Postural Low Back PainNCT06846203
Comparison of Core Stabilization and Neuromuscular Facilitation Exercises for Lowback Pain Prevention
A study testing Core stabilization Exercise Group and Neuromuscular Fascilitation Exercise Group in people with Postural Low Back Pain, run by Riphah International University at 1 site in Pakistan.
Trial summary
Low back pain (LBP) is a leading cause of disability worldwide, particularly affecting individuals in occupations that demand prolonged sitting or standing, such as healthcare professionals. Read more about this study
- Who is it for?
- Ages 20 to 45 yearsHealthy volunteers can take part
- Conditions the study is for
- Postural Low Back Pain
- What is being tested?
- Core stabilization Exercise Group and Neuromuscular Fascilitation Exercise Group
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 63 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Mar 2025to 2 Jan 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 45 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Professionals including nurses, dentist, surgeons, physiotherapists etc.
- 20-45 years.
- Both genders.
- Individuals with no back pain history from previous 3 months.
- Individuals having Biering sorensen test score less than 176 seconds.
Who cannot join
- Individuals who had experienced low back pain in previous 3 months.
- Diagnosed musculoskeletal and neuromuscular problems.
- Diagnosed cardiovascular or pulmonary problems.
- Any Fractures and spine surgery.
- Individuals who are already a part of any interventional research program.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Comparison of Core Stabilization and Neuromuscular Facilitation Exercises for Lowback Pain Prevention Among Health Care Professionals
Low back pain (LBP) is a leading cause of disability worldwide, particularly affecting individuals in occupations that demand prolonged sitting or standing, such as healthcare professionals. The nature of their work often involves sustained postures, physical exertion, and repetitive movements, which compromise core muscle function and neuromuscular control, increasing the risk of spinal dysfunction and pain. Core stabilization exercises have been widely recognized for their role in improving trunk strength, enhancing postural alignment, and reducing spinal loading, thereby preventing LBP. Similarly, neuromuscular facilitation exercises aim to optimize muscle activation patterns, improve coordination, and restore functional movement, making them a promising strategy for LBP prevention. Despite the individual benefits of these approaches, there is a paucity of comparative research investigating their relative effectiveness in the prevention of LBP, particularly in populations with demanding physical and postural requirements, such as healthcare professionals.
This study seeks to fill this gap by comparing the effects of core stabilization exercises and neuromuscular facilitation exercises on LBP prevention among healthcare professionals.The findings will provide evidence-based guidance for designing targeted interventions, ultimately promoting musculoskeletal health and enhancing the occupational well-being of this vulnerable group.
Read the detailed description
Healthcare professionals perform daily activities that can lead to musculoskeletal disorders among them the lower back, neck, shoulder and hand/wrist are the most exposed areas.Healthcare professionals frequently engage in activities that require lifting, bending, and prolonged standing or sitting, which can place significant stress on their lower back .Low back pain is prevalent among healthcare workers, with studies indicating that over 57% of professionals experience it at some point in their careers Contributing factors include prolonged standing, frequent bending and twisting, and the physical demands of nursing and medical roles .The prevalence is notably higher among healthcare professionals, highlighting the need for targeted prevention strategies.
Researches have been done in order to devise strategies for the reduction of low back pain. Core stabilization and Neuromuscular Facilitation exercises are among them. Research shows that core stability training can alleviate symptoms of nonspecific low back pain (NSLBP) in nurses by improving muscle endurance and balance between the multifidus muscles on both sides of the spine Engaging in regular physical activity, including stretching exercises, has been shown to reduce LBP symptoms and improve overall physical health. For instance, a study found that a structured stretching program significantly reduced pain levels among healthcare workers .Core strengthening exercises, which include the muscles of the abdomen, pelvis, and lower back, are crucial for maintaining spinal stability and preventing LBP. likewise propioceptive neuromuscular fascilitation exercises have been shown to improve trunk muscle endurance and strength, which are critical for supporting the lumbar spine. Studies found that participants engaging in Propioceptive neuromuscular fascilitation demonstrated substantial gains in trunk stability and mobility, essential factors in preventing future episodes of back pain .
