Low Back PainNCT07332390
Comparison of Moderate Load Eccentric Core Exercises and Pilates in Patients With Non-Specific Low Back Pain
A study testing MODERATE LOAD ECCENTRIC CORE EXERCISES and Pilates in people with Low Back Pain, run by Foundation University Islamabad at 1 site in Pakistan.
Trial summary
Low back pain (LBP) is a major global health concern, significantly affecting mobility, productivity, and quality of life. Non-specific low back pain (NSLBP), which accounts for most LBP cases, is associated with impaired proprioception, reduced lumbar range of motion (ROM), decreased muscular endurance, and altered… Read more about this study
- Who is it for?
- Ages 18 to 45 years
- Conditions the study is for
- Low Back Pain
- What is being tested?
- MODERATE LOAD ECCENTRIC CORE EXERCISES and Pilates
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 1 sitePakistan
- Study dates
- 15 Jan 2025to 15 Jan 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 18 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- • Adults 18 to 45 years
- Both genders
- Low back (from T12 to buttock line) pain for more than 3 months
- Non-specific low back pain i.e. signs or symptoms not attributable to any specific structure
- Low back pain on 3-8 NPRS
Who cannot join
- • Acute flare Low Back Pain
- Low back pain on NPRS (>8)
- Thoracic pain
- Centralization and peripheralization of pain
- Leg symptoms when walking, eased in flexion (Signs of stenosis)
- Pain due to repetitive movement
Show all 13Show fewer
- Paresthesia/numbness
- Structural deformity (scoliosis, spondylosis, spondylolisthesis)
- Curve reversal
- Pregnancy
- Post-surgery (within 6 months of abdominal, spinal, or lower limb surgery)
- Degenerative or inflammatory spinal diseases
- Malignancy
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Foundation University Islamabad
Islamabad, Punjab Province, 46000
Tehreem Zahra, DPT, 0334-9709725, tehreemzahra2310@gmail.com
About this study
Low back pain (LBP) is a major global health concern, significantly affecting mobility, productivity, and quality of life. Non-specific low back pain (NSLBP), which accounts for most LBP cases, is associated with impaired proprioception, reduced lumbar range of motion (ROM), decreased muscular endurance, and altered neuromuscular control. Joint position error (JPE) is a key indicator of proprioceptive dysfunction, contributing to postural instability and movement impairments in NSLBP patients. Effective rehabilitation strategies are essential to improve functional outcomes and prevent recurrence. Exercise therapy, particularly core stabilization exercises, plays a crucial role in NSLBP management. Among various approaches, moderate-load eccentric core exercises and Pilates have gained attention for their potential benefits. Eccentric exercises improve neuromuscular control, proprioception, and endurance by emphasizing controlled muscle lengthening. Pilates, on the other hand, focuses on core activation, postural alignment, and flexibility to enhance spinal stability and movement efficiency. However, limited research directly compares their effects on joint position error, pain, lumbar ROM, and core endurance in NSLBP patients. This randomized controlled trial (RCT) will recruit 44 NSLBP patients from Fauji Foundation Hospital, Rawalpindi, using purposive sampling. Participants will be randomly assigned to either the moderate-load eccentric core exercise group or the Pilates group for an 8-week supervised intervention. Assessments will be conducted at baseline, the 4th week, and post-intervention using an inclinometer (JPE), NPRS (pain), an inclinometer (lumbar ROM), and McGill Torso Endurance Battery (core endurance). SPSS version 21.0 will be used to analyze the data, with normality assessed through the Shapiro-Wilk test or the Kolmogorov-Smirnov test. Group differences will be analyzed using an Independent Sample t-test for normally distributed data and Mann-Whitney U test in case of non-normally distributed data (p < 0.05).
Read the detailed description
Low back pain (LBP) is the most prevalent musculoskeletal condition worldwide, affecting an estimated 619 million people and ranking among the leading causes of disability across all ages. It reduces quality of life, productivity, and mental well-being, creating a major socioeconomic burden. The biopsychosocial model describes LBP as a multifactorial disorder influenced by biological, psychological, and social factors, emphasizing the need for interdisciplinary management. According to the WHO, LBP is defined as pain occurring between the 12th rib and inferior gluteal folds, with or without referred pain, and is classified as acute (<6 weeks), subacute (6-12 weeks), or chronic (>12 weeks).
