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.