Evidence suggests that the benefits of Neuromuscular Fascilitation may extend beyond immediate pain relief, contributing to long-term improvements in muscle activity and overall spinal health. A study highlighted that PNF can lead to sustained reductions in pain and increases in functional capacity over time. When compared with traditional core strengthening exercises or conventional physical therapy, Neuromuscular Fascilitation has shown superior outcomes in terms of both pain reduction and functional improvement.This positions Neuromuscular Fascilitation as a potentially more effective intervention for healthcare professionals who are at risk for developing LBP.An RCT was conducted by waseem et al in 2017 inorder to compare core stabilization exercises with conventional physical therapy.They concluded that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. Pattanasin et al compared core stabilization exercises with Neuromuscular Fascilitation and reported that four-week Core stabilization and neuromuscular fascilitation training provided short-term and long-term effects on pain-related outcomes, along with increased deep trunk muscle activity in Chronic low back patients.Su et al in a study conducted in 2021 reported that Despite both core stabilization and strengthening exercises reducing pain, core stabilization exercise is superior to strengthening exercise. It is effective in improving proprioception, balance, and percentage change of muscle thickness of TrA and LM, and reducing functional disability and ear of movement in patients with subacute Non specific low back pain.
- Conditions
- Postural Low Back Pain
- Being tested
- Core stabilization Exercise Group, Neuromuscular Fascilitation Exercise Group
- Keywords
- Dynamic sit up test, Low Back Pain, Functional Movement Screen, PNF stretching exercises
- Medical subject headings
- Low Back Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Core stabilization Exercise GroupOther
This group will be subjected to following core stabilization exercises:
1: Sit-up-1, 2: Sit-up-2, 3: Back extention-1, 4: Back extention-2 , 5: Front plank, 6: Back bridge , 7: Quadruped , 8:Side bridge A combination of activities will be administered and alterations will be made every session.
Session will be held 3 times per week for 8 consecutive weeks.
Neuromuscular Fascilitation Exercise GroupOther
This group will be subjected to neuromuscular facilitation exercises :
Week 1: McGill curl up, Week 2: Bird dog stretch, Week 3: Side bridge or mermaid side bridge with bent knees, Week 4: Single leg stretching, Week 5: Shoulder bridge Week 6: "Tai chi Warrior" stance, Week 7 \& 8: Cat - cow - downward facing dog, Hip circumduction, hamstring stretching, starting position Session will be held 3 times per week for 8 consecutive weeks
| Study group | Role | What they receive |
|---|---|---|
| core stabilization exercises | Experimental | This group will be subjected to following core stabilization exercises which include Sit-up-1, Sit-up-2, Back extention-1,Back extention-2 , Front plank,Back bridge ,Quadruped and Side bridge. Receives: Other: Core stabilization Exercise Group |
| Neuromuscular Fascilitation exercises | Experimental | This group will be subjected to neuromuscular facilitation exercises which includes McGill curl up,Bird dog stretch, Side bridge or mermaid side bridge with bent knees, Single leg stretching ,Shoulder bridge,"Tai chi Warrior" stance ,Cat - cow - downward facing dog, Hip circumduction, hamstring stretching and starting position. Receives: Other: Neuromuscular Fascilitation Exercise Group |
| control group | No intervention | no intervention was given to this group |
What is being measured
The primary outcome is the main question the study is designed to answer.
Dynamic Sit Up Test.
The Dynamic Situp Test evaluates the endurance of the abdominal muscles and consists of consecutive performance of 3 increasingly difficult kinds of sit-up, 5 repetitions each. The examinee lies face-up on the floor with the knees bent at 90 degrees and the feet flat on the floor, held down by an examiner. The examinee then attempts to perform 15 situps in the following sequence. There should be no rest period or pause between the different types of sit-up:
5 situps each with the hands sliding along the thighs,while keeping the forearms crossed over the chest and with the fingertips maintaining contact with the back of the earlobes.
