Sports and Exercise Medicine

Open journal

ISSN 2379-6391

To Study the Effects of Core Stability Exercise in Desk Job Patients with Mechanical Low Back Pain

Michael Kaprail*, Paramdeep Kaur, Franky Valecha and Usha

Michael Kaprail, MPT Student

(MPT) Physiotherapist, DAV Institute of Physiotherapy and Rehabilitation, Jalandhar, Punjab, India; E-mail:


Mechanical low back pain (MLBP) is a mechanically-derived, musculoskeletal back pain not involving nerve root compression or serious spinal diseases. Prevalence is higher in young and active adults. Causes of MLBP typically are attributed to an acute traumatic event, but they may also include cumulative trauma as an etiology. The weakness of the superficial trunk and abdominal muscles is an important risk factor for low back pain. Strengthening these muscles markedly improves chronic low back pain and decreases functional disability. Another independent risk factor for chronic low back pain is weakness and lack of motor control of deep trunk muscles, such as the lumbar multifidus (LM) and transversus abdominis (TrA) muscles.1

Mechanical spinal pain due to mechanical deformation of soft tissues is classified into postural, dysfunctional and derangement syndromes. Excess flexion causes deformation in lumbar spines and progress with time irrespective of age.2

Mostly low-income group people are engaged in physically demanding jobs which increases the risk of low back pain and disability. In India, nearly 60% of the people suffered from low back pain at any point of time during their lifespan. Low back pain also restricts mobility, interferes with normal functioning and results in lifelong pain and permanent disability.3

Lack of spinal core stability is supposed to be one of the important predisposing causes of recurrent low back pain. As a result, more attention has been paid to the training of localized spinal stabilizer muscles in subjects with LBP specific stabilization exercises lead to changes in motor programming of the automatic feed-forward recruitment of deep core muscles. Therefore, stabilization exercises are suggested for chronic low back pain patients.4

Exercises for low back pain have evolved over the period of time with a specific emphasis on maintaining the spinal stability. Core stabilization exercises are aimed at improving the neuromuscular control, endurance, strength of muscles central to maintaining dynamic spinal stability. Transversus abdominis (TrA), lumbar multifidi, and other paraspinal, abdominal, diaphragmatic, and pelvic musculature are targeted in core stabilization exercises.5


All 10 eligible young patients both male and female were included in the study. They complained of a low backache in the last six weeks with non-specific cause. Informed consent was taken from subjects after explaining the protocol. Measures of pain intensity on visual analogue scale (VAS) were recorded. The study was conducted in a busy physiotherapy center in Ludhiana, Punjab, India. Data were collected on day 0 and day 21 and statistically analyzed by students unpaired t-test and results were obtained and comparisons were made between day 0 and day 21 on included subjects.

Treatment starting with activation of the core muscle like learning motor control for multifidus and transverse abdominis muscle like abdominal drawing maneuvers were taught to all patients and after that beginners/basic exercises for core muscles taken from Kisner 6 like abdominal curl-ups, hook-lying with straight leg lift to 45°, hook lying lower extremity alternating bicycle, quadruped position progressed to flexing upper extremity and extending contralateral lower extremity, prone position progressed to lifting legs, arms, trunk and head. Initially beginning as per patient convenience 30 seconds hold for 5 repetitions progressed to 10 at 14 days and 15 repetitions at 21 days on which follow-up was taken for PRE and POST exercise intervention.

Data analysis using the unpaired t-test

By conventional criteria, this difference is considered to be statistically significant.

Confidence interval:

The mean of VAS Day 0 minus VAS Day 21 equals 1.70

95% confidence interval of this difference: From 0.45 to 2.95


The study was completed with a total 10 subjects (Table 1) both male and female were included. There is no significant difference in the mean ages between the subjects. The comparison of pre and post scores of VAS within two groups (Figure 1 and Table 1). It shows, in both the groups there was significant improvement between pre and post mean scores.