Most LBP is nonspecific (≈90%), with no structural cause, and influenced by inactivity, obesity, smoking, and psychosocial stress. In 2019, LBP ranked 6th in DALYs for females, highlighting a greater burden among women. Impaired trunk muscle activation and proprioception contribute to motor control deficits, abnormal recruitment patterns, and recurrent pain. Core musculature plays a central role: Bergmark classified spinal muscles into deep stabilizers (e.g., multifidus, transversus abdominis) and superficial movers (e.g., extensors), both essential for spinal stability. Weakness of extensors predisposes to initial episodes of LBP, while dysfunction of deep stabilizers is associated with chronicity. Exercise therapy is a key intervention. Eccentric training has gained attention for superior neuromuscular adaptations, increasing strength, muscle fiber size, and coordination, with evidence from athletic populations showing functional benefits beyond concentric training. Pilates provides a holistic approach emphasizing controlled movement, breathing, and core activation, improving alignment, flexibility, proprioception, and quality of life. Core stabilization exercises (CSE) specifically target proprioception and motor control, reducing lumbar joint position error, pain, and disability.
Several randomized controlled trials support these interventions. Puntumetakul et al. reported that CSE significantly reduced lumbar JPE, pain, and disability compared to thermal therapy. Zirek et al. found that six weeks of Pilates decreased pain and disability and improved quality of life in chronic LBP. Su Su Hlaing et al. showed that core stabilization and strengthening improved proprioception and muscular thickness of TrA and multifidi. Antonelli et al. demonstrated that Pilates improved pelvic alignment, trunk stability, and reduced pain. Moradi et al. confirmed that modified Pilates led to greater improvements in motor control, pain, and functional recovery compared to traditional exercises.
- Conditions
- Low Back Pain
- Being tested
- MODERATE LOAD ECCENTRIC CORE EXERCISES, Pilates
- 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.
MODERATE LOAD ECCENTRIC CORE EXERCISESProcedure or surgery
MODERATE LOAD ECCENTRIC CORE EXERCISES: Eccentric training protocol will be incorporated in core strengthening regime . This will be conducted in two phases. Phase 1 will be the familiarization phase and phase 2 will be the acclimatization phase .
PilatesProcedure or surgery
Pilates description: participants will be enrolled in group B of the study and will follow a Pilates program designed to ensure progressive overload. The protocol will begin with foundational exercises focused on motor learning and core activation, progressing gradually to more advanced functional and load-bearing stability exercises. The primary focus will be on deep core recruitment, utilizing a beginner-level approach to avoid generalized movements and ensure targeted muscle activation. This structured progression will ensure that core stability remains the central focus, with each phase building upon the previous one.
Warm up:
Before starting the session, participants will perform warm up exercises for 10 minutes that include the following exercises:
- Seated trunk rotation.
- Standing trunk rotation
- High knees
- Standing side bends
- Standing back stretch Each exercise will be performed 10 -12 times on each side. Cool down: Child's pose,Cat-cow stretch,Knee to chin
| Study group | Role | What they receive |
|---|---|---|
| Moderate load eccentric core exercises | Experimental | Participants will perform moderate load eccentric core exercises targeting trunk stabilizer and global core muscles, including eccentric back extensions, abdominal rollouts etc. Exercises will emphasize slow eccentric contractions (3-5 sec) at 50-70% 1RM or equivalent resistance, performed for 8-12 reps, 2-3 sets, three times per week. The protocol aims to enhance core strength, proprioception, neuromuscular control, and spinal stability, thereby reducing pain, disability, and recurrence in nonspecific low back pain. Receives: Procedure: MODERATE LOAD ECCENTRIC CORE EXERCISES |
| Pilates | Experimental | Participants will undergo a Pilates-based exercise program focusing on core activation, controlled breathing, postural alignment, and trunk stability. The program will include mat-based Pilates movements such as pelvic tilts, bridging, hundred, leg stretch, and spine mobility exercises. Sessions will emphasize slow, controlled movements with deep stabilizer activation (transversus abdominis, multifidus), performed for 8-12 reps, 2-3 sets, three times per week. The aim is to improve core strength, posture, proprioception, flexibility, and overall functional control, leading to reduced pain and disability in nonspecific low back pain. Receives: Procedure: Pilates |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain intensity
it will be assessed by Numeric Pain Rating Scale NPRS. 0 means no pain and 10 means worst pain.
