Updates on core stabilization exercise and strengthening exercise: A review article

Main Article Content

Su Su Hlaing
Rungthip Puntumetakul
Sawitri Wanpen
Pongsatorn Saiklang

Abstract

Nowadays, core stabilization exercise (CSE) and strengthening exercise (STE) are widely used in clinical practice to treat lower back pain. CSE focuses on the transversus abdominis (TrA) and lumbar multifidus (LM) muscles, is based on a motor relearning approach, and retrains the function of the local trunk muscles, whereas STE emphasizes the global muscles. Both exercises reduce pain and functional disability, provide neuromuscular control, and enhance the stability of the spine. Although a variety of previous studies have compared the effectiveness of these two forms of exercise, the heterogeneity of treatment procedures and participants produced conflicting results. The aim of this article is to compare and contrast CSE and STE in four different categories: exercise performance, neuromuscular activation and muscle involvement, intensity and duration, and exercise adherence. Most previous research has concluded that there is no significant difference in effectiveness between the two forms of exercise because both utilize a similar approach. Therefore, both exercises can help to reduce lower back pain problems, and we suggest that therapies should be chosen according to which exercise is the most appropriate for the problems presented by each individual patient in terms of the severity and pathology of the lower back pain. Further studies need to explore the effects of CSE and STE in terms of motor control-proprioceptive sense, balance, and muscle thickness-in the early stages of lower back pain.

Article Details

How to Cite
Hlaing, S. S., Puntumetakul, R., Wanpen, S., & Saiklang, P. (2021). Updates on core stabilization exercise and strengthening exercise: A review article. Asia-Pacific Journal of Science and Technology, 26(04), APST–26. https://doi.org/10.14456/apst.2021.42
Section
Review Articles
Author Biographies

Su Su Hlaing, Human Movement Sciences, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand

Chief Physiotherapist

Physical Medicine and Rehabilitation department

Maubin General Hospital 

Maubin Township, Irrawaddy division, Myanmar.

Rungthip Puntumetakul, Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand

Associate Professor, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Muang District, Kohn Kaen, Thailand.

Sawitri Wanpen, Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand

Assistant Professor, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Muang District, Kohn Kaen, Thailand.

Pongsatorn Saiklang, Division of Physical Therapy, Faculty of Physical Therapy, Srinakharinwiroj University, Nakhonnayok, Thailand

PhD candidate, Human Movement Sciences, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.

References

Sánchez JS, Peñas FC, Garrido CP, Barrera HV, Blanco AC, Ceña PD, et al. Prevalence of chronic head, neck and low back pain and associated factors in women residing in the autonomous region of Madrid (Spain). Gac Sanit. 2012;26(6):534-540.

Oostroml SH, Verschurenl WM, Vetl HC, Picavetl HS. Ten year course of low back pain in an adult population-based cohort-the doetinchem cohort study. Eur J Pain. 2011;15(9):993-998.

Meucci RD, Fassa AG, Faria NM. Prevalence of chronic low back pain: systematic review. Rev De Saude Publica. 2015;49:1-10.

Kasai Y. A comparison of chronic pain prevalence in Japan, Thailand, and Myanmar. Pain Physician. 2013; 16(6):603-608.

Candotti CT, Noll M, Marchetti BV, Rosa BN, Medeiros MD, Vieira A, et al. Prevalence of back pain, functional disability, and spinal postural changes. Fisioterapia em Movimento. 2015; 28(4):711-722.

American Physical Therapy Association. Guide to physical therapist practice. 2nd ed. Virginia: APTA; 2001.

Sullivan PB, Phyty GD, Twomey LT, Allison GT. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997;22(24): 2959-2967.

Koumantakis GA, Watson PJ, Oldham JA. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther. 2005; 85(3):209-225.

Richardson CA, Hodges P, Hides JA. Therapeutic exercise for lumbopelvic stabilization: a motor control approach for the treatment and prevention of low back pain. 2nd ed. Edinburgh: Churchill Livingstone; 2004.

McGill SM. Low Back Disorders: evidence-based rehabilitation and prevention. 2nd ed. Champaign: Human Kinetics; 2007.

Saiklang P, Puntumetakul R, Swangnetr MN, Boucaut R. The immediate effect of the abdominal drawing-in ma-neuver technique on stature change in seated sedentary workers with chronic low back pain. Ergonomics. 2020;64(1):55-68.

Hayden JA, Tulder MW, Malmivaara AV, Koes BW. Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med. 2005;142(9):765-775.

