Comparison of the Effects of External Focus and Internal Focus Instructions Applied Chronic Low Back Pain: RCT

Comparison of the Effects of External Focus and Internal Focus Instructions Applied in Balance Training on Individuals With Chronic Low Back Pain: Randomized Controlled Trial

Postural control methods are impaired in people with chronic low back pain. While the person maintains balance with pain relief, fear of movement and pain increase with loss of balance. It was found that externally focused exercises are more effective than internal focus exercises in terms of motor control and motor learning. To investigate the place of externally focused balance exercises in conservative treatment of target low back pain. For this purpose, approval was obtained from the clinical research ethics committee of Kırşehir Ahi Evran University, Faculty of Medicine, with the decision numbered 2022-18/163.

Focusing on the inside of the body while performing a movement is called "internal (internal focus)", focusing on the outside of the body is called "external (external focus)". Many previous studies have shown that external focus is substantially more effective than internal focus in the performance of a movement.In our randomized controlled study, there were two groups and 22 people were treated in each group. Volunteers between the ages of 18-65 who had low back pain for the last 3 months and had no musculoskeletal problems were included. Balances were evaluated with Biodex Balance Device, pain with Visual Analog Scale, performance with Physical Performance Test Battery, functional level with osvewstry disability index, posture, spinal mobility,postural endurance with spinal mouse device. 8 weeks of treatment were applied to both groups as external focus and control groups. Basically similar exercises were applied to both groups, and there were tasks in the exercises in the external focus group, and the focus were on the task other than the exercise.

The results of the study show that externally focused balance exercises are effective on dynamic balance, fall risk, stability limits, physical performance, posture, spinal mobility, and postural endurance in individuals with CLBP.

Inclusion Criteria:

• Those with ongoing low back pain symptoms in the last three months (diagnosed with chronic low back pain),
• Individuals between the ages of 18-65
• Pain level 3 or more according to VAS
• Individuals who volunteer to participate in the study will be included.

Exclusion Criteria:

• Individuals with lower extremity and spine orthopedic and neurological disorders,
• Having a musculoskeletal injury in the last 9 months,
• Surgery, injection, etc. for low back pain in the last 3 months. with a history of treatment
• Those who are doing any sports activity,
• Subjects who do not cooperate well will not be included in the study. Inclusion and exclusion criteria will be the same for control group participants.