The effectiveness of a simplified core stabilization program (TRICCS—Trivandrum Community-based Core Stabilisation) for community-based intervention in chronic non-specific low back pain

Abstract

BackgroundChronic low back pain is a common public health problem all over the world. Conservative therapy is prescribed as the initial treatment strategy in chronic low back pain. The cornerstone of conservatism in back care is core muscle strengthening. However, exercises prescribed for the purpose are manifold and some are not easily done by patients in Asian countries. We developed an easy to adhere exercise protocol for core stabilization and tested its effectiveness in south Indian population.MethodsProspective study of 73 patients with chronic low back pain (CLBP) who were subjected to Trivandrum Community-based Core Stabilisation protocol of treatment. The enrolled patients underwent initial Oswestry Disability Index (ODI) evaluation and Keele Start Back (KSB) questionnaire before starting the protocol. Back education was given, and the patient started on stratified exercise protocol. ODI assessment was done weekly. The trend in ODI changes and the factors determining them were assessed using ANOVA. The correlation of quantitative variables like age, initial ODI score, and KSB score with the rate of reduction of ODI was assessed using Pearson’s correlation. Cross-tabulations were done using the chi-square test. Parametric tests were used throughout the analysis as the quantitative study variables found to be linear. Multiple linear regression (for the quantitative outcome) and binary logistic regression (for the dichotomous outcome) were performed.ResultsMean (SD) of ODI score has reduced significantly from 43.4 (16.6) to 24.6 (17.1) over the period of 6 weeks (p value < 0.001). The trend in reduction of ODI scores was significantly more in KSB score less than or equal to 3 compared to KSB more than 3 even after adjusting for the general trend of decreasing ODI score over time. The reduction in ODI scores appeared to be low for advancing age (p = 0.468) and higher KSB scores (p = 0.001).ConclusionThe TRICCS protocol is effective in a community-based approach in achieving satisfactory outcomes in CLBP in a period of 6 weeks. Patients with high KSB scores may require cognitive intervention also.

Effekte akzentuierter sensomotorischer Reize bei chronischen Rückenschmerzpatienten – eine kontrollierte Pilotstudie

“…Insbesondere Patienten mit orthopädischen Erkrankungen weisen jedoch häufig erheblich eingeschränkte sensorische, beziehungsweise propriozeptive Qualitäten auf [9,10]. Daher sollten sensomotorische Belastungsreize insbesondere zur koordinativen Ansteuerung und neuromuskulären Stabilisierung des lumbosakralen Übergangs feste Bestandteile in der Therapie orthopädischer Schadensbilder sein [11,12]. Das Training an Kraftgeräten bietet den Patienten allerdings kaum Trainingsreize, die eine Schulung der Propriozeption erlauben [13].…”

Analysis of Sagittal Spinal Morphology and Function of Adolescents: A Cross-Sectional Study

“…Effective exercise methods for maintaining the strength and quality of the small muscle groups that contribute to the correct shape of the spine are lacking. Several studies have shown that the small muscle groups, especially the stable muscle groups in the core area of the body, are closely related to spine health [35][36][37]. This study showed poor small muscle strength among the participants, which may suggest that the coordinated development of the small and large muscles should be emphasized in future physical education reforms and adolescent health interventions.…”

Comparison of the Effects of Self-Myofascial Release and Combined Core Stabilization Exercises in Physiotherapy and Rehabilitation Students with Non-Specific Low Back Pain

“…Nevertheless, MFR combined with core exercise protocols has become quite prominent recently and studies had different protocols for comparison of the effectiveness of those interventions, such as "Core exercise versus MFR" or "MFR combined core exercises versus core exercises alone" (Meltzer et al, 2017). According to the recent systematic review, both MFR and MFR combined with other interventions seem to be effective in the management of NSLBP, yet there is no consensus between studies regarding MFR protocols, myofascial meridians, and study duration (Akhtar et al, 2017;Majeed A et al, 2019). To our best knowledge, there is no study conducted for the comparison of the effectiveness of SMFR combined with core exercises and SMFR alone on patients with NSLBP regarding pain intensity and FC.…”