Telerehabilitation versus clinic-based core stabilization exercise with abdominal drawing-in maneuver for chronic non-specific low back pain with lumbar instability: a randomized controlled trial

Abstract

Background: Despite growing telerehabilitation use, few other studies have investigated the effectiveness of telerehabilitation-based core stabilization exercises for chronic non-specific low back pain (CNSLBP) with lumbar instability (LI). The aim of this study was to compare telerehabilitation versus clinic-based core stabilization exercise with abdominal drawing-in maneuver (CSE with ADIM) on pain, function, lumbar reposition error, quality of life, and satisfaction in CNSLBP with LI.

Materials and Methods: In this single-blind randomized controlled trial, 30 participants CNSLBP with LI participants were randomly allocated to telerehabilitation (n=15) or clinic-based (n=15) groups. Both received a 7-week CSE with ADIM programs, delivered via video calls or in-clinic sessions respectively. Outcomes measured included numeric pain rating scale (NRS), Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), 36-Item Short Form Survey (SF-36), and lumbar reposition error at baseline and post-intervention. Participant satisfaction was assessed upon completion.

Results: Interim analysis (n=10 per group) showed significant within-group NRS, ODI, and RMDQ score reductions (p<0.05), with no significant between-group differences. Telerehabilitation improved 6/8 SF-36 domains (p<0.05), excluding emotional well-being and social function. Clinic-based improvements were limited to bodily pain and general health, with no significant between-group differences. Both groups achieved 96% adherence with high satisfaction: 99.4% (telerehabilitation-based) and 98% (clinic-based). Neither group exhibited significant differences in lumbar repositioning error within or between groups. No adverse events occurred.

Conclusion: Telerehabilitation-delivered CSE with ADIM effectively reduces pain and improves function and quality of life in CNSLBP with LI, offering a viable alternative to clinic-based treatment.