Effect of Lumbar Stabilization Exercises as Home Program in Treatment of Young Women with Non Specific Low Back Pain - A Comparative Study

Objective

To compare the effect of lumbar stabilization exercises along with back care and ergonomic advice over back care and ergonomic advice alone, when given as a home program in young women with non specific low back pain.

Design

A nonrandomized clinical trial which included an exercise group and a control group.

Settings

Outpatient department of physiotherapy, Kasturba Medical College Hospital, Manipal.

Participants

Purposive sampling was done to include 40 subjects in the experimental group with mean age of 22.95±2.846 years. An age and gender matched control group of 28 subjects with mean age of 21.71±2.291 years was selected. The participants were included if they were within the age group of 20-30 years an were having complaints of low back pain with /without referred pain to one or both lower limbs but no structural pathology.

Interventions

Participants in the experimental group were given home exercise programwhich included lumbar stabilization exercises, flexibility training and lower extremity proximal muscle strengthening and advice on back care and ergonomics. Participants in the control group were given advice on back care and ergonomics.

Outcome measures

Visual analog scale, Rolland Morris Questionnaire, Oswestry Disability Index.

Results

The statistical significance was set at 0.05 with 95% CI. In the experimental group, there was a statistically significant decrease in pain and disability. The results for the control group suggested a statistically significant decrease sores of VAS and RMQ but not in the ODI scores. There was a statistically significant difference between the two groups.

Conclusion

The lumbar stabilization exercises along with back care and ergonomic advice is more effective than back care and ergonomic advice alone when given as a home program in young women with NSLBP. Low back pain is a pandemic musculoskeletal disorder. Nachemson has stated that 80% of all adults have significant low back pain in their life time (Nachemson 1971). Non specific low back pain (NSLBP) represents approximately 80% of primary care low back pain (LBP) presentations.1 NSLBP disorders exist where mal-adaptive movement and motor control impairments appear to result in ongoing abnormal tissue loading and mechanically provoked pain. 2 Empirical research has shown that physiologic changes (e.g muscle dysfunction) occur in lumbar spine in tandem with initial episodes of pain that remain after pain has subsided.3,4 Conventional physical therapy options available are back care advice and ergonomics, flexibility training, spinal flexionextension exercises, spinal mobilization and manipulation, electrotherapy modalities, traction and lumbar supports. A recent focus in management of patients with LBP is on the specific training of muscles like internal oblique and transverse abdominus whose primary role is considered to be the provision of dynamic stability and segmental control of the spine. The emphasis on these muscles is based on evidence of motor control deficits in these muscles function in individuals with low back pain (LBP).5,6 Hence, addressing muscular dysfunction by spinal stabilization exercises along with back care and ergonomic advice will help in decreasing the pain and improving the function.