Outcome of core stability exercises versus general exercises in improving the function and pain levels in chronic low back pain: Systematic review of randomised clinical trial

Background: Core muscles (lumbo-pelvic region) instability influences the lumbo-pelvic control, an imperative precipitating factor for Chronic Low Back Pain (CLBP), leading to appreciable activity limitations and participation restrictions. This systematic review of randomized clinical trials (RCTs) aims to explore the efficacy of core stability exercises (CSEs) compared to general exercises (GEs) in improving the function and pain among individuals with CLBP. Methods: The RCTs evaluating CSEs and GEs in people with CLBP were searched in Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica Database (EMBASE), Clinical Index of Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), The Cochrane Central Register of Controlled Trials (CENTRAL), Google scholar, and PubMed from January 1992 to July 2019. The primary outcomes were pain and disability that were measured using validated pain and disability instruments, respectively. Results: Two of the five RCTs were of high methodological quality (PEDro score; 7-8/10), while the remaining three RCTs were of moderate methodological quality (PEDro score; 5-6/10). Lack of blinding was the major methodological concern of the included studies. Only three studies supported that CSEs was more effective than GEs, while remaining two studies demonstrated that CSEs and GEs were equally effective in reducing pain and disability in CLBP. Conclusion: The CSEs in CLBP is more effective in treating pain and disability compared to GEs. However, evidences don’t strongly support CSEs as an optimal therapeutic choice for the patients with CLBP, hence more comprehensive systema