Effects of lumbar stabilisation and treadmill exercise on function in patients with chronic mechanical low back pain

Abstract

Background/Aims: Multifidus muscle is an important contributor to low back pain as it atrophies and is inhibited during the first episode of low back pain. This study aims to compare the effectiveness of lumbar stabilisation exercise with treadmill walking on multifidus muscle activation, pain intensity and functional disability among people with chronic mechanical low back pain. Methods: Individuals with chronic mechanical low back pain were randomised into two groups: Group 1 (n=25) performed lumbar stabilisation exercises following the McGill protocol; and Group 2 (n=25) followed the modified Bruce treadmill walking protocol. Participants walked or exercised three times a week for 8 weeks. Pain intensity (measured using a visual analogue scale), functional disability (using the Oswestry Disability Index Questionnaire) and amplitude of multifidus muscle activation (using a surface electromyography machine) were assessed at baseline and at the end of week 8. Data were analysed using descriptive statistics, paired and independent t-tests at α≤0.05. Findings: There were no significant differences between the groups' anthropometric and clinical characteristics at baseline. Both groups demonstrated significant reductions in pain intensity and functional disability and increases in multifidus muscle activation at the end of the study (all P<0.05). Group 1 had lower pain intensity (2.60 ± 0.48 vs 4.50 ± 0.12) and functional disability (24.20 ± 4.06 vs 40.00 ± 10.56) and significantly higher multifidus muscle activation levels (40.00 ± 4.16 vs 26.95 ± 4.04; P<0.05) than Group 2 at the end of week 8. Conclusions: Lumbar stabilisation exercises are more effective than treadmill walking exercises in activating the multifidus muscle, reducing pain intensity and functional disability in individuals with chronic mechanical low back pain.