The Effect of Core Stability Exercises Combined With Abdominal Hollowing on Postural Balance in Patients With Non-specific Chronic Low Back Pain: A Randomized Controlled Trial

Abstract

Purpose: Altered movement patterns and spine instability are crucial factors in the etiology of chronic non-specific low back pain (CNSLBP). The faulty recruitment pattern of core muscles causes poor support and increased loading on the lumbar spine, ultimately leading to postural instability. This study aims to examine the effect of core stability exercises (CSE) combined with abdominal hollowing (AH) on postural balance in patients with CNSLBP. Methods: The present study is a double-blind clinical trial. Thirty women with CNSLBP were recruited for the clinical trial. Patients were randomly assigned to experimental and control groups (15 patients in each group). The experimental group followed CSE with AH for 8 weeks. The control group received no intervention. Primary outcomes included pain (10 cm visual analogue scale), disability (Oswestry questionnaire), and proprioception (goniometer). Secondary outcomes included static and dynamic balance (biodex balance system). Analysis of covariance (ANCOVA) was used to compare the results and confidence intervals between groups. Results: The experimental group compared to the control group with a high effect size had a significant difference in reducing pain (P=0.021, ηp2=0.183), disability (P=0.007, ηp2=0.237), and postural reconstruction error (P=0.000, ηp2=0.566). Also, the experimental group compared to the control group with a high effect size had a significant difference in the improvement of static (P=0.008, ηp2=0.367) and dynamic balance (P=0.008, ηp2=0.757). Conclusion: The CSE combination with AH affects three active, passive, and nervous systems. It seems that the CSE combination with AH can modify the faulty movement control in local muscles, proprioception restoration, and subsequently lead to postural stability.