Comparison Of The Efficacy Of Different Core Stability Exercise Therapies For Chronic Non-Specific Low Back Pain

Objective: To evaluate the clinical efficacy of three different types of core stability training,namely conventional mat-based core stability training,whole-body vibration training and sling exercise therapy,on pain,function,muscle strength,dynamic and static core stability and neuromuscular function in patients with chronic non-specific low back pain,and to provide a reasonable and effective basis for choosing exercise therapy for patients with chronic nonspecific low back pain in clinical practice.Methods: Fifty patients with chronic non-specific lower back pain were recruited to complete the intervention trial from September 2021 to December 2021 at the Sports Rehabilitation Centre of Wuhan Institute of Physical Education.A randomized controlled trial design was adopted and the subjects were divided into three groups according to the random number table method: 16 in the control group,17 in the whole-body vibration training group and 17 in the sling exercise therapy group.The control group(CON group)underwent conventional matbased core stability training;the whole-body vibration training group(WBVT group)and the sling exercise therapy group(SET group)completed training on the whole-body vibration trainer and suspension system respectively.Each training session lasted approximately 45 min,3 times per week for 6 weeks.The patients’ VAS score,Oswestry lumbar dysfunction(ODI)score,maximum lumbar isometric strength,Y-balance test and eight-level abdominal bridge index were assessed before and after the test.SPSS 25.0 statistical software was used for processing.The χ~2 test was used for the count data.Paired t-test was used for intra-group comparisons and one-way ANOVA was used for inter-group comparisons.The measured data were expressed in the form of((?) ± s),and p < 0.05 was regarded as a statistically significant difference.Results:(1)After 6 weeks of intervention,the VAS scores of all three groups improved significantly compared to those before treatment(p<0.05),and the one-way ANOVA showed no statistically significant difference between groups(p>0.05).(2)After 6 weeks of intervention,the ODI scores of all three groups improved significantly compared with those before treatment(p<0.05),and the one-way ANOVA showed no statistically significant difference between the groups(p>0.05).(3)After 6 weeks of intervention,the maximum isometric muscle strength of trunk forward flexion,posterior extension,left flexion and right flexion increased significantly in all three groups compared to the pre-treatment period(p<0.05),and the one-way ANOVA showed that the differences between the posterior extension,left flexion and right flexion groups were statistically significant(p<0.05).(4)After 6 weeks of intervention,the total Ybalance score was significantly higher in the SET group than before the intervention(p<0.05).One-way ANOVA showed statistically significant differences in the total Y-balance scores between the three groups of subjects after the intervention(p<0.01),with no significant difference in the total Y-balance scores in the CON group compared to the WBVT group(p>0.05),and the total Y-balance scores in the SET group significantly higher than those in the CON group(p<0.01)and WBVT group(p<0.01)After the 6-week intervention,the difference in the post-intervention Y-balance bilateral scores in the SET group was significantly lower than that before the intervention(p<0.01).By one-way ANOVA,there was no statistically significant difference between the three groups of subjects in the post-intervention Y-balance bilateral scores(p>0.05).(5)After 6 weeks of treatment,all three groups of subjects showed a significant improvement in the eight-level abdominal bridge score compared to the pre-treatment period(p<0.05),and a one-way ANOVA showed no statistically significant difference between the groups(p>0.05).(6)After 6 weeks of intervention,the MF values of the erector spinae in all three groups were significantly lower than before the intervention(p<0.01),and the MF values of the multifidus in both the WBVT and SET groups were significantly lower than before the intervention(p<0.01).After 6 weeks of intervention,there was a significant increase in FLEX/MVF values in the SET group compared to the pre-intervention group(p<0.05),and no significant improvement in the CON and WBVT groups(p>0.05),and a one-way ANOVA showed a significant increase in FLEX/MVF values in the SET group compared to the CON and WBVT groups(p< 0.05).After 6 weeks of intervention,all three groups showed a significant increase in FLEX/MVF values compared to pre-intervention(p<0.05),with a oneway ANOVA showing a significant increase in FLEX/MVF values in the SET group compared to the CON and WBVT groups(p<0.05).The SET and WBVT groups showed a significant increase in FLEX/MVF values compared to the pre-intervention period(p<0.05),while the CON group did not show a significant increase(p>0.05),and the one-way ANOVA showed no statistically significant difference between the groups(p>0.05).Conclusions:(1)In terms of pain and functional improvement in patients with CNLBP,the CON group,WBVT group and SET group all achieved significant efficacy.(2)In terms of improvement in lumbar muscle strength in CNLBP,the CON group,WBVT group and SET group all showed significant improvement,while the WBVT group and SET group showed better improvement.(3)Regarding the improvement of dynamic and static core stability in CNLBP,the CON,WBVT and SET groups could all obtain better static core postural stability enhancement,while the SET group could better improve dynamic core stability and postural control and improve bilateral stability imbalance.(4)In terms of improvement in neuromuscular function of CNLBP,significant improvement in core muscle endurance and neuromuscular coordination was observed in the CON,WBVT and SET groups,while better improvement in core muscle endurance was observed in the WBVT and SET groups,and the SET group could provide better improvement in neuromuscular coordination.