Effects of Core Stability Training on Muscle Physiology among Adults with Low Back Pain

Background: Low back pain(LBP) is the leading cause of disability years lived worldwide. Muscle physiology, including core muscle activation, fatigue, strength, endurance, and thickness, could be deteriorated in LBP. One of the specific physiotherapy interventions for LBP is core stability training(CST). However, a review of the effects of CST on muscle physiology in adults with chronic non-specific low back pain(CNSLBP) has yet to be reported. Significance: Provide a reference for clinical optimization of LBP treatment prescriptions and efficient improvement of pain and muscle physiology in patients with CNSLBP. Aim: To explore CST's effects on muscle physiology in adults with CNSLBP. Objectives: To determine whether CST is better than other exercise treatments in improving muscle physiology in patients with CNSLBP. Methods: Eligible studies published in English from inception to October 2023 were extracted from PubMed, Web of Science, and Scopus. The search strategy uses a Boolean operator. The main terms include "core stabilization exercise," core stability training," low back pain," lumbar pain," and "LBP." This study followed PRISMA guidelines and required subjects to fulfill the following conditions according to the PICO mode： patients with LBP aged 18-60 years old used CST as an intervention, there was a control group that got another intervention, and the primary outcomes of interest were muscle physiology and pain intensity. PEDro was chosen for additional scoring. Limitations: Only RCT studies written in English and published as full papers were considered. Relatively few research have looked at the long-term implications of CST in the treatment of CNSLBP. Findings: Eight studies on improving pain showed that CST was more effective than other exercise therapies, while ten studies disagreed. Four studies on improving core muscle thickness showed that CST was more effective. Six studies have shown that CST was more effective in terms of improving core muscle activation. Regarding improving core muscle fatigue, two studies showed that CST has no advantage over other exercise therapies. One study showed that CST was more effective in terms of improving muscle strength. Regarding improving trunk muscular endurance, two studies showed that CST was more effective. However, two studies disagreed. Implications: Relative to other exercise treatments, for LBP patients, CST was more efficacious in improving core muscle thickness, strength, and activation, but CST did not have an advantage in improving core muscle fatigue, whereas the efficacy of CST in improving pain and trunk muscle endurance is still controversial