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Pain and disability therapy with stabilization exercises in patients with chronic low back pain: a meta-analysis
Dimitrijevic V, Raskovic B, Jevtic N, Nikolic S, Viduka D, Obradovic B
Healthcare 2025 Apr;13(9):960
systematic review

BACKGROUND: Chronic low back pain is a leading cause of disability worldwide, necessitating effective interventions to alleviate pain and improve function. This meta-analysis aimed to evaluate the effectiveness of stabilization exercises for pain relief and disability reduction in patients with chronic low back pain. METHODS: A meta-analysis was conducted following PRISMA and Cochrane guidelines. Randomized controlled trials evaluating stabilization exercises for chronic low back pain were included. Subgroup analyses were performed based on treatment duration, type of pain (specific versus non-specific), study quality, and exercise type. Effect sizes were calculated using standardized mean differences (SMD), and evidence quality was assessed using the GRADE tool. RESULTS: A total of 23 studies involving 1132 participants were included. The meta-analysis revealed that longer treatment durations (8 to 12 weeks) showed the strongest effects on pain reduction (SMD -0.88) and disability improvement (SMD -0.85). For pain type, non-specific low back pain responded better (SMD -0.81 for pain, -0.73 for disability) compared to specific LBP (SMD -0.61 and -0.42, respectively). The 6-week duration also demonstrated moderate effects (SMD -0.72 for pain). Core stability exercises had superior pain reduction (SMD -0.90, large effect) compared to spinal stability exercises (SMD -0.57), while spinal stability exercises showed higher-quality evidence for disability improvement (SMD -0.56, high-quality) versus core stability (SMD -0.62, low-quality). CONCLUSION: Stabilization exercises are a highly effective intervention for chronic low back pain, offering significant pain relief and functional improvement. They outperform other common interventions and should be prioritized in clinical practice, particularly in longer-duration, supervised programs. These findings provide strong evidence to guide treatment protocols and improve outcomes for patients with chronic low back pain.

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