Puntumetakul R, Areeudomwong P, Emasithi A, Yamauchi J. Effect of 10-week core stabilization exercise training and detraining on pain-related outcomes in patients with clinical lumbar instability. Patient Prefer Adherence. 2013;7:1189-1199.

Aly SM. Trunk muscles’response to core stability exercises in patients with chronic low back pain: a randomized controlled trial. Int J Physiother Res. 2017;5(1):1836-1845.

Bergmark A. Stability of the lumbar spine: a study in mechanical engineering. Acta Orthopaedica Scandinavica. 1989;60 Suppl 230:1-54.

Stanford ME. Effectiveness of specific lumbar stabilization exercises: a single case study. J Man Manip Ther. 2002;10(1):40-46.

Comerford MJ, Mottram SL. Movement and stability dysfunction-contemporary developments. Man Ther. 2001;6(1):15-26.

Neumann D. Kinesiology of the musculoskeletal system: foundations for rehabilitation. 2nd ed. Philadephia: Saunder and Mosby; 2010.

MacDonald DA, Moseley GL, Hodges PW. The lumbar multifidus: does the evidence support clinical beliefs?. Man Ther. 2006;11(4):254-263.

Cholewicki J, McGill SM. Mechanical stability of the in vivo lumbar spine: implications for injury and chronic low back pain. Clin Biomech. 1996;11(1):1-5.

Morse GM, Stokes IA. Trunk stiffness increases with steady-state effort. J. Biomech. 2001;34(4):457-463.

Sale DG. Neural adaptation to resistance training. Med Sci Sports Exerc. 1988;20 Suppl 5:S135-145.

Tsao H, Galea MP, Hodges PW. Driving plasticity in the motor cortex in recurrent low back pain. Eur J Pain. 2010;14(8):832-839.

Tsao H, Galea MP, Hodges PW. Reorganization of the motor cortex is associated with postural control deficits in recurrent low back pain. Brain. 2008;131(8):2161-2171.

Pollock ML, Graves JE, Bamman MM, Leggett SH, Carpenter DM, Carr C, et al. Frequency and volume of resistance training: effect on cervical extension strength. Arch Phys Med Rehabil. 1993;74(10):1080-1086.

Puntumetakul R, Saiklang P, Yodchaisarn W, Hunsawong T, Ruangsri J. Effects of core stabilization exercise versus general trunk-strengthening exercise on balance performance, pain intensity and trunk muscle activity patterns in clinical lumbar instability patients. Walailak J Sci Technol. 2021;18(7):1-13.

Hwangbo G, Lee CW, Kim SG, Kim HS. The effects of trunk stability exercise and a combined exercise program on pain, flexibility, and static balance in chronic low back pain patients. J Phys Ther Sci. 2015; 27(4):1153-1155.

Bhadauria EA, Gurudut P. Comparative effectiveness of lumbar stabilization, dynamic strengthening, and Pilates on chronic low back pain: randomized clinical trial. J Exerc Rehabil. 2017;13(4):477-485.

Shamsi M, Sarrafzadeh J, Jamshidi A, Arjmand N, Ghezelbash F. Comparison of spinal stability following motor control and general exercises in nonspecific chronic low back pain patients. Clin Biomech. 2017;48:42-48.

Nabavi N, Bandpei MA, Mosallanezhad Z, Rahgozar M, Jaberzadeh S. The effect of 2 different exercise programs on pain intensity and muscle dimensions in patients with chronic low back pain: A randomized controlled trial. J Manipulative Physiol Ther. 2018;41(2):102-110.

Sabaté E, Sabaté E. Adherence to long-term therapies: evidence for action. 1st ed. Geneva: World Health Organization; 2003.

Wang X, Zheng J, Yu Z, Bi X, Lou S, Liu J, et al. A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One. 2012;7(12):e52082.

Slade SC, Patel S, Underwood M, Keating JL. What are patient beliefs and perceptions about exercise for nonspecific chronic low back pain?: a systematic review of qualitative studies. Clin J Pain. 2014;30(11):995-1005.

Bringas NT, Desatnik RA, Hernández AA, Medina CE. Adherence to a stability exercise programme in patients with chronic low back pain. Cir Cir. 2016;84(5):384-391.

Palazzo C, Klinger E, Dorner V, Kadri A, Thierry O, Boumenir Y, et al. Barriers to home-based exercise program adherence with chronic low back pain: Patient expectations regarding new technologies. Ann Phys Rehabil Med. 2016;59(2):107-113.

Hicks GE, Benvenuti F, Fiaschi V, Lombardi B, Segenni L, Stuart M, et al. Adherence to a community-based exercise program is a strong predictor of improved back pain status in older adults: an observational study. Clin J Pain. 2012;28(3):195.