Stabilization Exercises versus Flexi-Bar Exercises in Chronic Non-Specific Low Back Pain: Pain, Disability, Back Muscles Endurance. A Randomized Controlled Trial

Abstract

Background. Low back pain (LBP) is one of the most prevalent and costly musculoskeletal problems. Impaired neuromuscular control and reduced use of the dorsal and abdominal muscles lead to instability in the spine and subsequent injury. Recently, vibration therapy has been proposed as an alternative method for LBP rehabilitation. Flexi-bar is a vibratory tool. When it is shaken, the core muscles are automatically activated to control the trunk against oscillatory forces created by the Flexi-bar. This study aimed to compare the efficacy of Flexi-bar and stabilization exercises in LBP rehabilitation. Methods. Thirty-eight patients were randomly assigned into Flexi-bar (n = 19) and stabilization (n = 19) groups. The Flexi-bar group received general physiotherapy and Flexi-bar exercises and the stabilization group received general physiotherapy and stabilization exercises. Both groups received treatment for 3 sessions per week, a total of 10 sessions. The outcome measures were Numeric Pain Rating Scale, Oswestry Disability Index, and Sorensen test. Results. After the intervention, both groups showed a significant improvement in pain, functional disability, and back muscles endurance (p < 0.05) however, no significant differences were found between the groups after treatment, while only back muscles endurance was significantly improved in the Flexi-bar group over the stabilization group (p < 0.001). Conclusions. Neither of the two exercise interventions wasn't superior in reducing pain and functional disability. However, the Flexi-bar group showed significant improvement in back muscles endurance over the stabilization group. Flexi-bar is recommended as an effective, portable, and cheap tool in LBP rehabilitation. Study registration. This study was registered in the Clinical Trial Center with no: IRCT20191015045122N1.

Effects of Core Stability Training on Muscle Physiology among Adults with Low Back Pain

“…One study was an excellent quality study, five studies were good quality studies, and two studies were fair quality studies. Ten studies, however, concluded that CST had no advantage over other exercise therapies in improving pain (Ahmadizadeh et al, 2020;Alp et al, 2014;Amiri et al, 2022;Areeudomwong & Buttagat, 2019;Bae et al, 2018;Franca et al, 2010;Nabavi et al, 2018;Salamat et al, 2017;Ulger et al, 2023;Wang et al, 2022). Three of the studies were excellent quality studies, six were good quality studies, and one was a fair quality study.…”

“…In terms of improving trunk muscular endurance, two good-quality studies showed that CST was more effective than other exercise therapies (Alp et al, 2014;Salik Sengul et al, 2021). However, two good-quality studies showed that CST was less effective than Flexibar exercise, walking exercise, and stabilization with walking (Amiri et al, 2022;Suh et al, 2019).…”