the study. Subjects were randomly allocated to 02 treatment groups A & B which were treated with core stabilization exercises and routine physical therapy exercises respectively. Transcutaneous Electric Nerve Stimulation (TENS) and ultrasound therapy were given as a baseline treatment to both treatment groups. Outcomes of the treatment were recorded on Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI) for disability and lumbar range of motion (ROM) (flexion & extension) pretreatment, at 2nd, 4th and 6th week post treatment. Results: The results of this study illustrate that clinical and therapeutic effects of core stabilization exercises program over the period of 6 weeks are more effective in terms of reduction in pain, disability and improvement in lumbar ROM (flexion and extension) compared to routine physical therapy exercises for similar duration. This study found that there was statistically significant difference in pain, disability and lumbar ROM across the two groups at 2nd, 4th and 6th week of treatment with p value less than 0.05. The mean reduction of pain was 3.05 ± 0.86 and 1.84 ± 1.05 across the core stabilization group and routine physical therapy exercise group respectively. Similarly the mean reduction in Oswestry disability index, lumbar flexion and lumbar extension was 39.39 ± 9.56 & 31.89 ± 10.12, 15.86 ± 4.20 & 9.10 ± 4.48, 10.56 ± 2.42 & 5.50 ± 1.27 across the core stabilization group and routine physical therapy exercise group respectively. Conclusion: From the results of this study it was concluded that core stabilization exercises were more effective than routine physical therapy exercises in terms of greater reduction in pain, disability and improvement in lumbar range of motion.