Figure 1. Measures of Pain Intensity from Day 0 till Day 21



Table 1. Measures from Pain Intensity Measured Using VAS Scale


VAS Day 0 (PRE) VAS Day 21 (POST)


4.50 2.80
SD 1.43


SEM 0.45







Mechanical low back pain is described as a musculoskeletal pain which varies with physical activities and not involving root compression or serious spinal diseases.7

The primary aim of this study was to determine performing exercises for the core stabilization resulted in reducing back pain more effectively. Exercise programs that aim to improve the stability of the lumbar spine are widely utilized in the management of patients with chronic low back pain. These programs target a variety of trunk muscles and aim to optimize the control of segmental motion, spinal stability, spinal stiffness, spinal orientation, or a combination of these characteristics.8

Franca et al compared the efficacy of two exercises programs-segmental stabilization and superficial strengthening of abdominal and trunk muscles-on pain, functional disability, and activation of the TrA muscle in individuals with chronic low back pain. Both techniques resulted in pain amelioration and reduced disability.9

Similar studies by Koumantakis and O’Sullivan of chronic low back pain, spondylolysis or spondylolisthesis demonstrated a decrease in pain in subjects allocated to the core stabilization group. Core stabilization exercise enhances the ability of the segmental muscles that result in improved function and decreased pain in the subject with chronic nonspecific low back pain.10


Core stabilization exercises lowered pain intensity in mechanical non-specific low back pain hence Core stabilization exercises should be an integral component of the treatment protocol for patients with low back pain.


In a short period of time, there was a reduction in intensity of back pain. It is easy to learn and an inexpensive method of treatment.


The sample size was small, limited outcome measures for investigation were used.


Usage of sophisticated instruments for investigating the muscle function and fitness level can be used.


Authors express their sense of gratitude to the people who helped and encouraged them for the guidance and completion of this study.


None of the authors have any conflicts of interest.

1. Soundararajan LR, Thankappan SM. Efficacy of the multifidus retraining program in computer professionals with chronic low back pain. Asian Spine J. 2016; 10(3): 450-456. doi: 10.4184/asj.2016.10.3.450

2. Ghosh S, Datta S, Nayak S, Chaudhuri A, Dhanasekaran P. Comparative study of muscle strengthening exercises for treatment of chronic low backache. Med J DY Patil Univ. 2014; 7(4): 443-446. doi: 10.4103/0975-2870.135258

3. Ahdhi GS, Subramanian R, Saya GK, Yamuna TV. Prevalence of low back pain and its relation to quality of life and disability among women in rural area of Puducherry, India. Indian J Pain. 2016; 30(2): 111-115. doi: 10.4103/0970-5333.186467

4. Hosseinifar M, Akbari M, Behtash H, Amiri M, Sarrafzadeh J. The effects of stabilization and McKenzie exercises on transverse abdominis and multifidus muscle thickness, pain, and disability: A randomized controlled trial in nonspecific chronic low back pain. J Phys Ther Sci. 2013; 25(12): 1541-1545. doi: 10.1589/jpts.25.1541

5. Akhtar MW, Karimi H, Gilani SA. Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic nonspecific low back pain: A randomized controlled clinical trial. Pak J Med Sci. 2017; 33(4): 1002-1006. doi: 10.12669/pjms.334.12664

6. Kisner C, Colby LA. Therapeutic Exercise: Foundations and Techniques. Philadelphia, USA: F.A. Davis Company. 1996.

7. Vikranth GR, Mathias L, Ghori M. Effectiveness of core stabilization exercises and motor control exercises in patients with low back ache. International Journal of Physiotherapy. 2015; 2(3): 544-551. doi: 10.15621/ijphy/2015/v2i3/67029

8. MacDonald DA, Moseley GL, Hodges PW. The lumbar multifidus: Does the evidence support clinical beliefs. Man Ther. 2006; 11(4): 254-263.
doi: 10.1016/j.math.2006.02.004

9. Franca FR, Burke TN, Hanada ES, Marques AP. Segmental stabilization and muscular strengthening in chronic low back pain: A comparative study. Clinics (Sao Paulo). 2010; 65(10): 1013-1017. doi: 10.1590/S1807-59322010001000015

10. Akhtar MW, Karimi H, Gilani SA. Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic nonspecific low back pain: A randomized controlled clinical trial. Pak J Med Sci. 2017; 33(4): 1002-1006. doi: 10.12669/pjms.334.12664


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