Core and Hip Exercise for Improving Nonspecific Low Back Pain

Introduction

  • Low Back Pain (LBP): 80% of the population will experience LBP at least once in their lifetime.
  • Non-Specific Low Back Pain (NSLBP): 90% of LBP cases are classified as non-specific, meaning the cause cannot be clinically identified.
  • Importance of Core Stability (CS) and hip muscle exercises for alleviating NSLBP.

Study Overview

  • Objective: Investigate the effects of Core Stability Exercise (CSE) and hip muscle exercises on NSLBP patients regarding physical function and activity.
  • Patients were divided into three groups:
    • Stretch Group: Focused on hip muscle stretching.
    • Strengthen Group: Focused on hip muscle strengthening.
    • Sham Group: Received only gentle palpation.

Key Definitions

  • Core Stability: Essential for balancing load within the pelvis and spine.
  • Hip Muscle Flexibility: Critical for maintaining proper movement and stability in low back pain patients.

Methodology

  • Participants: 66 patients (aged 30-65) with NSLBP for at least 3 months and pain intensity of 3 or higher based on the Visual Analog Scale (VAS).
  • Intervention Duration: 6 weeks, 3 times per week.
  • Outcome Measures:
    • Pain intensity, lower back instability, hip muscle flexibility.
    • Disability level, balance ability, quality of life.
  • Statistical Tools: ANOVA, paired t-tests, and analysis of covariance were used to analyze data.

Results

Pain Intensity

  • Significant reductions in pain intensity observed across all treatment groups, with the Stretch and Strengthen groups showing more improvement compared to the Sham group.
    • Stretch Group: 5.95 to 2.37 (P < 0.05).
    • Strengthen Group: 6.12 to 2.37 (P < 0.05).
    • Sham Group: 5.85 to 2.92 (P < 0.05).

Lower Back Instability

  • Significant improvements were noted:
    • Stretch group improved from 64.71° to 72.21°.
    • Strengthen group improved from 65.23° to 68.86°.

Hip Muscle Flexibility

  • Variances indicated improvements:
    • Stretch group showed drastic improvements in flexibility across tested muscles compared to other groups.

Disability and Balance

  • Both active groups significantly improved disability scores and balance capabilities compared to the Sham group.
  • Quality of Life: Enhanced in both the Stretch and Strengthen groups post-intervention.

Discussion

  • Effectiveness of CSE: CSE is crucial for stabilizing the spine and alleviating pain via improved muscle activation.
  • Hip Muscle Stretching: Particularly beneficial for enhancing flexibility and reducing lower back instability.
  • Clinical Implications: Emphasizes the integration of hip stretching exercises in physiotherapy for NSLBP.

Conclusion

  • Hip muscle stretching and strengthening exercises combined with CSE are both effective for improving physical function and activity in NSLBP patients.
  • Suggests an increasing need for tailored exercise regimens focusing on hip musculature in rehabilitation settings.