Top

European Review of Aging and Physical Activity

Published in:

01-12-2022 | Back Pain | Research article

Effects of core stability training on older women with low back pain: a randomized controlled trial

Authors: Le Ge, Huanjie Huang, Qiuhua Yu, Yan Li, Xin Li, Zhicheng Li, Xi Chen, Le Li, Chuhuai Wang

Published in: European Review of Aging and Physical Activity | Issue 1/2022

Abstract

Background

Studies have demonstrated that elderly people with low back pain (LBP) may have poor postural control compared to healthy older adults. Poor postural control is associated with poor balance performance and a high risk of serious falls. A variety of training strategies are proposed for LBP therapy, particularly core stabilization training. But this treatment for older people with LBP remains unclear.

Methods

31 participants were randomly placed in a core stability training group (TG, n = 15) and a control group (CG, n = 16). The participants in the training group were required to complete 4 sets of core stability training and conventional physiotherapy 4 times per week for 4 weeks, whereas the participants in the control group only completed physiotherapy 4 times per week for 4 weeks. Ultrasound imaging was used to measure transverse abdominal muscle (TrA) thickness before and after the intervention. A 10-cm visual analog scale (VAS), the Oswestry Disability Index (ODI), and mobility functions were applied before and after the intervention. Data are reported as the median and range and were compared using two-way repeated-measures ANOVA,t-tests and chi-squared tests. P < 0.05 was considered significant in all statistical tests.

Results

After intervention, there was a statistically significant difference in scores in the intervention group, especially for VAS, ODI, timed up-and-go,10-m walking and the four-square step test. TrA thickness was increased after core stability training, which was not observed in the control group.

Conclusion

Core stability training is an effective intervention for older women with LBP.

Available only for authorised users

Garcia WJ, Johnson A, Keldermans D, Tang B. Exercise and low Back pain in the older adult: current recommendations. J Allied Health. 2019;48(4):302–7.PubMed

Podichetty VK, Mazanec DJ, Biscup RS. Chronic non-malignant musculoskeletal pain in older adults: clinical issues and opioid intervention. Postgrad Med J. 2003;79(937):627–33. https://doi.org/10.1136/pmj.79.937.627.CrossRefPubMedPubMedCentral

Morone NE, Greco CM, Moore CG, Rollman BL, Lane B, Morrow LA, et al. A Mind-Body Program for Older Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Intern Med. 2016;176(3):329–37. https://doi.org/10.1001/jamainternmed.2015.8033.CrossRefPubMedPubMedCentral

Calvo Lobo C, Vilar-Fernández JM, Losa-Iglesias ME, López-López D, Rodríguez-Sanz D, Palomo-López P, et al. Depression Symptoms Among Older Adults With and Without Subacute Low Back Pain. Rehabil Nurs. 2019;44(1):47–51. https://doi.org/10.1097/rnj.0000000000000137.CrossRefPubMed

Hicks GE, Simonsick EM, Harris TB, Newman AB, Weiner DK, Nevitt MA, et al. Trunk muscle composition as a predictor of reduced functional capacity in the health, aging and body composition study: the moderating role of back pain. J Gerontol Ser A Biol Med Sci. 2005;60(11):1420–4. https://doi.org/10.1093/gerona/60.11.1420.CrossRef

Sions JM, Elliott JM, Pohlig RT, Hicks GE. Trunk muscle characteristics of the multifidi, erector spinae, psoas, and Quadratus Lumborum in older adults with and without chronic low Back pain. J Orthop Sports Phys Ther. 2017;47(3):173–9. https://doi.org/10.2519/jospt.2017.7002.CrossRefPubMedPubMedCentral

ShahAli S, Arab AM, Ebrahimi E, Shah Ali S, Rahmani N, Negahban H, et al. Ultrasound measurement of abdominal muscles during clinical isometric endurance tests in women with and without low back pain. Physiother Theory Pract. 2019;35(2):130–8. https://doi.org/10.1080/09593985.2018.1441345.CrossRef

Shamsi M, Sarrafzadeh J, Jamshidi A, Zarabi V, Pourahmadi MR. The effect of core stability and general exercise on abdominal muscle thickness in non-specific chronic low back pain using ultrasound imaging. Physiother Theory Pract. 2016;32(4):277–83. https://doi.org/10.3109/09593985.2016.1138559.CrossRefPubMed

Hodges PW, Richardson CA. Contraction of the abdominal muscles associated with movement of the lower limb. Phys Ther J. 1997;77(2):132–42. https://doi.org/10.1093/ptj/77.2.132.CrossRef

10.

Brumitt J, Matheson JW, Meira EP. Core stabilization exercise prescription, part I: current concepts in assessment and intervention. Sports Health. 2013;5(6):504–9. https://doi.org/10.1177/1941738113502451.CrossRefPubMedPubMedCentral

11.

