Comparison of Core Stability versus McKenzie Exercises in people with low back pain: effects induced by 4 weeks of training on pain, flexibility and spine mobility

Purpose: Low back pain (LBP) is one of the major spine disorders which seriously impairs many daily activities and limits functional skills. The role of exercise in LBP management is well documented, even if the debate about the most effective type of training is still present. The aim of this study is to investigate the effects of a 4 weeks specific training on LBP symptoms, trunk mobility and muscle flexibility in adult people suffering from this pathology. Methods: Thirty people (age: 30-50 years old) were recruited for the study. All participants were untrained and affected from chronic non-specific LBP. Participants were divided into 2 groups composed by 15 people each one: Training Group 1 (TG-1) and Training Group 2 (TG-2). Both groups trained twice a week for 4 weeks (8 sessions in total) with a duration of 30 minutes each session. TG-1 performed 7 Core Stability exercises with focus on core muscles activation while TG-2 executed 6 McKenzie method exercises (spine mobility and specific LBP antalgic positions). All participants were assessed pre and post training to evaluate pain intensity (Numerical Rating Scale – NRS), posterior chain muscles flexibility (Forward Bending Test - BEND) and trunk mobility (Schober Test - SCHOBER). In addition to group training, participants repeated Core Stability (TG-1) or McKenzie (TG-2) exercises individually at home. Results: NRS and SCHOBER significantly improved in both TG-1 and TG-2 (p<0.01), while significance was observed in BEND for TG-2 only (p<0.05). Group comparison evidenced significance for NRS, with better improvements observed TG-1 (p<0.01). No differences were reported for SCHOBER and BEND during TG-1 and TG-2 comparison (p>0.05). Conclusions: Previous results suggest that both type of training are effective for pain reduction and lumbar spine mobility improvements, while only McKenzie exercises increased posterior muscle chain flexibility during forward bending test. Since Core Stability exercises leaded to better results about LBP symptomatology after 4 weeks of specific training, the combination of both kind of exercises could be useful in people suffering from LBP. Reference: Hosseinifar M., Akbari M., Behtash H., Amiri M., Sarrafzadeh J., The Effects of Stabilization and Mckenzie Exercises on Transverse Abdominis and Multifidus Muscle Thickness, Pain, and Disability: A Randomized Controlled Trial in Non Specific Chronic Low Back Pain, J Phys Ther Sci 2013 Dec;25(12):1541-5.