Effects of Core Stabilization Exercise on Balance
Condition: Lumbar Spine Instability
Study type: Interventional

Summary: 
      Recent studies indicate that patients with chronic low back pain (LBP) present problems in
      balance. Alterations in proprioception are the possible causes of alteration of postural
      balance in LBP.

      Previous studies reported an improvement of CSE on joint mobility, pain, functional
      disability, and trunk muscle activation pattern in patients with clinical lumbar instability
      (CLI); however, it was an immediate effect. However, previous studies did not report indirect
      effect may occur in CLI as postural balance and other kinds of exercise as strengthening in
      CLI. The general trunk strengthening exercise is common used in physical therapy clinic on
      LBP, that improve pain, physical disability, and trunk muscles activity. To our knowledge,
      the usefulness of CSE has not yet been investigated in CLI patients with outcome measure of
      balance.

      The present study will conduct to fill the gaps of previous studies which will provide
      immediate-, accumulative- and detraining-effects of CSE on postural balance, pain intensity
      and ratio activation of trunk muscles and included blinding process of the assessor.
    

Detailed description: 
      Low back pain (LBP) is the most common musculoskeletal complaint. In most LBPs, it is benign
      and disappears within six weeks, but approximately 20% of individuals with LBP do not show
      any improvement in their condition, which may progress to chronic low back pain. LBP not only
      interferes with biomechanical change, but also causes ability to work leading to reduced
      productivity, economic burden to individuals and society for medical costs Recent studies
      indicate that patients with chronic low back pain present diminished postural control,
      manifesting problems in balance. Postural balance is controlled by sensory information,
      central processing and neuromuscular responses. Alterations in proprioception are the
      possible causes of alteration of postural balance in individuals with low back pain.

      For clinical studies using core stabilization exercise (CSE) as treatment have revealed
      conflicting findings on pain, functional disability and muscle responses in chronic LBP. The
      few studies that investigated CSE as an isolated factor. Kumar (2011) reported an improvement
      of CSE on joint mobility and pain pressure threshold in patients with clinical lumbar
      instability; however, it was an immediate effect of CSE and blinding process was not
      performed. However, an effectiveness of CSE on pain intensity, functional disability, and
      trunk muscle activation pattern were improved in clinical lumbar instability (CLI). In
      addition, after 10-week CSE provides greater training and retention effects on pain-related
      outcomes and induced activation of deep abdominal muscles in CLI compared with conventional
      treatment (stretching exercise and hot pack). However, previous studies did not report
      indirect effect may occur in CLI as postural balance and other kinds of exercise as
      strengthening in CLI. The general trunk strengthening exercise is common used in physical
      therapy clinic on LBP, that improve pain, physical disability, and trunk muscles activity. To
      our knowledge, the usefulness of CSE technique as abdominal drawing-in maneuver (ADIM) has
      not yet been investigated in CLI patients with outcome measure of balance.
    

Intervention name(s): core stabilization exercise; general trunk strengthening exercise
Intervention type(s): Other; Other
Intervention description(s): core stabilization exercise, 2 times/week, 10 weeks; general trunk strengthening exercise, 2 times/week, 10 weeks
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment