Movement Quality and Balance Improvement in People With Chronic Low Back Pain Following Trunk Muscle Training

Trunk and Lower Limb Movement Quality and Stability Improvement in People With Chronic Low Back Pain Following Different Types of Isometric Trunk Muscle Training

The goal of this project is to assess if Chronic Low Back Pain (CLBP) participant's movement quality and balance variables can change after training that decreases their pain and disability. It will also compare the difference between structural exercise (SE) and isolated trunk exercise (ITE). The main questions it aims to answer are:

1. What are the effect of the training on the participant's movement quality and balance.
2. What are the difference between different types of trunk muscle training on people with CLBP.

Researchers will compare SE, ITE and control. Control group will receive back school education that was shown not to be effective in reducing pain and disability.

Participants will:

1. Do home and in-lab based SE or ITE training, or maintain active daily living over 2 months.
2. Complete the pain and disability questionnaire and do several physical functioning tests while having their trunk and lower limb movement and muscle activation measured.

Both ITE and SE training are equalized in terms of training intensity based on rate of perceived exertion, training duration per session, training frequency, and intervention period. Training intensity measurement does not use other methods of quantification as ITE training does not increase heart rate or blood lactate significantly regardless of the intensity.

Inclusion Criteria:

• body mass index (BMI) 18-25 kg/m2
• experiencing intermittent pain lasting at least 3 months
• had Oswestry Disability Index (ODI) score ranging between 17% and 45%.

Exclusion Criteria:

• exercise contraindication based on physical activity readiness questionnaire
• indication or diagnosis of other chronic diseases (such as cancer, cardiovascular disease, diabetes, bone fracture, or infection)
• artificial lower limb joints, history of spinal surgery, walking aid use
• personal mobility restrictions (due to connective tissue diseases, rheumatoid arthritis, or central nervous system disorders)
• pregnancy or within 1 year post partum