Investigation of the effects of stabilization exercises of different intensities on the mechanical properties of core muscles and pain in chronic low back pain

Hasan Kalyoncu University, Graduate School of Postgraduate Education, Physiotherapy and Rehabilitation Department PhD Thesis Gaziantep, (2025). This study evaluated the effects of spinal stabilization exercises applied at different intensities on the mechanical properties of the core muscles and pain in patients with chronic low back pain (CLBP). 54 individuals who agreed to participate in the study voluntarily were divided into three groups using the block randomization method. The first group was given spinal stabilization exercises four days a week, the second group was given spinal stabilization exercises two days a week, and the third group was given a home program for the waist and abdominal muscles. The study lasted 12 weeks, and 2 people from group 1 and 1 person each from groups 2 and 3 could not complete the study. Participants' transversus abdominis (TrA) muscle stiffness, pain level with visual analog scale (VAS), lumbar disability level with Oswestry disability questionnaire, pain sensitivity and trunk muscle endurance were measured before and after the 12th week of treatment, and an interim measurement was made for VAS and Oswestry parameters at the 6th week of treatment. After treatment, left and right side TrA muscle stiffness increased in groups 1 and 2 compared to pre-treatment (p<0,001). In Group 3, no change was observed in left and right side TrA muscle stiffness compared to pre-treatment (p=0.207) (p=0.082). Differences in muscle stiffness for left and right TrA were higher in group 1 than in group 2. VAS values decreased in all groups in the measurements taken at 6 and 12 weeks (p<0.005). Participants' disability levels decreased in all groups at 6 weeks and 12 weeks (p<0.005). There was a decrease in pain sensitivity in all groups after 12 weeks of treatment. In endurance tests, there was an increase in flexion, extension and bilateral lateral flexion tests in group 1 and group 2, and an increase in other tests except the extension endurance test in group 3. In conclusion, spinal stabilization exercises performed under the supervision of a physiotherapist are more effective than home exercises. Stabilization exercises performed 4 days a week are superior to exercises performed 2 days a week in improving muscle stiffness, disability level, pain sensitivity and muscle endurance. We recommend that supervised exercise intensity be planned as 4 days in CLBP rehabilitation.