To compare the effects of pelvic control training using pressure biofeedback with core stability training on pain, range of motion, muscle strength, and functional disability in patients with non specific low back pain
A randomized controlled trial compared core stabilization exercises with routine exercise therapy in patients with chronic nonspecific low back pain. Participants were randomly allocated into two groups, with both groups receiving conventional hot pack therapy three times per week for four weeks. Pain and functional disability were assessed using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI). Both interventions significantly improved outcomes; however, core stabilization exercises produced greater reductions in pain and disability than routine exercise therapy. Another randomized controlled trial investigated the effects of core stability training (CST) alone versus combined core and pelvic floor muscle (PFM) training in sedentary women with low back pain. Participants were allocated into a control group, a CST group, and a combined training group, with supervised sessions conducted three times weekly for four weeks. Although both exercise interventions significantly improved trunk muscle endurance and reduced pain, CST alone demonstrated greater improvements in lumbar function than the combined intervention. A randomized controlled trial compared traditional lumbar dynamic strength training with stabilization exercises using pressure biofeedback in patients with chronic low back pain. Outcomes included pain intensity, disability, lumbar mobility, transversus abdominis strength, quality of life, and fear-avoidance beliefs. Both interventions significantly improved all measured outcomes, with no statistically significant differences between groups, indicating comparable effectiveness. A comparative study evaluated Maitland mobilization and core stability exercises in adults with chronic nonspecific low back pain. Pain and disability were measured using the VAS and ODI before and after treatment. Both interventions significantly reduced pain and improved functional disability, with no clear superiority of either treatment approach. A randomized study compared pelvic floor muscle training (PFMT) with conventional physiotherapy treatment. Participants received routine physiotherapy alone, PFMT, or PFMT combined with transversus abdominis co-activation. Functional disability and pain were assessed using the ODI and Numeric Pain Rating Scale (NPRS). PFMT, particularly when combined with transversus abdominis activation, resulted in greater improvements in pain and disability, supporting its role as an adjunct to conservative management. Another study evaluated the effectiveness of a core stability training program in women with chronic nonspecific low back pain. Participants who completed the structured exercise program demonstrated significant reductions in pain intensity and improvements in functional performance compared with the control group, supporting the therapeutic benefits of core stabilization exercises. A randomized trial compared stabilization exercises alone with stabilization exercises combined with pelvic floor muscle training and physical therapy in women with nonspecific low back pain. The combined intervention produced greater improvements in pain, functional ability, and static and dynamic trunk muscle endurance than stabilization exercises alone. A clinical study examined the effects of performing proprioceptive neuromuscular facilitation (PNF) lower extremity patterns with and without a pressure biofeedback unit (PBU) in individuals with chronic low back pain. The use of the PBU significantly increased abdominal muscle activation and reduced lumbopelvic rotation, indicating enhanced lumbopelvic stability and motor control during exercise.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
Participants in the core stability exercise group completed a 6-week program performed 3-5 sessions per week, with each session lasting 25 minutes. The program progressed from core activation exercises (abdominal drawing-in, pelvic tilts, heel slides, and supine marching) to low- and moderate-load stabilization exercises, including dead bugs, glute bridges, bird-dogs, and modified side planks. Exercise intensity and complexity were gradually increased by adding full planks, unstable limb movements, and functional reaching tasks. Throughout the intervention, emphasis was placed on maintaining a neutral spine, controlled breathing, postural stability, and proper neuromuscular control while avoiding compensatory movements.
Participants in the core stability exercise group completed a 6-week program consisting of 3-5 sessions per week, with each session lasting 25 minutes. Training progressed from core muscle activation exercises (abdominal drawing-in, pelvic tilts, heel slides, and supine marching) to low- and moderate-load stabilization exercises, including dead bugs, glute bridges, bird-dogs, and modified side planks. Exercise intensity and complexity were gradually increased by adding full planks, unstable limb movements, and functional reaching tasks. Throughout the program, emphasis was placed on maintaining a neutral spine, proper breathing, neuromuscular control, postural stability, and avoiding compensatory movements.
Nishter Hospital Multan, CMH Multan
Lahore, Punjab Province, Pakistan
RECRUITINGOswestry Disability Index (ODI)
The ODI is comprised of ten categories, each of which evaluates a distinct element of daily functioning. These sections include the following: the level of pain, personal care, lifting, walking, sitting, standing, sleeping, social life, sexual function, and traveling. Every sentence has a score between 0 and 5, where 0 denotes the least amount of handicap and 5 the greatest score. The index, which varies from 0 to 100, is calculated by adding the scores for each question that has been answered, then multiplying the amount by two. A higher score denotes a higher degree of low back pain-related disability
Time frame: 6 weeks
Numeric Pain Rating Scale (NPRS)
The 11-point Numeric Rating Scale (NRS) goes from 0 to 10, with 10 denoting "the highest level of pain imaginable" and 0 denoting "no pain". It is a simple indicator of pain intensity since patients choose the number that most accurately represents their level of pain. Both the NRS and other well-validated pain measuring scales have shown strong correlation, validity, and sensitivity to treatments that are known to improve pain. The test-retest reliability for patients has been fairly high, with values of 0.96 and 0.95, respectively. The NRS and the Visual Analog Scale (VAS) demonstrated a high construct validity relationship in individuals with chronic pain syndromes (correlations varied from 0.86 to 0.95)
Time frame: 6 weeks
Bubble Inclinometer
The bubble inclinometer has high reliability for measuring lumbar range of motion in healthy individuals and patients with LBP. They can be used for evaluating lumbar range of motion in healthy individuals and patients suffering from lumbar back pain, as well as for monitoring therapeutic interventions. For healthy persons, the bubble inclinometer reliably measures the range of motion both within and between days (ICC˃0.75). Regarding the ICC measure, they deemed it high if it was between 0.80 and 1.00, average if it was between 0.60-0.79, and low if it was ≥0.59. Bubble inclinometer has a high degree of reliability when it comes to monitoring all of the aforementioned ranges of motion in the within-day test on patients. Regarding the Between Days Test, while the measurement reliability for side flexions, back extensions, and forward bends was excellent when standing, cut off value for lumbar flexion is less than 40 degrees, while for lumbar extension, it is less than 20 degrees. T
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Time frame: 6 weeks
Pressure Biofeedback Unit (PBU)
The Pressure Biofeedback Unit (PBU) is a clinical instrument that assesses and trains the lumbopelvic stability through the changes in the pressure of an inflated cushion that is placed beneath the lumbar spine or Abdomen. It entails the employment of a pressure gauge that gets attached to a pressure cell so that the slightest movement in the pelvic or spinal region can be sensed during the period that particular muscles are being used in a synergistic exercise. One of the numerous functions of the PBU in the field of physical therapy and rehabilitation is the assessment of the capacity of the patient to maintain his spine in a neutral position when his deep abdominal muscles, i.e., multifidus and transversus abdominis, are contracted. When training, the unit is inflated to a basal pressure, which is usually 40 mmHg when the unit is below the lumbar spine. Subsequently, the patient performs the exercises (leg sliding, bridging and belly hollowing) against the desired range of pressure
Time frame: 6 weeks