Impact of Core Stabilization Exercises Versus Pilates on Pain Intensity, Lumbar Range of Motion, and Daily Activity Performance in Patients with Lumbar Disc Herniation: A Randomized Controlled Trial
DOI:
https://doi.org/10.61919/cxj8p995Keywords:
Lumbar disc herniation, core stabilization, Pilates, pain intensity, lumbar range of motion, daily activity, randomized controlled trialAbstract
Background: Lumbar disc herniation (LDH) is a common source of pain and disability, often impairing mobility and daily function. While core stabilization exercises and Pilates are widely used in rehabilitation for LDH, comparative evidence of their effectiveness remains limited. Objective: To compare the effects of core stabilization exercises and Pilates on pain intensity, lumbar range of motion (ROM), and daily activity performance in patients with lumbar disc herniation. Methods: In this single-center randomized controlled trial, 60 patients aged 30 to 55 years with MRI-confirmed LDH and moderate to severe pain (VAS ≥4) were randomly assigned to core stabilization (n = 30) or Pilates (n = 30) groups. Both groups received 12 supervised sessions over six weeks. Pain intensity (Visual Analog Scale), lumbar ROM (flexible goniometer), and functional disability (Roland-Morris Disability Questionnaire) were measured at baseline and post-intervention by blinded assessors. Data were analyzed using paired and independent t-tests, with effect sizes and confidence intervals reported. Results: Both interventions significantly reduced pain and disability and increased lumbar ROM (all p < 0.001). Core stabilization yielded greater improvements in VAS (mean change: -3.1 vs. -1.7), ROM (+14.7° vs. +9.8°), and RMDQ (-7.7 vs. -4.4) compared to Pilates, with significant between-group differences favoring core stabilization for all outcomes (VAS p = 0.02, ROM p = 0.01, RMDQ p = 0.03). Conclusion: Core stabilization exercises are more effective than Pilates in reducing pain and disability and enhancing lumbar mobility in patients with LDH. These findings support prioritizing core stabilization protocols in conservative LDH management.
References
1 Jafari S, Dehesh T, Iranmanesh F. Classifying patients with lumbar disc herniation and exploring the most effective risk factors for this disease. J Pain Res. 2019;12:1179-87.
2 Benzakour T, Igoumenou V, Mavrogenis AF, Benzakour A. Current concepts for lumbar disc herniation. Int Orthop. 2019;43:841-51.
3 Lee K. The relationship of trunk muscle activation and core stability: a biomechanical analysis of Pilates-based stabilization exercise. Int J Environ Res Public Health. 2021;18(23):12804.
4 Alkhathami K. Effectiveness of spinal stabilization exercises on movement performance in adults with subacute and chronic low back pain: A randomized clinical trial. Texas Woman’s University; 2019.
5 Fernández-Rodríguez R, Álvarez-Bueno C, Cavero-Redondo I, Torres-Costoso A, Pozuelo-Carrascosa DP, Reina-Gutiérrez S, et al. Best exercise options for reducing pain and disability in adults with chronic low back pain: Pilates, strength, core-based, and mind-body. A network meta-analysis. J Orthop Sports Phys Ther. 2022;52(8):505-21.
6 Patel L, Subramanian SS, Cherian SB, Oraon AK, Behera MK. Effect of 4 weeks core stabilization exercise on muscle activity, range of motion and function in lumbar spondylosis. Fizjoterapia Polska. 2024;5.
7 Salahuddin S, Jabbar W, Tariq N, Ahmed MI, Shah MAA, Fatima K, et al. Effects of Pilates Exercises as a Treatment Approach in Patients with Non-Specific Low Back Pain. J Health Rehabil Res. 2024;4(1):1062-7.
8 da Silva ML, Miyamoto GC, Franco KFM, dos Santos Franco YR, Cabral CMN. Different weekly frequencies of Pilates did not accelerate pain improvement in patients with chronic low back pain. Braz J Phys Ther. 2020;24(3):287-92.
9 Frizziero A, Pellizzon G, Vittadini F, Bigliardi D, Costantino C. Efficacy of core stability in non-specific chronic low back pain. J Funct Morphol Kinesiol. 2021;6(2):37.
10 Yu Z, Yin Y, Wang J, Zhang X, Cai H, Peng F. Efficacy of Pilates on pain, functional disorders and quality of life in patients with chronic low back pain: a systematic review and meta-analysis. Int J Environ Res Public Health. 2023;20(4):2850.
11 Hornung AL, Baker JD, Mallow GM, Sayari AJ, Albert HB, Tkachev A, et al. Resorption of lumbar disk herniation: mechanisms, clinical predictors, and future directions. JBJS Rev. 2023;11(1):e22.
12 Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14(7):798-804.
13 Roland M, Morris R. A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine (Phila Pa 1976). 1983;8(2):141-4.
14 Dimitrijević V, Rašković B, Jevtić N, Nikolić S, Viduka D, Obradović B. Pain and disability therapy with stabilization exercises in patients with chronic low back pain: a meta-analysis. Healthcare (Basel). 2025;13(3):445.
15 Akram A, Imtiaz K, Maryem S, Mahmood W, Mahmood T, Babur MN. Comparison of Pilates exercises versus muscle energy technique with Kinesio taping in non-specific low back pain: a randomized controlled trial. Khyber Med Univ J. 2024;16(1):3-9.
16 Hayat R, Salik S, Rani S, Zia A, Jamal N, Khan LN, et al. Comparing the effectiveness of specific lumbar mobilization and core stability exercises in mechanical low back pain in decreasing pain and disability: a randomized control trial. The Therapist. 2024;7:7-13.
17 Patti A, Thornton JS, Giustino V, Drid P, Paoli A, Schulz JM, et al. Effectiveness of Pilates exercise on low back pain: a systematic review with meta-analysis. Disabil Rehabil. 2024;46(16):3535-48.
18 Franks J, Thwaites C, Morris ME. Pilates to improve core muscle activation in chronic low back pain: a systematic review. Healthcare (Basel). 2023;11(8):1122.
19 Martínez-Milán J, Perpiñá Martínez V, López-Torres Hidalgo J. Efficacy of exercise therapy in patients with chronic low back pain: a network meta-analysis. Spine J. 2021;21(8):1321-30.
20 Shiri R, Coggon D, Falah-Hassani K. Exercise for prevention of low back pain: systematic review and meta-analysis of controlled trials. Am J Epidemiol. 2018;187(5):1093-101.
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Copyright (c) 2025 Muhammad Danial Baig Chughtai, Hamza Shabbir, Muhammad Basim, Um e Rubab, Aasim Manzoor, Amir Ali, Kashmala Khan, Hafiz Ali Bin Asim (Author)
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