IAJPS 2018, 05 (05), 3705-3709 Iqra Shoukat et al ISSN 2349-7750

CODEN [USA]: IAJPBB ISSN: 2349-7750

INDO AMERICAN JOURNAL OF

PHARMACEUTICAL SCIENCES
http://doi.org/10.5281/zenodo.1245913

Available online at: http://www.iajps.com Research Article

AN EXPERIMENTAL AND COMPARATIVE RESEARCH ON THE CORE

STABILIZATION EFFECTS IN THE ABSENCE AND PRESENCE OF
CONVENTIONAL PHYSICAL THERAPIES TO MANAGE NON-
SPECIFIED PAIN IN THE LOWER BACK AREA: MAYO HOSPITAL,
LAHORE
1
Iqra Shoukat, 2Dr Ammara Farooq,3Dr. Iqra Akhter
1
DHQ Hospital Hafizabad
2
BHU Banshaheed Tehsil Dina District Jhelum
3
WMO Anaesthesia Dept, Govt General Hospital Ghulam Muhammad Abad Faisalabad
Abstract:
Objectives: The research aim was the examination of the core stabilization exercises effects on the conventionalphysiotherapy to
manage non-specified low back ache and pain also known as LBP.
Methodology: The research design was comparative and experimental conducted at Mayo Hospital, Lahore (Physiotherapy
Department). Our research included a total of forty cases that were diagnosed with the non-specified LBP in the age group of 18
to 65 years. All the included patients were divided into two groups randomly:
Group – A (Experimental Group): The patients of this group were managed with the help of conventionalphysiotherapy and
core stabilization exercises.
Group – B (Control Group): The treatment of these cases was carried out with conventional physiotherapy as the sole treatment
therapy. Measured outcomes were functional outcomes of physical and pain which were measured through VAS (Visual
AnalogueScale). Physical outcomes in terms of function were measured through Modified Oswestery Disability Questionnaire
(MODQ).
Results: We applied T – Test on A group and obtained MODQ and VAS p-values which were significantly observed as (0.000 for
both); whereas, in group B the p-values were also same as mentioned earlier. With the AVOVA application insignificant p-values
were observed for VAS and MODQ as 0.09& MODQ as 0.018.
Conclusion: Improvement was observed in both A and B groups for functional activity and pain; whereas, A group was treated
with the core stabilization exercises assisted with the conventional treatment which reflected a bit of improvement in the function
and pain in B group. For the attainment of better outcomes any of the mentioned intervention can be used in order to produce
effective management.
Keywords: Conventionalphysiotherapy, Core stabilization exercises, Lower back pain (LBP), (VAS) Visual analoguescale.
Corresponding author:
Iqra Shoukat, QR code
DHQ Hospital,
Hafizabad

Please cite this article in press Iqra Shoukat et al., An Experimental and Comparative Research On the Core
Stabilization Effects in the Absence and Presence of Conventional Physical Therapies to Manage Non-Specified
Pain in the Lower Back Area: Mayo Hospital, Lahore, Indo Am. J. P. Sci, 2018; 05(05).

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 IAJPS 2018, 05 (05), 3705-3709 Iqra Shoukat et al ISSN 2349-7750

INTRODUCTION: specified LBP in the age group of 18 to 65 years.

