Comparison of Moderate Load Eccentric Core Exercises and Pilates in Patients With Non-Specific Low Back Pain

Summary

Low back pain (LBP) is a major global health concern, significantly affecting mobility, productivity, and quality of life. Non-specific low back pain (NSLBP), which accounts for most LBP cases, is associated with impaired proprioception, reduced lumbar range of motion (ROM), decreased muscular endurance, and altered neuromuscular control. Joint position error (JPE) is a key indicator of proprioceptive dysfunction, contributing to postural instability and movement impairments in NSLBP patients. Effective rehabilitation strategies are essential to improve functional outcomes and prevent recurrence. Exercise therapy, particularly core stabilization exercises, plays a crucial role in NSLBP management. Among various approaches, moderate-load eccentric core exercises and Pilates have gained attention for their potential benefits. Eccentric exercises improve neuromuscular control, proprioception, and endurance by emphasizing controlled muscle lengthening. Pilates, on the other hand, focuses on core activation, postural alignment, and flexibility to enhance spinal stability and movement efficiency. However, limited research directly compares their effects on joint position error, pain, lumbar ROM, and core endurance in NSLBP patients. This randomized controlled trial (RCT) will recruit 44 NSLBP patients from Fauji Foundation Hospital, Rawalpindi, using purposive sampling. Participants will be randomly assigned to either the moderate-load eccentric core exercise group or the Pilates group for an 8-week supervised intervention. Assessments will be conducted at baseline, the 4th week, and post-intervention using an inclinometer (JPE), NPRS (pain), an inclinometer (lumbar ROM), and McGill Torso Endurance Battery (core endurance). SPSS version 21.0 will be used to analyze the data, with normality assessed through the Shapiro-Wilk test or the Kolmogorov-Smirnov test. Group differences will be analyzed using an Independent Sample t-test for normally distributed data and Mann-Whitney U test in case of non-normally distributed data (p \< 0.05).

Conditions

• Low Back Pain

Interventions

PROCEDURE

MODERATE LOAD ECCENTRIC CORE EXERCISES

MODERATE LOAD ECCENTRIC CORE EXERCISES: Eccentric training protocol will be incorporated in core strengthening regime . This will be conducted in two phases. Phase 1 will be the familiarization phase and phase 2 will be the acclimatization phase .

PROCEDURE

Pilates

Pilates description: participants will be enrolled in group B of the study and will follow a Pilates program designed to ensure progressive overload. The protocol will begin with foundational exercises focused on motor learning and core activation, progressing gradually to more advanced functional and load-bearing stability exercises. The primary focus will be on deep core recruitment, utilizing a beginner-level approach to avoid generalized movements and ensure targeted muscle activation. This structured progression will ensure that core stability remains the central focus, with each phase building upon the previous one. Warm up: Before starting the session, participants will perform warm up exercises for 10 minutes that include the following exercises: 1. Seated trunk rotation. 2. Standing trunk rotation 3. High knees 4. Standing side bends 5. Standing back stretch Each exercise will be performed 10 -12 times on each side. Cool down: Child's pose,Cat-cow stretch,Knee to chin

Sponsors & Collaborators

• Foundation University Islamabad

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

45 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-01-15

Primary Completion

2025-12-31

Completion

2026-01-15

Countries

• Pakistan

Study Locations