The score is the total number of situps performed (max = 15) A Cronbach's alpha reliability analysis of the entire sample revealed a high degree of interrater reliability for the sit-up test. (α = .925)
Measured: Baseline to 8th week
Biering sorenson Test.
The Biering-Sørensen test is commonly used to assess endurance of the paraspinal musculature using two metrics: test duration (the time that an individual maintains the Sørensen test position), and rate of muscle fatigue it is reported to predict low back pain within the next year in males. The test consists in measuring the amount of time a person can hold the unsupported upper body in a horizontal prone position with the lower body fixed to the examining table For the Sørensen tests, participants lay on a Roman chair with their lower limbs stabilized and their head, arms, and trunk unsupported. Participants were instructed to maintain a horizontal body position for as long as possible. The end of the test occurred when the participant could no longer maintain the horizontal test position or when the participant felt unable to continue the test. A low Biering-Sorensen score has been found to predict who will have nonspecific low back pain.
Measured: Baseline to 8th week
Functional movement Screen.
The Functional Movement Screen (FMS) is a screening system that attempts allow the professional to assess the fundamental movement patterns of an individual. Its seven components are: Deep Squat, Hurdle Step, and In-Line Lunge, Shoulder Mobility, the Active Straight Leg Raise, the Trunk Stability Push-up, and Rotary Stability The maximum possible score on the FMS is 21, which is achieved by scoring a perfect 3 on all seven tests. Conversely, a score below 14 suggests a higher risk for injury due to poor body mechanics.The FMS demonstrates good to excellent interrater reliability, with intraclass correlation coefficients (ICCs) reported between 0.76 and 0.98 across various studies.The FMS has shown predictive validity for injury risk, particularly with a composite score of ≤14, which indicates a significantly higher likelihood of sustaining injuries .
Measured: Baseline to 8th week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Feb 2025
- Study start1 Mar 2025
- Primary completion30 Dec 2025
- Study completion2 Jan 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Postural Low Back PainStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 63 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Aisha Razzaq, PHD*, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06846203
- Sponsor's protocol ID
- Riphah Mehreen Raza
- Status last verified
- Feb 2026
- First submitted
- 20 Feb 2025
- Last updated
- 19 Feb 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 19 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Core Stabilization and Neuromuscular Facilitation Exercises for Lowback Pain Prevention Among Health Care Professionals
- ClinicalTrials.gov ID
- NCT06846203
- Acronym / sponsor ID
- Riphah Mehreen Raza
- Conditions
- Postural Low Back Pain
- Keywords
- Dynamic sit up test, Low Back Pain, Functional Movement Screen, PNF stretching exercises
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 63 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 1 Mar 2025 (actual)
- Primary completion
- 30 Dec 2025 (actual)
- Study completion
- 2 Jan 2026 (actual)
- First posted
- 26 Feb 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Low back pain (LBP) is a leading cause of disability worldwide, particularly affecting individuals in occupations that demand prolonged sitting or standing, such as healthcare professionals. The nature of their work often involves sustained postures, physical exertion, and repetitive movements, which compromise core muscle function and neuromuscular control, increasing the risk of spinal dysfunction and pain. Core stabilization exercises have been widely recognized for their role in improving trunk strength, enhancing postural alignment, and reducing spinal loading, thereby preventing LBP. Similarly, neuromuscular facilitation exercises aim to optimize muscle activation patterns, improve coordination, and restore functional movement, making them a promising strategy for LBP prevention. Despite the individual benefits of these approaches, there is a paucity of comparative research investigating their relative effectiveness in the prevention of LBP, particularly in populations with demanding physical and postural requirements, such as healthcare professionals.
This study seeks to fill this gap by comparing the effects of core stabilization exercises and neuromuscular facilitation exercises on LBP prevention among healthcare professionals.The findings will provide evidence-based guidance for designing targeted interventions, ultimately promoting musculoskeletal health and enhancing the occupational well-being of this vulnerable group.