Ganesh GS, Kaur P, Meena S. Systematic reviews evaluating the effectiveness of motor control exercises in patients with non-specific low back pain do not consider its principles - a review. J Bodyw Mov Ther. 2021;26:374–93. https://doi.org/10.1016/j.jbmt.2020.08.010 Epub 2020 Sep 6.CrossRefPubMed

12.

Szafraniec R, Bartkowski J, Kawczyński A. Effects of Short-Term Core Stability Training on Dynamic Balance and Trunk Muscle Endurance in Novice Olympic Weightlifters. J Hum Kinet. 2020;74:43–50. Published 2020 Aug 31. https://doi.org/10.2478/hukin-2020-0012.CrossRefPubMedPubMedCentral

13.

Zou CJ, Li JH, Wu FC, Li YZ, Pan HY, Wu T. The effects of core stability training in nurses with nonspecific low back pain. Medicine (Baltimore). 2021;100(25):e26357. https://doi.org/10.1097/MD.0000000000026357.CrossRef

14.

Wang XQ, Zheng JJ, Yu ZW, Bi X, Lou SJ, Liu J, et al. A Meta-analysis of Core stability exercise versus general exercise for chronic low Back pain. PLoS One. 2012;7(12):e52082. https://doi.org/10.1371/journal.pone.0052082.CrossRefPubMedPubMedCentral

15.

Muraki S, Akune T, Oka H, En-Yo Y, Yoshida M, Nakamura K, et al. Prevalence of falls and the association with knee osteoarthritis and lumbar spondylosis as well as knee and lower back pain in Japanese men and women. Arthritis Care Res (Hoboken). 2011;63(10):1425–31. https://doi.org/10.1002/acr.20562.CrossRef

16.

Palacios-Ceña D, Alonso-Blanco C, Hernández-Barrera V, Carrasco-Garrido P, Jiménez-García R, Fernández-de-las-Peñas C. Prevalence of neck and low back pain in community-dwelling adults in Spain: an updated population-based national study (2009/10-2011/12). Eur Spine J. 2015;24(3):482–92. https://doi.org/10.1007/s00586-014-3567-5.CrossRefPubMed

17.

Le G, Yu Q, Wang C, Huang H, Li X, Zhang S, et al. How cognitive loads modulate the postural control of older women with low back pain? BMC Geriatr. 2021;21(1):82. https://doi.org/10.1186/s12877-021-02025-z.CrossRef

18.

Kim B, Yim J. Core stability and hip exercises improve physical function and activity in patients with non-specific low Back pain: a randomized controlled trial. Tohoku J Exp Med. 2020;251(3):193–206. https://doi.org/10.1620/tjem.251.193.CrossRefPubMed

19.

Fontana Carvalho AP, Dufresne SS, Rogerio de Oliveira M, Couto Furlanetto K, Dubois M, Dallaire M, et al. Effects of lumbar stabilization and muscular stretching on pain, disabilities, postural control and muscle activation in pregnant woman with low back pain. Eur J Phys Rehabil Med. 2020 Jun;56(3):297–306. https://doi.org/10.23736/S1973-9087.20.06086-4.CrossRefPubMed

20.

Roland M, Fairbank J. The Roland-Morris disability questionnaire and the Oswestry disability questionnaire. Spine (Phila Pa 1976). 2000;25(24):3115–24. https://doi.org/10.1097/00007632-200012150-00006.CrossRef

21.

Liu H, Tao H, Luo Z. Validation of the simplified Chinese version of the Oswestry disability index. Spine (Phila Pa 1976). 2009;34(11):1211–6. https://doi.org/10.1097/BRS.0b013e31819e2b34.CrossRef

22.

Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of participants for the clinician. J Psychiatr Res. 1975;12(3):189–98. https://doi.org/10.1016/0022-3956(75)90026-6.CrossRefPubMed

23.

Abzhandadze T, Rafsten L, Lundgren Nilsson Å, Palstam A, Sunnerhagen KS. Very Early MoCA Can Predict Functional Dependence at 3 Months After Stroke: A Longitudinal, Cohort Study. Front Neurol. 2019;10:1051 Published 2019 Oct 11.CrossRefPubMedPubMedCentral

24.

Whittaker JL. Ultrasound imaging of the lateral abdominal wall muscles in individuals with lumbopelvic pain and signs of concurrent hypocapnia. Man Ther. 2008;13(5):404–10. https://doi.org/10.1016/j.math.2007.03.008 Epub 2007 Jun 4.CrossRefPubMed

25.

Duncan RP, Combs-Miller SA, McNeely ME, et al. Are the average gait speeds during the 10meter and 6minute walk tests redundant in Parkinson disease? Gait Posture. 2017;52:178–82. https://doi.org/10.1016/j.gaitpost.2016.11.033.CrossRefPubMed

26.