Research was aimed at the effective determination of Patients were selected from both the genders
the various therapeutic techniques to manage the including female and male. All the cases having non-
incidence of LBP in the patients. This pain known as specified LBP in the age of 18 – 65 years were
LBP is felt in the area between 12th rib and lower included in the research paper. All the cases of
gluteal folds also known as the lower back. This pain malignancies, spinal infections, tumors, fever,
may radiate to the side of both legs or it may be felt ankylosing spondylitis, weight loss and chills were
as there is no radiation [1]. In the incidence of non- not made a part of the research. Systematic random
specified pain evidence of reason and cause is sampling was used for the selection of the sample in
unknown. There may be a specific reason behind the the even order such as every second, fourth and sixth
incidence of the LBP because of the known cause or onward was short listed in “A” group and odd in the
because of the specific pathology such as prolapsed “B” group. Twenty cases were included in both the
disc, tumors, inflammatory conditions, fracture, groups such as Group – A (Experimental Group):
osteoporosis, herniated nucleus pulpous [2]. The The patients of this group were managed with the
cause is known in five to ten percent of the cases help of conventionalphysiotherapy and core
which is non-specified [1]. Number of reasons are stabilization exercises. Group – B (Control Group):
involved behind the radiation of LBP or without the The treatment of these cases was carried out with
incidence of pain; which are idiopathic, degenerative, conventional physiotherapy as the sole treatment
inflammatory, congenital, renal, traumatic, therapy. Measured outcomes were functional
gynecological, neo-plastic, postural, mechanical, outcomes of physical and pain which were measured
metabolic or rectal systemic causes [3]. LBP has through VAS (Visual AnalogueScale). Physical
become the second common most cause in USA outcomes in terms of function were measured
which causes the absence from work centers [4]. It through Modified Oswestery Disability
includes various factors of risk such as life style, Questionnaire (MODQ).
gender, age, socioeconomic status, occupation and
smoking [5]. Many methods are used conventionally Thirty minutes thrice in a month were given to the
for the reduction of symptoms and pain to improve patients in the treatment session. Physical outcome
the function of the activity. Use of drugs to reduce and pain were the outcomes measurements. VAS was
the pain is also common practice such as NSAIDS, used for the measurement of pain in the range of zero
analgesics, naproxen ibuprofen, muscle relaxants, to ten which indicated mild to severe pain in the
opioids and steroids [6, 7]. Few other related patients. MODQ was used for the measurement of
modalities also include heat therapy, mechanical or patient’s physical functional results. The presentation
manual traction, short-wave diathermy (SWD), of the results was made through lower percentage and
transcutaneous electrical nerve stimulator (TENS), percentage observed with visible improvement. Pre
therapeutic ultrasound, and therapeutic exercises and and post treatment in the second month the values of
massage [8]. the MODQ and VAS were also compared for both
groups. Research used various materials such as table
It has been observed through the core stabilization of treatment, MODQ, VAS, consent form and data
exercises that they are effective in the treatment of collection sheet. For pre and post treatment
the LBP.Core stabilizationexercises primarily aims at measurements of the MODQ and pain scales were
the spinal stability improvement, endurance, utilized for four months and after that values were
strengthand function which decreases the intensity of compared within the groups and inter groups for the
pain. The core musculature strength playsvery analysis of the reduction of the pain observed through
important role in the spine stability and also VAS and functional outcomes improvements
decreased the instability issues [9]. The target of the observed through MODQ.
core stabilization exercises is to abdominal, gluteal
muscles and para-spinal stabilization. The exercises SPSS – 16 was used for the data analysis at the p-
included in the stability are abdominal curls up, side value as (0.05) and (< 0.05) were observed
– bridge, oblique curls up, quadruped exercises with significant. Frequency tables were used for the
the exercise progression. representation of the quantitative data such as mean
and SD. Frequencies were used for the qualitative
MATERIALS AND METHODS: data representation. Double intervention affect was
The research design was comparative and observed with paired T – Test. Both groups’
experimental conducted at Mayo Hospital, Lahore interventions were compared through ANOVA.
(Physiotherapy Department). Our research included a Windows – 7 was used as the operating software.
total of forty cases that were diagnosed with the non-

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 IAJPS 2018, 05 (05), 3705-3709 Iqra Shoukat et al ISSN 2349-7750