Detailed description
Healthcare professionals perform daily activities that can lead to musculoskeletal disorders among them the lower back, neck, shoulder and hand/wrist are the most exposed areas.Healthcare professionals frequently engage in activities that require lifting, bending, and prolonged standing or sitting, which can place significant stress on their lower back .Low back pain is prevalent among healthcare workers, with studies indicating that over 57% of professionals experience it at some point in their careers Contributing factors include prolonged standing, frequent bending and twisting, and the physical demands of nursing and medical roles .The prevalence is notably higher among healthcare professionals, highlighting the need for targeted prevention strategies.
Researches have been done in order to devise strategies for the reduction of low back pain. Core stabilization and Neuromuscular Facilitation exercises are among them. Research shows that core stability training can alleviate symptoms of nonspecific low back pain (NSLBP) in nurses by improving muscle endurance and balance between the multifidus muscles on both sides of the spine Engaging in regular physical activity, including stretching exercises, has been shown to reduce LBP symptoms and improve overall physical health. For instance, a study found that a structured stretching program significantly reduced pain levels among healthcare workers .Core strengthening exercises, which include the muscles of the abdomen, pelvis, and lower back, are crucial for maintaining spinal stability and preventing LBP. likewise propioceptive neuromuscular fascilitation exercises have been shown to improve trunk muscle endurance and strength, which are critical for supporting the lumbar spine. Studies found that participants engaging in Propioceptive neuromuscular fascilitation demonstrated substantial gains in trunk stability and mobility, essential factors in preventing future episodes of back pain .
Evidence suggests that the benefits of Neuromuscular Fascilitation may extend beyond immediate pain relief, contributing to long-term improvements in muscle activity and overall spinal health. A study highlighted that PNF can lead to sustained reductions in pain and increases in functional capacity over time. When compared with traditional core strengthening exercises or conventional physical therapy, Neuromuscular Fascilitation has shown superior outcomes in terms of both pain reduction and functional improvement.This positions Neuromuscular Fascilitation as a potentially more effective intervention for healthcare professionals who are at risk for developing LBP.An RCT was conducted by waseem et al in 2017 inorder to compare core stabilization exercises with conventional physical therapy.They concluded that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. Pattanasin et al compared core stabilization exercises with Neuromuscular Fascilitation and reported that four-week Core stabilization and neuromuscular fascilitation training provided short-term and long-term effects on pain-related outcomes, along with increased deep trunk muscle activity in Chronic low back patients.Su et al in a study conducted in 2021 reported that Despite both core stabilization and strengthening exercises reducing pain, core stabilization exercise is superior to strengthening exercise. It is effective in improving proprioception, balance, and percentage change of muscle thickness of TrA and LM, and reducing functional disability and ear of movement in patients with subacute Non specific low back pain.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| core stabilization exercises | Experimental | Other: Core stabilization Exercise GroupThis group will be subjected to following core stabilization exercises which include Sit-up-1, Sit-up-2, Back extention-1,Back extention-2 , Front plank,Back bridge ,Quadruped and Side bridge. |
| Neuromuscular Fascilitation exercises | Experimental | Other: Neuromuscular Fascilitation Exercise GroupThis group will be subjected to neuromuscular facilitation exercises which includes McGill curl up,Bird dog stretch, Side bridge or mermaid side bridge with bent knees, Single leg stretching ,Shoulder bridge,"Tai chi Warrior" stance ,Cat - cow - downward facing dog, Hip circumduction, hamstring stretching and starting position. |
| control group | No intervention | –no intervention was given to this group |
Who may qualify
- Ages
- 20 to 45 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Professionals including nurses, dentist, surgeons, physiotherapists etc.
- 20-45 years.
- Both genders.
- Individuals with no back pain history from previous 3 months.
- Individuals having Biering sorensen test score less than 176 seconds.