Fritz CO, Morris PE, Richler JJ. Effect size estimates: current use, calculations, and interpretation. J Exp Psychol Gen. 2012;141(1):30. https://doi.org/10.1037/a0024338 Epub 2011 Aug 8.CrossRef

27.

Goh EY, Chua SY, Hong SJ, et al. Reliability and concurrent validity of Four Square Step Test scores in subjects with chronic stroke: a pilot study. Arch Phys Med Rehabil. 2013;94(7):1306–11.CrossRefPubMed

28.

Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x.CrossRefPubMed

29.

Gamble K, Chiu A, Peiris C. Core stability exercises in addition to usual care physiotherapy improve stability and balance after stroke: a systematic review and Meta-analysis. Arch Phys Med Rehabil. 2021;102(4):762–75. https://doi.org/10.1016/j.apmr.2020.09.388 Epub 2020 Oct 22.CrossRefPubMed

30.

Saravanakumar P, Higgins IJ, van der Riet PJ, Marquez J, Sibbritt D. The influence of tai chi and yoga on balance and falls in a residential care setting: a randomised controlled trial. Contemp Nurse. 2014;48(1):76–87. https://doi.org/10.1080/10376178.2014.11081929.CrossRefPubMed

31.

Ishak NA, Zahari Z, Justine M. Muscle functions and functional performance among older persons with and without low Back pain. Curr Gerontol Geriatr Res. 2016;2016:8583963–10. https://doi.org/10.1155/2016/8583963.CrossRefPubMedPubMedCentral

32.

Russo M, Deckers K, Eldabe S, Kiesel K, Gilligan C, Vieceli J, et al. Muscle control and non-specific chronic low Back pain. Neuromodulation. 2018;21(1):1–9. https://doi.org/10.1111/ner.12738 Epub 2017 Dec 12.CrossRefPubMed

33.

Kato S, Murakami H, Demura S, et al. Abdominal trunk muscle weakness and its association with chronic low back pain and risk of falling in older women. BMC Musculoskelet Disord. 2019;20(1):273. Published 2019 Jun 3. https://doi.org/10.1186/s12891-019-2655-4.CrossRefPubMedPubMedCentral

34.

Kong YS, Lee WJ, Park S, Jang GU. The effects of prone bridge exercise on trunk muscle thickness in chronic low back pain patients. J Phys Ther Sci. 2015;27(7):2073–6. https://doi.org/10.1589/jpts.27.2073 Epub 2015 Jul 22.CrossRefPubMedPubMedCentral

35.

Park SD, Yu SH. The effects of abdominal draw-in maneuver and core exercise on abdominal muscle thickness and Oswestry disability index in subjects with chronic low back pain. J Exerc Rehabil. 2013;9(2):286–91. https://doi.org/10.12965/jer.130012.CrossRefPubMedPubMedCentral

36.

Bickel CS, Cross JM, Bamman MM. Exercise dosing to retain resistance training adaptations in young and older adults. Med Sci Sports Exerc. 2011;43(7):1177–87. https://doi.org/10.1249/MSS.0b013e318207c15d.CrossRefPubMed

37.

Halliday MH, Pappas E, Hancock MJ, Clare HA, Pinto RZ, Robertson G, et al. A randomized clinical trial comparing the McKenzie method and motor control exercises in people with chronic low back pain and a directional preference: 1-year follow-up. Physiotherapy. 2019;105(4):442–5. https://doi.org/10.1016/j.physio.2018.12.004 Epub 2018 Dec 21.CrossRefPubMed

38.

Gong W. Correlations between transversus abdominis thickness, lumbar stability, and balance of Female University students. J Phys Ther Sci. 2013;25(6):681–3. https://doi.org/10.1589/jpts.25.681.CrossRefPubMedPubMedCentral

Title: Effects of core stability training on older women with low back pain: a randomized controlled trial
Authors: Le Ge
Huanjie Huang
Qiuhua Yu
Yan Li
Xin Li
Zhicheng Li
Xi Chen
Le Li
Chuhuai Wang
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Back Pain
Back Pain
Back Pain
Published in: European Review of Aging and Physical Activity / Issue 1/2022
Print ISSN: 1813-7253
Electronic ISSN: 1861-6909
DOI: https://doi.org/10.1186/s11556-022-00289-x

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Effects of core stability training on older women with low back pain: a randomized controlled trial

Abstract

Background

Methods

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2022

The relationship of weather with daily physical activity and the time spent out of home in older adults from Germany – the ActiFE study

Distinct physical activity and sedentary behavior trajectories in older adults during participation in a physical activity intervention: a latent class growth analysis

The burden of mild cognitive impairment attributable to physical inactivity in Colombia

The effects of interventions to enhance cognitive and physical functions in older people with cognitive frailty: a systematic review and meta-analysis

Onset of the COVID-19 pandemic reduced active time in patients with implanted cardiac devices

“… Exercise opportunities became very important”: Scottish older adults’ changes in physical activity during Covid19’

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page