Impact of Core Stabilization Exercises on Postural Control in Patients with Chronic Nonspecific Low Back Pain

Abstract

Background: Chronic nonspecific low back pain (CNSLBP) is associated with impaired postural control and persistent disability. Although core stabilization exercises are recommended, objective evidence comparing their effect on posturographic parameters versus conventional therapy remains limited in low-resource settings. Objective: To compare the effects of core stabilization exercises versus conventional physiotherapy on postural control, balance, pain, and disability in patients with CNSLBP. Methods: Assessor-blinded randomized controlled trial involving 64 adults with CNSLBP (≥12 weeks). Participants were allocated to 8-week core stabilization (n=32) or conventional therapy (n=32), three sessions/week. Primary outcomes were static postural sway area, velocity, and COP displacement measured by force plate. Secondary outcomes included Berg Balance Scale, VAS pain, ODI, and trunk endurance. ANCOVA examined between-group differences adjusted for baseline. Results: Core stabilization produced significantly greater improvements than conventional therapy in sway area (−160 vs −94 mm²; between-group difference −66 mm², 95% CI −98 to −34, p<0.001), sway velocity (−9.8 vs −4.9 mm/s; −4.9 mm/s, 95% CI −7.2 to −2.6, p<0.001), BBS (+7.6 vs +3.8 points), pain (−3.6 vs −2.0), and ODI (−20.2% vs −9.2%) (all p<0.001). Group allocation was the strongest predictor of post-treatment sway area (β=−62.4, p<0.001). Conclusion: Core stabilization exercises are superior to conventional therapy for restoring postural control and reducing pain and disability in CNSLBP.