The Role of a Multi-Step Core Stability Exercise Program in the Treatment of Nurses with Chronic Low Back Pain: A Single-Blinded Randomized Controlled Trial

Abstract

Study DesignSingle-blinded randomized controlled trial.PurposeTo evaluate the effects of a multi-step core stability exercise program in nurses with chronic low back pain (CLBP).Overview of LiteratureCLBP is a common disorder among nurses. Considering that patient-handling activities predispose nurses to CLBP, core stability exercises suggested for managing CLBP in the general population may also be helpful in nurses. However, sufficient evidence is not available on whether a multi-step core stability exercise program affects pain, disability, quality of life, and the diameter of lateral abdominal muscles in nurses with CLBP.MethodsIn this single-blinded randomized controlled trial, 36 female nurses with CLBP were recruited. The sample was divided into two groups of 18 patients (intervention and control). Nurses in the intervention group performed core stability exercises for 8 weeks, based on a progressive pattern over time. Roland–Morris Disability Questionnaire (RDQ), quality of life (36-item Short Form Health Survey [SF-36]), ultrasound assessment of the diameter of lateral abdominal muscles, and Visual Analog Scale (VAS) score for pain were evaluated in the participants before and after the trial. Sixteen nurses (eight from each group) dropped out of the study, and analysis of covariance was used to compare outcomes for the remaining nurses in the intervention (10 nurses) and control (10 nurses) groups.ResultsThe results after the trial showed significant improvements in RDQ, SF-36, and VAS score in the intervention group compared with that in the control group (p <0.005). Furthermore, the ultrasound data showed a significant increase in the left and right muscle diameter of all three abdominal muscles during the abdominal drawing-in maneuver in the intervention group compared with that in the control group (p <0.05).Conclusions This study showed that a multi-step core stability exercise program is a helpful treatment option for improving quality of life and reducing disability and pain in female nurses with CLBP.

Comparison of the recruitment of transverse abdominis through drawing-in and bracing in different core stability training positions

“…On the basis of this, activation and strengthening of TrA have been suggested as possible therapeutic interventions in patients with low back pain (Panjabi, 1992;Selkow et al, 2017). The efficacy of these treatments has been shown in previous studies (Noormohammadpour et al, 2012;Noormohammadpour et al, 2018).…”

“…The rehabilitation approach toward low back pain usually includes core stability exercises to enhance the spinal stabilization (Hwangbo et al, 2015;Noormohammadpour et al, 2018). There are many proposed core stability exercises in variety of positions (supine, quadruped, etc.)…”

Meta-Analysis of Integrated Therapeutic Methods in Noninvasive Lower Back Pain Therapy (LBP): The Role of Interdisciplinary Functional Diagnostics

“…e global muscles participate in movements of the torso, while local muscles play an important stabilizing role. Stabilization training in patients with LBP reduces pain and instability as well as preventing relapses [133][134][135]. Hides et al described how cricket players suffering from LBP were subjected to stability training (multifidus, transverse abdominal and pelvic floor muscles) with the consequent decrease in pain [136].…”

Neuromuscular electrical stimulation associated with core stability exercises in nonspecific postural low back pain: a randomized clinical trial

“…Lumbar pain, also called low back pain (LBP), is the most common musculoskeletal disorder affecting the adult population.1 It has been recognized as one of the most debilitating conditions worldwide.1 It can also lead to high economic costs to society due to productivity losses caused by early retirement or low-quality work (1) Chronic low back pain has a high prevalence (reaching 84%), being characterized as lasting longer than 12 weeks.2 Despite its high prevalence, there are no specific causes for almost 85% of the cases, being denominated in these cases as nonspecific low back pain (2). In approximately half of them, pain is self-limited (1). Regarding the therapeutic approach to LBP, exercises have evolved over time, with specific emphasis on maintain-ing spine stability (3).…”

“…Regarding the therapeutic approach to LBP, exercises have evolved over time, with specific emphasis on maintain-ing spine stability (3). CORE muscle exercises improve lumbopelvic stability and can be included as part of prevention and clinical rehabilitation for patients with low back pain (1). CORE is a concept that describes the central part of the body, especially the thoracolumbar spine, pelvis, and hips (4).…”