Comparison of Core Stability Exercises with Williams’ Flexion Exercises in Patients with Non-Specific low back pain

Abstract

Low back pain is the most common complaint experienced by the majority of people at some point in their lifetime. Physical therapy has been in favor of effective treatment and prevention of low back pain. However, there is a lack of agreement on the best exercise treatment and abundant studies are in progress. Categorical studies are lacking particularly in this part of the world. This study was designed to compare the effectiveness and efficiency of two specific exercises, core stability exercises with Williams’ flexion exercises, in patients with non-specific low back pain. Objective:The objective of this study was to find out the most effective treatment for patients with non-specific low back pain Methods: This study is a single-blinded randomized clinical trial that was conducted in the physiotherapy outdoor patient department of the public hospital, Jinnah Hospital Lahore (JHL). 20 patients with non-specific low back pain were randomly allocated in two treatment groups, 10 in A (core stability exercises) and 10 in B (Williams’ flexion exercises), after giving informed consent. The conventional treatment of low back pain. e.g. Hot or cold pack, electrotherapeutic modalities was given to the patients of both groups along with their specialized group treatment. The visual analog scale (VAS) and Modified Oswestry Low Back Pain Disability Questionnaire were used before treatment and after the third treatment session during the period of one to two weeks to measure outcomes. The independent samples T-test was used for data analysis. A P-value <0.05 was considered statistically significant Results: The results of this study illustrated that there is a significant difference between the two groups in clinical and therapeutic effect in the reduction of pain as the P-value is <0.05. While the results in the reduction of pain-related disability, measured by the Modified Oswestry Low Back Pain Disability Questionnaire, were not significant as P-value >0.05(P= 0.184). Conclusions: The study indicates that core stability exercises are more effective than Williams’ flexion exercises for the reduction of non-specific low back pain except for a reduction in pain-related disability.

Perbedaan Pengaruh Core Stability Exercise Dan William’s Flexion Exercise Terhadap Penurunan Nyeri Pada Penderita LBP Myogenic

“…Hal tersebut dapat menimbulkan pemendekan otot sehingga terjadi spasme otot yang dapat menyebabkan nyeri pada punggung bawah. Spasme otot yang berkepanjangan dapat menyebabkan atrofi otot sehingga menimbulkan penurunan kekuatan otot yang akan berdampak pada penurunan stabilitas lumbal dan penurunan aktivitas seseorang (Noor, 2016) Penanganan untuk menurunkan nyeri LBP myogenic dapat menggunakan intervensi core stability exercise (CSE) dan william's flexion exercise (WFE), karena menurut penelitian yang dilakukan oleh Zahoor et al (2021), Akhtar et al (2017), Sari et al (2019, serta Wijayanti (2019) core stability exercise dan william's flexion exercise terbukti dapat menurunkan nyeri pada penderita LBP myogenic.…”

“…Terdapat penelitian yang membandingkan intervensi core stability exercise dan william's flexion exercise pada pasien chronic low back pain. Penelitian ini menunjukkan CSE lebih baik daripada WFE dalam menurunkan tingkat nyeri punggung bawah kronis (Zahoor et al, 2021). Penelitian oleh Wijayanti (2019) yang juga membandingkan intervensi core stability exercise dan william flexion exercise pada kuli panggul beras di daerah Masaran, Sragen menunjukkan bahwa CSE dan WFE sama baiknya dalam menurunkan nyeri punggung bawah.…”

“…Proses peregangan daerah lumbal menyebabkan otot menjadi rileks yang disebabkan karena penguluran pada golgi tendon dan muscle spindle sehingga spasme otot akan menurun. Dengan menurunnya spasme otot maka nyeri punggung bawah akan berkurang (Kisner, 2007) Hasil penelitian ini sejalan dengan penelitian yang dilakukan oleh Zahoor et al (2021). Latihan ini merupakan latihan yang mengaktivasi otototot trunk bagian dalam (core).…”

“…Latihan ini berdampak terhadap stabilitas otot trunk serta postural untuk menopang beban tubuh serta koaktivasi dan koordinasi antar otot yang sinergis menyebabkan beban kerja atau tegangan otot tidak berpusat pada otot tertentu saja. Sedangkan pada william's flexion exercise lebih mengutamakan gerakan penguluran pada otot punggung bawah dan gluteus sehingga kurang optimalnya beban kerja otot abdominal (core) (Zahoor et al, 2021).…”