Mechanical low back pain is one of the most common musculoskeletal disorders among overweight adults and can lead to pain, disability, and reduced quality of life. Weakness of the core muscles may contribute to poor spinal stability and persistence of symptoms. Core strengthening exercises have been proposed as an effective treatment; however, evidence regarding their additional benefit over conventional physical therapy remains limited.
This randomized controlled trial aimed to determine the effects of adding core strengthening exercises to conventional physical therapy in overweight adults with mechanical low back pain. Sixty participants aged 25-45 years with a body mass index (BMI) of 25 kg/m² or greater and chronic mechanical low back pain lasting more than three months were randomly assigned to either an experimental group or a control group.
The experimental group received core strengthening exercises (planks, side planks, and superman exercises) in addition to conventional physical therapy, while the control group received conventional physical therapy alone. Both groups also received therapeutic hot packs and transcutaneous electrical nerve stimulation (TENS). Participants attended three treatment sessions per week for six weeks.
Primary outcomes included pain intensity measured by the Numeric Pain Rating Scale (NPRS), functional disability measured by the Oswestry Disability Index (ODI), and body fat percentage measured using the Jackson-Pollock skinfold method. Outcomes were assessed before and after the six-week intervention.
The study evaluated whether adding core strengthening exercises to conventional physical therapy provides greater improvements in pain, disability, and body fat percentage in overweight adults with mechanical low back pain.
Inclusion Criteria:
Male and female participants. Age between 25 and 45 years. Diagnosed with chronic mechanical low back pain lasting more than 3 months. Body Mass Index (BMI) ≥ 25 kg/m² (overweight or obese). Body fat percentage > 25%. Numeric Pain Rating Scale (NPRS) score < 7 at baseline. Able and willing to provide written informed consent. Willing to participate in the complete 6-week intervention program.
Exclusion Criteria:
Non-mechanical low back pain. Acute low back pain. Previous lumbar spine surgery (e.g., laminectomy or discectomy). Spondylolisthesis. Osteoporosis or spinal fractures. Cauda equina syndrome. Current history of spinal trauma or surgery. Lumbar spine myelopathy. Diagnosed metabolic diseases. Neurological disorders affecting the spine or lower limbs. Any medical condition that would contraindicate participation in the exercise program.
Participants were randomly assigned to one of two parallel groups. The experimental group received core strengthening exercises in addition to conventional physical therapy, while the control group received conventional physical therapy alone. Both groups were treated concurrently for six weeks, and outcomes were compared between groups at the end of the intervention.
Participants assigned to the experimental arm received a combination of core strengthening exercises (plank, side plank, and superman exercises) together with conventional physical therapy exercises (bridging, knee-to-chest, back extension, and pelvic rotation). All participants also received a therapeutic hot pack and continuous transcutaneous electrical nerve stimulation (TENS) for 10 minutes. Treatment was provided three times per week for six weeks (18 sessions).
Participants assigned to the control arm received conventional physical therapy consisting of bridging, knee-to-chest, back extension, and pelvic rotation exercises. All participants also received a therapeutic hot pack and continuous transcutaneous electrical nerve stimulation (TENS) for 10 minutes. Treatment was provided three times per week for six weeks (18 sessions).
Rawalpindi, Punjab Province, Pakistan
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