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This study is designed as a single-blind randomized controlled trial. Male and female patients aged 18-65 years with complaints of non-specific low back pain (NSLBP) lasting longer than 12 weeks will be included in the study. Participants will be randomly assigned into two parallel groups: control and intervention. The control group will perform core stabilization exercises five days a week for three weeks. In the intervention group, core stabilization exercises will be combined with 360-degree breathing exercises. To our knowledge, there is no randomized controlled trial investigating the effect of combining core stabilization with 360-degree breathing in individuals with NSLBP. The aim of this study is to examine the acute effects of combining 360-degree breathing techniques with core stabilization exercises on balance and proprioception in individuals with NSLBP.
Low back pain is a major health problem worldwide. Non-specific low back pain (NSLBP) is the most common form of back pain. The lifetime prevalence of back pain can reach up to 84%. Various non-pharmacological and non-invasive methods are used for back pain management. One such method is core stabilization exercises. Core stabilization exercises enhance trunk stability by activating the muscles around the spine and have the potential to improve balance in individuals with NSLBP. This may help overcome balance disorders associated with pain and contribute to safer movements in daily life activities. Breathing exercises, by activating the diaphragm muscle, support spinal stability and provide benefits in pain management. It is known that breathing supports trunk stability through its relationship with core muscles and strengthens balance mechanisms. Studies in this field show that stabilization exercises can provide short-term improvements, especially in balance. However, the combined effects of core stabilization and breathing exercises in individuals with NSLBP have not been fully investigated. Therefore, this study aims to investigate the acute effects of combining 360-degree breathing exercises with core stabilization exercises on balance and proprioception in individuals with NSLBP.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control Group (Core Exercises) | Other | Core Exercises Group |
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| Intervention Group (Core Exercises + Breathing Exercises): | Other | Core Exercises + Breathing Exercises |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Core Egzercise | Other | The core exercise group will perform core stabilization exercises for a total of 15 sessions, five days a week for three weeks. Exercises will include pelvic tilt, bridge, dead bug, bird dog, mini squats on a balance board, and wall planks. The number of repetitions will be increased from 10 to 20, and plank duration will be increased from 30 seconds to 45 seconds. A 5-minute warm-up and cool-down session will be included. |
| Measure | Description | Time Frame |
|---|---|---|
| • Proprioception Assessment | Proprioception will be evaluated using an inclinometric method. An inclinometer is usually placed and fixed at the L3-L4 segment of the lumbar spine. The patient will be asked to achieve and then reproduce a target position. The difference between the reference angle and the reproduced angle (position error) will be recorded as a measure of proprioceptive perception. | 3 week |
| Y Balance Test (YBT) | The Y Balance Test (YBT) will be used to assess balance. Patients will remove their shoes and place the stance foot on the center footplate of the YBT platform. They will attempt to reach maximally with the opposite leg in three directions (anterior, posteromedial, and posterolateral), maintaining balance on the stance leg. Maximum reach distances will be recorded. | 3 week |
| Measure | Description | Time Frame |
|---|---|---|
| Core Muscle Endurance Assessment: | Core endurance will be assessed using McGill's protocol, including trunk extension, trunk flexion, lateral bridge, and prone bridge tests.
The patient lies in a side-lying position with the lower arm flexed at 90° and forearm on the table. The upper arm is crossed over the chest. Lower extremities are extended |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Study Coordinator, PhD | Contact | +905065945067 | sbalki@cumhuriyet.edu.tr |
| Name | Affiliation | Role |
|---|---|---|
| Balki, PhD | Sivas Cumhuriyet University Faculty of Health Sciences Department of Physiotherapy and Rehabilitation | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sivas Cumhuriyet University Faculty of Health Sciences Department of Physiotherapy and Rehabilitation | Recruiting | Sivas | Merkez | 58000 | Turkey (Türkiye) |
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two groups with a conventional therapy control group.
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| Core Exercises + Breathing Exercises | Other | This group will perform core stabilization exercises combined with the 360-degree breathing technique, for a total of 15 sessions over three weeks (five days a week). "360-degree breathing" is a novel breathing method targeting deep and controlled inhalations into various regions of the body. Unlike traditional breathing exercises, 360-degree breathing ensures that all directions of the lungs are equally ventilated. |
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| 3 week |
| Visual Analog Scale (VAS) | Pain levels will be evaluated using the Visual Analog Scale (VAS), ranging from 0 to 10. A score of 0 indicates no pain; 1-4 indicates mild pain; 5-6 indicates moderate pain; 7-10 indicates severe pain. | 3 week |
| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D001945 | Breathing Exercises |
| ID | Term |
|---|---|
| D026441 | Mind-Body Therapies |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026241 | Exercise Movement Techniques |
| D026741 | Physical Therapy Modalities |
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