Effects of different exercise approaches on physical and cognitive parameters in chronic low back pain individuals

In this study, the impact of yoga, aerobic exercise, and spinal stabilization exercises on physical and cognitive variables in individuals with chronic low back pain was investigated. Seventy-four individuals with low back pain whose pain persisted for three months or longer were included in the study. Individuals were randomly divided into three groups. The first group consisted of 25 people who were given spinal stabilization exercise training. The second group consisted of 24 people who were given aerobic exercise training. The third group consisted of 25 people, and these individuals applied a yoga program consisting of breathing, asana (posture), and relaxation exercises. All individuals had exercises performed under the supervision of a physiotherapist two days a week for eight weeks. Sociodemographic data of the individuals were recorded. Pain intensity was assessed using the Visual Analog Scale (VAS), functional status with the Oswestry Disability Index (ODI), metabolic capacity through the 6-Minute Walk Test, fear avoidance beliefs using the Fear-Avoidance Beliefs Questionnaire (FABQ), pain catastrophizing level with the Pain Catastrophizing Scale (PCS), cognitive functions with the Montreal Cognitive Assessment (MoCA), alexithymia level with the Toronto Alexithymia Scale (TAS), and back awareness with the Fremantle Back Awareness Questionnaire (FreBAQ). Quality of life was evaluated using the Nottingham Health Profile (NHP). The results indicated that all interventions reduced pain and improved function, Transversus Abdominis (TrA) activation, and quality of life while enhancing cognitive parameters in individuals with chronic low back pain. No superiority was observed among spinal stabilization, yoga, and aerobic exercises in terms of pain, function, quality of life, cognitive level, fear avoidance, pain catastrophizing, back awareness, and alexithymia (p>0.05). However, improvement in metabolic capacity was observed in the yoga and aerobic exercise groups (p<0.05). In conclusion, for individuals with chronic low back pain without neurological deficits, these exercise programs, when administered by trained physiotherapists, can be tailored to the needs, expectations, and interests of the individuals. Key words: low back pain, yoga, exercise, kinesiophobia, cognitive function, back awareness