Influence of core stability exercise on lumbar vertebral instability in patients presented with chronic low back pain: A randomized clinical trial

Background: Excessive lumbar vertebrae translation and rotation in sagittal plane has been attributed as an associated factor of lumbar segmental instability (LSI) and low back pain (LBP). Reduction of these abnormalities improves back pain. The aim of this study was to investigate the effect of core stability exercise on the translation and rotation of lumbar vertebrae in sagittal plane in patients with nonspecific chronic LBP (NSCLBP). Methods: In this randomized clinical trial, 30 patients with NSCLBP due to LSI were included. The participants were randomly divided into two groups of treatment and control. The treatment group received general exercises plus core stability exercise for 8 weeks whereas the control group received only general exercises.  The magnitude of translation (mm) and rotation (deg) of lumbar vertebrae in the sagittal plane was determined by radiography in flexion and extension at baseline and after intervention. The primary outcome measures were to determine the mean changes from baseline in translation and rotation of the lumbar vertebrae in the sagittal plane after 8 weeks of intervention in each group. The secondary outcome was to compare the two groups in regard to translation and rotation of the lumbar vertebrae at the end of the study period. Data were analyzed using paired t-test and independent t-test. Results: Thirty patients aged 18-40 years old with clinical diagnosis of NSCLBP entered the study. Compared with baseline values, mean value of translation and rotation of the lumbar vertebra reduced significantly in both groups (P<0.05), except L3 translation in the control group. At the endpoint, mean translation value of L4 (P=0.04) and L5 (P=0.001) and rotation of the L5 (P=0.01) in the treatment group was significantly lower than the control group.Conclusion: These findings indicate that in patients presented with NSCLBP due to lumbar segmental instability, core stability exercises plus general exercises are more efficient than general exercises alone in the improvement of excessive lumbar vertebrae translation and rotation

The Quality of Life in Patients with Nonspecific Chronic Low Back Pain

Objective: Quality of life is a multi-faceted concept and goes beyond an examination merely in terms of physical health. Lower back pain is among the most prevalent musculoskeletal disorders, and chronic illnesses such as the nonspecific chronic lower back pain have important consequences like an alteration in the quality of life of the person. This study was conducted to evaluate the quality of life in people with nonspecific chronic lower back pain. Materials & Methods: The present study is a descriptive inquiry carried out using the cross-sectional method at the Shahid Beheshti Hospital in Babol, Iran. The sample volume was estimated to be 125 subjects where individuals were evaluated through four questionnaires, namely demographic information, the assessment of the level of disability (Oswestry), quality of life (WHOQOL-BREF), and an evaluation of the intensity of the pain. Results: The participants were from an age range of 18 to 58 years whose mean and deviation of pain intensity and disability were 73.54±32.21 and 56.31±69.16, respectively. In Terms of gender and marital status, no meaningful variation was observed in the physical health, mental health, social relationships, and environmental health variables, but participants with academic education had meaningful differences in all of the above variables compared to individuals from other educational levels. Pain intensity was negatively correlated with general health and mental health, and was positively correlated with the overall disability score. Also, the overall score of disability was negatively correlated with the general quality of life, general health, physical health, mental health, and social relationships, and was positively correlated with the pain intensity. Conclusion: Since pain intensity and disability not only have physical consequences but affect other facets too, future interventions need to consider the physical aspect, and put emphasis on the mental and social improvement of the patients