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Core strength training for patients with chronic low back pain


Tags: treatment, abdominals, back pain, exercise, movement, strength, self-treatment, pain problems, spine

PainSci notes on Chang 2015:

This review of four studies of core strength training for back pain concludes that “core strength training is more effective than typical resistance training for alleviating chronic low back pain.” This is surprising to me, given that I am not aware of any individual high quality trials showing that, and indeed have seen plenty of evidence to the contrary.

Certainly it’s a problem that the authors begin with the assumption that “one major cause [of back pain] involves the weakening of the shallow trunk and abdominal muscles.” That is not established, and their citations to support are minimal and bogus — just two, both with poor relevance, and one by the author of this review. They then proceed to also assume the efficacy of what they are studying: “Mitigating CLBP and improving mobility typically involves strengthening these muscles.” So in my opinion this a very biased review, a fishing expedition: researchers looking for confirmation of what they already believe.

It’s also a problem that they found only four studies that met their inclusion criteria, and all four studies were small. They aren’t reviewing much data, which makes it easy for bias

So I’m skeptical, but I’m also not writing it off. I will revise this summary when I have had a chance to read the full review.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

PURPOSE: Through core strength training, patients with chronic low back pain can strengthen their deep trunk muscles. However, independent training remains challenging, despite the existence of numerous core strength training strategies. Currently, no standardized system has been established analyzing and comparing the results of core strength training and typical resistance training. Therefore, we conducted a systematic review of the results of previous studies to explore the effectiveness of various core strength training strategies for patients with chronic low back pain.

METHODS: We searched for relevant studies using electronic databases. Subsequently, we evaluated their quality by analyzing the reported data.

RESULTS: We compared four methods of evaluating core strength training: trunk balance, stabilization, segmental stabilization, and motor control exercises. According to the results of various scales and evaluation instruments, core strength training is more effective than typical resistance training for alleviating chronic low back pain.

CONCLUSION: All of the core strength training strategies examined in this study assist in the alleviation of chronic low back pain; however, we recommend focusing on training the deep trunk muscles to alleviate chronic low back pain.

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