Comparison of Core Stabilization and Neuromuscular Facilitation Exercises for Lowback Pain Prevention

Low back pain (LBP) is a leading cause of disability worldwide, particularly affecting individuals in occupations that demand prolonged sitting or standing, such as healthcare professionals. The nature of their work often involves sustained postures, physical exertion, and repetitive movements, which compromise core muscle function and neuromuscular control, increasing the risk of spinal dysfunction and pain. Core stabilization exercises have been widely recognized for their role in improving trunk strength, enhancing postural alignment, and reducing spinal loading, thereby preventing LBP. Similarly, neuromuscular facilitation exercises aim to optimize muscle activation patterns, improve coordination, and restore functional movement, making them a promising strategy for LBP prevention. Despite the individual benefits of these approaches, there is a paucity of comparative research investigating their relative effectiveness in the prevention of LBP, particularly in populations with demanding physical and postural requirements, such as healthcare professionals.

This study seeks to fill this gap by comparing the effects of core stabilization exercises and neuromuscular facilitation exercises on LBP prevention among healthcare professionals.The findings will provide evidence-based guidance for designing targeted interventions, ultimately promoting musculoskeletal health and enhancing the occupational well-being of this vulnerable group.

Healthcare professionals perform daily activities that can lead to musculoskeletal disorders among them the lower back, neck, shoulder and hand/wrist are the most exposed areas.Healthcare professionals frequently engage in activities that require lifting, bending, and prolonged standing or sitting, which can place significant stress on their lower back .Low back pain is prevalent among healthcare workers, with studies indicating that over 57% of professionals experience it at some point in their careers Contributing factors include prolonged standing, frequent bending and twisting, and the physical demands of nursing and medical roles .The prevalence is notably higher among healthcare professionals, highlighting the need for targeted prevention strategies.

Researches have been done in order to devise strategies for the reduction of low back pain. Core stabilization and Neuromuscular Facilitation exercises are among them. Research shows that core stability training can alleviate symptoms of nonspecific low back pain (NSLBP) in nurses by improving muscle endurance and balance between the multifidus muscles on both sides of the spine Engaging in regular physical activity, including stretching exercises, has been shown to reduce LBP symptoms and improve overall physical health. For instance, a study found that a structured stretching program significantly reduced pain levels among healthcare workers .Core strengthening exercises, which include the muscles of the abdomen, pelvis, and lower back, are crucial for maintaining spinal stability and preventing LBP. likewise propioceptive neuromuscular fascilitation exercises have been shown to improve trunk muscle endurance and strength, which are critical for supporting the lumbar spine. Studies found that participants engaging in Propioceptive neuromuscular fascilitation demonstrated substantial gains in trunk stability and mobility, essential factors in preventing future episodes of back pain .

Evidence suggests that the benefits of Neuromuscular Fascilitation may extend beyond immediate pain relief, contributing to long-term improvements in muscle activity and overall spinal health. A study highlighted that PNF can lead to sustained reductions in pain and increases in functional capacity over time. When compared with traditional core strengthening exercises or conventional physical therapy, Neuromuscular Fascilitation has shown superior outcomes in terms of both pain reduction and functional improvement.This positions Neuromuscular Fascilitation as a potentially more effective intervention for healthcare professionals who are at risk for developing LBP.An RCT was conducted by waseem et al in 2017 inorder to compare core stabilization exercises with conventional physical therapy.They concluded that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. Pattanasin et al compared core stabilization exercises with Neuromuscular Fascilitation and reported that four-week Core stabilization and neuromuscular fascilitation training provided short-term and long-term effects on pain-related outcomes, along with increased deep trunk muscle activity in Chronic low back patients.Su et al in a study conducted in 2021 reported that Despite both core stabilization and strengthening exercises reducing pain, core stabilization exercise is superior to strengthening exercise. It is effective in improving proprioception, balance, and percentage change of muscle thickness of TrA and LM, and reducing functional disability and ear of movement in patients with subacute Non specific low back pain.

Eligibility Criteria:
Inclusion Criteria:

* Professionals including nurses, dentist, surgeons, physiotherapists etc.
* 20-45 years.
* Both genders.
* Individuals with no back pain history from previous 3 months.
* Individuals having Biering sorensen test score less than 176 seconds.

Exclusion Criteria:

* Individuals who had experienced low back pain in previous 3 months.
* Diagnosed musculoskeletal and neuromuscular problems.
* Diagnosed cardiovascular or pulmonary problems.
* Any Fractures and spine surgery.
* Individuals who are already a part of any interventional research program.