Comparison Between the Effectiveness of Core Strengthening Exercises and William Flexion Exercises for Treatment of Non-Specific Low Back Pain in Elderly Individuals

Abstract

Background: Non-specific low back pain (NSLBP) is highly prevalent among elderly individuals and substantially impairs mobility and independence. Exercise-based rehabilitation is a cornerstone of conservative management, yet comparative evidence between commonly used exercise strategies remains limited in older adults. Objective: To compare the effectiveness of core strengthening exercises (CSE) versus William flexion exercises (WFE) in reducing pain, improving disability, and enhancing trunk muscle strength among elderly individuals with NSLBP. Methods: A randomized controlled trial was conducted among 60 participants aged 60–80 years with NSLBP, allocated to CSE (n=30) or WFE (n=30). Both groups received supervised sessions three times weekly for eight weeks. Outcomes included pain intensity (VAS), functional disability (ODI), and trunk flexor/extensor strength measured using dynamometry at baseline, Week 4, and Week 8. Results: Both groups improved significantly over time. At Week 8, CSE demonstrated superior outcomes compared with WFE for pain (mean difference −0.70, 95% CI −1.19 to −0.21; p=0.006), disability (mean difference −6.70, 95% CI −9.31 to −4.09; p<0.001), flexor strength (mean difference 4.80 Nm, 95% CI 1.16 to 8.44; p=0.011), and extensor strength (mean difference 7.70 Nm, 95% CI 3.85 to 11.55; p<0.001). Conclusion: Both exercise programs improved outcomes in elderly NSLBP, but core strengthening produced greater disability reduction and trunk strength gains by Week 8.