BACKGROUND: Blood flow restriction (BFR) is considered an alternative method for increasing muscle activity and thickness to reduce Nonspecific Chronic Low back pain (NSCLBP). OBJECTIVES: This study aimed to evaluate the effects of BFR with core stabilization exercise (CSE) on muscle activity, muscle thickness, and disability in individuals with NSCLBP. METHODS: A total of 38 individuals with NSCLBP aged 18 to 45 years were included in this study. The participants were randomly divided into the BFR plus CSE and CSE groups (n = 19 each). All participants underwent supervised rehabilitation sessions three times per week over a period of four consecutive weeks. Muscle activity, muscle thickness, and disability were assessed before and after the four-week intervention. RESULTS: The BFR plus CSE group showed significant within-group improvement in muscle activity of the transversus abdominis (TrA), multifidus (MF), and gluteus maximus (Gmax), muscle thickness at rest and during contraction, and disability (p < 0.05). The CSE group showed a significant increase in electromyography activity of the MF muscle (p < 0.05), a significant increase in muscle thickness at rest for the TrA, MF, and Gmax muscles (p < 0.05), and only a significant increase in muscle thickness during contraction for the TrA muscle (p < 0.05). Additionally, the BFR plus CSE group exhibited superior benefits compared to the CSE group across all variables. CONCLUSION: BFR combined with CSE over four weeks is more effective in improving TrA, MF, and Gmax muscle strength, muscle thickness, and disability.

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