Key exclusion criteria (5 listed)
- Individuals who had experienced low back pain in previous 3 months.
- Diagnosed musculoskeletal and neuromuscular problems.
- Diagnosed cardiovascular or pulmonary problems.
- Any Fractures and spine surgery.
- Individuals who are already a part of any interventional research program.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Core stabilization Exercise GroupThis group will be subjected to following core stabilization exercises: 1: Sit-up-1, 2: Sit-up-2, 3: Back extention-1, 4: Back extention-2 , 5: Front plank, 6: Back bridge , 7: Quadruped , 8:Side bridge A combination of activities will be administered and alterations will be made every session. Session will be held 3 times per week for 8 consecutive weeks. | Other | core stabilization exercises |
| Neuromuscular Fascilitation Exercise GroupThis group will be subjected to neuromuscular facilitation exercises : Week 1: McGill curl up, Week 2: Bird dog stretch, Week 3: Side bridge or mermaid side bridge with bent knees, Week 4: Single leg stretching, Week 5: Shoulder bridge Week 6: "Tai chi Warrior" stance, Week 7 \& 8: Cat - cow - downward facing dog, Hip circumduction, hamstring stretching, starting position Session will be held 3 times per week for 8 consecutive weeks | Other | Neuromuscular Fascilitation exercises |
Primary outcome
Dynamic Sit Up Test.
Time frame: Baseline to 8th week
The Dynamic Situp Test evaluates the endurance of the abdominal muscles and consists of consecutive performance of 3 increasingly difficult kinds of sit-up, 5 repetitions each. The examinee lies face-up on the floor with the knees bent at 90 degrees and the feet flat on the floor, held down by an examiner. The examinee then attempts to perform 15 situps in the following sequence. There should be no rest period or pause between the different types of sit-up: 5 situps each with the hands sliding along the thighs,while keeping the forearms crossed over the chest and with the fingertips maintaining contact with the back of the earlobes. The score is the total number of situps performed (max = 15) A Cronbach's alpha reliability analysis of the entire sample revealed a high degree of interrater reliability for the sit-up test. (α = .925)
Biering sorenson Test.
Time frame: Baseline to 8th week
The Biering-Sørensen test is commonly used to assess endurance of the paraspinal musculature using two metrics: test duration (the time that an individual maintains the Sørensen test position), and rate of muscle fatigue it is reported to predict low back pain within the next year in males. The test consists in measuring the amount of time a person can hold the unsupported upper body in a horizontal prone position with the lower body fixed to the examining table For the Sørensen tests, participants lay on a Roman chair with their lower limbs stabilized and their head, arms, and trunk unsupported. Participants were instructed to maintain a horizontal body position for as long as possible. The end of the test occurred when the participant could no longer maintain the horizontal test position or when the participant felt unable to continue the test. A low Biering-Sorensen score has been found to predict who will have nonspecific low back pain.
Functional movement Screen.
Time frame: Baseline to 8th week
The Functional Movement Screen (FMS) is a screening system that attempts allow the professional to assess the fundamental movement patterns of an individual. Its seven components are: Deep Squat, Hurdle Step, and In-Line Lunge, Shoulder Mobility, the Active Straight Leg Raise, the Trunk Stability Push-up, and Rotary Stability The maximum possible score on the FMS is 21, which is achieved by scoring a perfect 3 on all seven tests. Conversely, a score below 14 suggests a higher risk for injury due to poor body mechanics.The FMS demonstrates good to excellent interrater reliability, with intraclass correlation coefficients (ICCs) reported between 0.76 and 0.98 across various studies.The FMS has shown predictive validity for injury risk, particularly with a composite score of ≤14, which indicates a significantly higher likelihood of sustaining injuries .
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Feb 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Aisha Razzaq, PHD* principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Core stabilization Exercise Group and Neuromuscular Fascilitation Exercise Group in people with Postural Low Back Pain, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 19 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Dynamic Sit Up Test. (time frame: Baseline to 8th week). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Feb 2026.