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      Interventional effect of core stability training on pain and muscle function of youth with chronic non-specific lower back pain: A randomized controlled trial

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          Abstract

          Nowadays, due to lifestyle changes, the number of young people suffering from chronic non-specific low back pain (CNLBP) is gradually increasing. The recent guidelines for the treatment of low back pain emphasize that exercise therapy is the preferred treatment method for CNLBP. This study take ordinary college male students with CNLBP as objective of the study, focused into how core stability training affected the pain and muscle function of the CNLBP of youth. Herein, 60 male subjects were randomly divided into a control group and an experimental group, and conducted a randomized control trial in the Sports Rehabilitation Laboratory of Guangxi Normal University from September to October 2023. The control group received traditional waist strength training, while the experimental group received core stability training. VAS scores, pain symptoms scores and clinical efficacy grades were evaluated. Waist muscles fitness was evaluated, including back muscle strength, the prone upper body up's static holding time, 1-min modified sit-ups' pcs, the supine abdominal curling's static holding time and the supine leg raising's static holding time. Waist movement function was also evaluated using oswestry disability index (ODI) questionnaire. Surface electromyographic (EMG) signals were collected from rectus abdominis, erector spinae and multifidus. The independent sample t-test was used to compare groups, and the paired sample t-test was used for the data comparison before and post-exercise within the group. The results of the study found that CNLBP was improved in both the experimental and control groups in the post-exercise. Compared to pre-exercise, there are significant decrease in the VAS scores (95%CI: 2.51 to 6.51, p = 0.000), pain symptoms scores (95%CI: 2.95 to 3.55, p = 0.000), waist movement function's evaluation scores for ODI (95%CI: 2.23 to 4.31, p = 0.000), rectus abdominis' IEMG values (95%CI: 2.29 to 4.39, p = 0.000), erector spinae and multifidus' IEMG values (95%CI: 2.18 to 4.45, p = 0.000) of experimental group in the post-exercise. Compared to pre-exercise, there are significant improvement in the back muscle strength (95%CI: 12.85 to 19.49, p = 0.000), the prone upper body up's static holding time (95%CI: 9.67 to 19.17, p = 0.000), the 1-min modified sit-ups' pcs (95%CI: 8.56 to 18.12, p = 0.000), the supine abdominal curling's static holding time (95%CI: 6.73 to 19.14, p = 0.000), and the supine leg raising's static holding time (95%CI: 8.21 to 18.35, p = 0.000) of experimental group in the post-exercise. In the post-exercise,there are significant lower in the VAS scores (95%CI: 1.41 to 4.98, p = 0.000), pain symptoms scores (95%CI: 1.14 to 1.79, p = 0.011), waist movement function's evaluation scores for ODI (95%CI: 1.13 to 2.25, p = 0.000), rectus abdominis' IEMG values (95%CI: 2.36 to 4.47, p = 0.000), erector spinae and multifidus' IEMG values (95%CI: 2.24 to 4.23, p = 0.017) of experimental group than those of control group. In the post-exercise, there are significant higher in the recovery rate (p = 0.000), the prone upper body up's static holding time (95%CI: 4.16 to 8.32, p = 0.008), and the supine abdominal curling's static holding time (95%CI: 3.89 to 7.44, p = 0.000) of experimental group than those of control group. Therefore, it can be concluded that core stability training is significantly effective in treating CNLBP in youth, enhancing lower back muscle function. This therapeutic effect is primarily attributed to the improvement in muscle function.

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          Most cited references33

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          Non-specific low back pain.

          Non-specific low back pain affects people of all ages and is a leading contributor to disease burden worldwide. Management guidelines endorse triage to identify the rare cases of low back pain that are caused by medically serious pathology, and so require diagnostic work-up or specialist referral, or both. Because non-specific low back pain does not have a known pathoanatomical cause, treatment focuses on reducing pain and its consequences. Management consists of education and reassurance, analgesic medicines, non-pharmacological therapies, and timely review. The clinical course of low back pain is often favourable, thus many patients require little if any formal medical care. Two treatment strategies are currently used, a stepped approach beginning with more simple care that is progressed if the patient does not respond, and the use of simple risk prediction methods to individualise the amount and type of care provided. The overuse of imaging, opioids, and surgery remains a widespread problem.
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            Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians.

            The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on noninvasive treatment of low back pain.
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              Low back pain

              Low back pain covers a spectrum of different types of pain (eg, nociceptive, neuropathic and nociplastic, or non-specific) that frequently overlap. The elements comprising the lumbar spine (eg, soft tissue, vertebrae, zygapophyseal and sacroiliac joints, intervertebral discs, and neurovascular structures) are prone to different stressors, and each of these, alone or in combination, can contribute to low back pain. Due to numerous factors related to low back pain, and the low specificity of imaging and diagnostic injections, diagnostic methods for this condition continue to be a subject of controversy. The biopsychosocial model posits low back pain to be a dynamic interaction between social, psychological, and biological factors that can both predispose to and result from injury, and should be considered when devising interdisciplinary treatment plans. Prevention of low back pain is recognised as a pivotal challenge in high-risk populations to help tackle high health-care costs related to therapy and rehabilitation. To a large extent, therapy depends on pain classification, and usually starts with self-care and pharmacotherapy in combination with non-pharmacological methods, such as physical therapies and psychological treatments in appropriate patients. For refractory low back pain, a wide range of non-surgical (eg, epidural steroid injections and spinal cord stimulation for neuropathic pain, and radiofrequency ablation and intra-articular steroid injections for mechanical pain) and surgical (eg, decompression for neuropathic pain, disc replacement, and fusion for mechanical causes) treatment options are available in carefully selected patients. Most treatment options address only single, solitary causes and given the complex nature of low back pain, a multimodal interdisciplinary approach is necessary. Although globally recognised as an important health and socioeconomic challenge with an expected increase in prevalence, low back pain continues to have tremendous potential for improvement in both diagnostic and therapeutic aspects. Future research on low back pain should focus on improving the accuracy and objectivity of diagnostic assessments, and devising treatment algorithms that consider unique biological, psychological, and social factors. High-quality comparative-effectiveness and randomised controlled trials with longer follow-up periods that aim to establish the efficacy and cost-effectiveness of low back pain management are warranted.
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                Author and article information

                Contributors
                Journal
                Heliyon
                Heliyon
                Heliyon
                Elsevier
                2405-8440
                13 June 2024
                30 June 2024
                13 June 2024
                : 10
                : 12
                : e32818
                Affiliations
                [a ]College of Sports Medicine and Health, Chengdu Sports University, Chengdu 61004, China
                [b ]College of Physical Education and Health, Guilin Institute of Information Technology, Guilin 541004, China
                [c ]School of Public Administration, Guilin University of Technology, Guilin 541004, China
                Author notes
                [* ]Corresponding author. mashuzhen@ 123456glut.edu.cn
                [** ]Corresponding author. cdtyxy@ 123456126.com
                Article
                S2405-8440(24)08849-2 e32818
                10.1016/j.heliyon.2024.e32818
                11226851
                e238d607-4f51-4478-b3b5-42c44b5ed7df
                © 2024 The Authors. Published by Elsevier Ltd.

                This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).

                History
                : 5 February 2024
                : 9 June 2024
                : 10 June 2024
                Categories
                Research Article

                core stability training,chronic non-specific low back pain,college students,muscle function,surface electromyography

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