value (0.09) and in the case of MODQ the value was

RESULTS: observed as (0.018) being significant.
We observed in the forty patients of the research
sample that male and female were respectively27 DISCUSSION:
males (67.5%) and 13 females (32.5%). About 22 LBP is a serious issue and poses serious threats to the
cases (55%) were observed with gradual symptoms health of the human being. It is among the common
onsetand 18 cases shown sudden onset (45%). In and repeated issues and eighty-five percent of the
these cases, 14 cases (35%) were observed with world population is suffering from this issue, this
visible outcomes of the radiology with underlying incidence is bad in fifty percent of the population
pathology. More involvement was observed in the [10]. Research was aimed at the comparison of the
right side of the back in comparison to the left side in core stabilization exercises effects in the presence
25 cases (62.5%). Group – A was observed with pre- and absence of the conventional methods of
treatment VAS scale values as (7.3 ± 1.2) and pre- management for the non-specified backache issues in
treatment MODQ values as (66.5 ± 12.3);whereas, in the intervention of the core stabilization with
the event of post treatment as (46.7 ± 8.8). Significant conventional treatment of physiotherapy that is
p-values were observed in both MODQ and VAS as known as effective and improves the overall comfort
(0.00) in both the groups. B group was observed with scores and decreases the pain scale. Males were
the mean values of VAS in the pre-treatment as (7.4 dominant in this research in the incidence of LBP as
± 1.04) and in the event of post treatment it was 67.5% males were observed with LBP developed
observed as (3.7 ± 1.09). In the same way, MODQ stage. Gradually developed symptoms in most of the
mean values in the event of pre-treatment was (70 ± cases were observed in 55% of the cases.
10) and post treatment MODQ was (45 ± 9.2). Radiological changes were observed in 35% of the
Significant p-values for both the groups in MODQ cases which were linked with the back ache right side
and VAS were observed as (0.00). Repeated measure involvement was observed in 62.5% of the cases.
ANOVA was applied and VAS was observed as p-

Table – I: Paired T – test for group “A” (number = 20) given core stabilization exercises and conventional
therapy.
Variables Mean Std. Deviation T P – value

VAS (pre)
Pair 1 3.99444 1.57871 10.735 0
VAS (post)
MODQ (pre)
Pair 2 19.77778 18.11257 4.633 0
MODQ (post)

Group - A Paired T - Test

4.633
T
10.735

18.11257
Std. Deviation
1.57871

19.77778
Mean
3.99444

0 5 10 15 20 25

Pair 2 Pair 1 Poly. (Pair 1 )

*p-value (< 0.05)

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 IAJPS 2018, 05 (05), 3705-3709 Iqra Shoukat et al ISSN 2349-7750

Table – II: Paired T – Test for group “B” (number = 20) given core stabilization exercises alone
Std.
Variables Mean t p-value
Deviation
VAS (pre)
Pair 1 3.65 1.3518 11.456 0
VAS (post)
MoDQ (pre)
Pair 2 24.88889 14.54765 7.259 0
MoDQ (post)

Group - B Paired T - Test

0
p-value
0

7.259
t
11.456

14.54765
Std. Deviation
1.3518

24.88889
Mean
3.65

0 5 10 15 20 25 30

Pair 2 Pair 1 Poly. (Pair 1 )

*p-value (<0.05)

Van Tulder states that medications including

analgesic and NSAIDs reduces incidence of LBP in Ferreira states that core stabilization produces better
the patients [6]. The role of the muscle relaxant outcomes when compared to the non-treated cases or
cannot be over ruled in the reduction of stiffness and in other words for the cases treated in a conventional
pain [7]. Few of the research studies also observed way [14]. Limited availability of data has been
modalities utilization TENS USG, SWD which observed in terms of core stabilization exercises
reduces the pain and improves the LBP patient’s including conventional methods which are used for
functional activities [11]. the LBP treatment. Both techniques have been
proved through various research studies. Combined
According to the research of Rubinstein SM and his effectiveness has not been highlighted by any of the
colleagues, although conservative and safe is comparative research studies.
considered the spinal manipulation to manage the
pain but it does not improve stability and do not Our research proves that both the strategies are
effectively reduces the pain [12]. effective for the management of the LBP in order to
John Wiley is of the view that exercise has its own improve functional status and for the reduction of
benefits and also reduces the pain in the chronic LBP pain especially in the chronic cases of LBP. Both the
patients [13]. We emphasized in our research on the methods are effective in order to reduce the pain and
core stabilization exercises with conventional agony in the lower back and areas adjacent to the
physiotherapy because significant changes were ribs. It also helps in the regaining of the functional
observed in the level of pain and the functional stability. Significant p-value was observed for VAS
stability for the improvement of the overall lifestyle and MoDQ as (0.000) and (0.000).
of the affected cases. CONCLUSIONS:

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reflected a bit of improvement in the function and the assessment of lumbar pain in athletes.
pain in B group. For the attainment of better Journal of Athletic Training, 2000; 35 (2): 204-
outcomes any of the mentioned intervention can be 211.
used in order to produce effective management. 14. Ferreira PH, Ferreira ML. Specific stabilization
exercise for spinal and pelvic pain. Australian J
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