Individuals with low back pain improve in standing tolerance and sagittal plane muscle activation following exercise intervention

BACKGROUND: Healthy individuals who develop low back pain (LBP) during standing (standing intolerant) respond favorably to stabilization-based exercise interventions. People with clinical LBP meeting clinical prediction rules for stabilization-based exercise share characteristics with standing intolerant individuals. OBJECTIVE: To investigate the impact of stabilization-based exercise on standing tolerance, muscle activation and clinical measures in individuals with LBP meeting clinical prediction rules for stabilization-based exercise. METHODS: Participants with and without LBP completed testing pre- and post-6 weeks of progressive home exercise intervention. Testing included clinical examination and electromyography during sagittal and frontal plane movements. LBP was also assessed by visual analogue scale (VAS) during standing. Outcomes included clinical findings, muscle sequencing, and VAS in standing. RESULTS: The LBP group had non-significant decreases in Oswestry Disability Index (-2.1%, p = 0.22), baseline VAS (-7.1 mm, p = 0.11), lumbopelvic reversal (p = 0.06) and positive active hip abduction test (p = 0.06). Significant improvements were seen in standing VAS (-5.6 mm, p < 0.001). The LBP group had beneficial changes in activation strategies in standing flexion (p < 0.05) following intervention, with no changes during frontal plane movement strategies. CONCLUSIONS: Individuals with LBP meeting clinical prediction rules for stabilization-based exercise demonstrated increased standing tolerance and sagittal plane muscle sequencing following a 6-week intervention.