Measured: baseline , 4th week and 8th week.
Lumber range of motion
Lumber range of motion will be measured through dual inclinometer. Ranges include lumber flexion, lumber extension, right lateral flexion and left lateral flexion.
Measured: Baseline , 4th week and 8th week.
Core endurance
It will be assessed through McGill core endurance battery. Core endurance will be assessed by measuring the time to hold a certain position. Time will be recorded.
Core endurance include:
Flexor trunk endurance Extensor trunk endurance Right side plank Left side plank
Measured: baseline , 4th week and 8th week
Inclinometer For Lumbar Joint Position Error
Two inclinometers will be used for measuring JPE, one will be positioned at T12 spinous process and other will be placed at S1 spinous process. Participants will be blindfolded to eliminate visual cues and will memorize a target position by holding it for 5 seconds before returning to neutral. They will then attempt to reposition their spine into the target position in lumber flexion without visual feedback. The difference between the achieved and target positions will be recorded as the joint position error, measuring proprioceptive accuracy.
Measured: BASELINE, 4th and 8th week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jan 2026
- Study start15 Jan 2025
- Primary completion31 Dec 2025 (estimated)
- Study completion15 Jan 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Low Back PainStudies of the same condition, open and under way.
- More trials run by Foundation University IslamabadThe 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
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 44 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Foundation University Islamabad
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07332390
- Sponsor's protocol ID
- FUI/CTR/2025/26
- Status last verified
- Dec 2025
- First submitted
- 30 Dec 2025
- Last updated
- 12 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 12 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Moderate Load Eccentric Core Exercises and Pilates in Patients With Non-Specific Low Back Pain
- ClinicalTrials.gov ID
- NCT07332390
- Acronym / sponsor ID
- FUI/CTR/2025/26
- Conditions
- Low Back Pain
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 44 participants (estimated)
- Lead sponsor
- Foundation University IslamabadUniversity, hospital or other
- Study start
- 15 Jan 2025 (actual)
- Primary completion
- 31 Dec 2025 (estimated)
- Study completion
- 15 Jan 2026 (estimated)
- First posted
- 12 Jan 2026 (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 major global health concern, significantly affecting mobility, productivity, and quality of life. Non-specific low back pain (NSLBP), which accounts for most LBP cases, is associated with impaired proprioception, reduced lumbar range of motion (ROM), decreased muscular endurance, and altered neuromuscular control. Joint position error (JPE) is a key indicator of proprioceptive dysfunction, contributing to postural instability and movement impairments in NSLBP patients. Effective rehabilitation strategies are essential to improve functional outcomes and prevent recurrence. Exercise therapy, particularly core stabilization exercises, plays a crucial role in NSLBP management. Among various approaches, moderate-load eccentric core exercises and Pilates have gained attention for their potential benefits. Eccentric exercises improve neuromuscular control, proprioception, and endurance by emphasizing controlled muscle lengthening. Pilates, on the other hand, focuses on core activation, postural alignment, and flexibility to enhance spinal stability and movement efficiency. However, limited research directly compares their effects on joint position error, pain, lumbar ROM, and core endurance in NSLBP patients. This randomized controlled trial (RCT) will recruit 44 NSLBP patients from Fauji Foundation Hospital, Rawalpindi, using purposive sampling. Participants will be randomly assigned to either the moderate-load eccentric core exercise group or the Pilates group for an 8-week supervised intervention. Assessments will be conducted at baseline, the 4th week, and post-intervention using an inclinometer (JPE), NPRS (pain), an inclinometer (lumbar ROM), and McGill Torso Endurance Battery (core endurance). SPSS version 21.0 will be used to analyze the data, with normality assessed through the Shapiro-Wilk test or the Kolmogorov-Smirnov test. Group differences will be analyzed using an Independent Sample t-test for normally distributed data and Mann-Whitney U test in case of non-normally distributed data (p < 0.05).
Detailed description
Low back pain (LBP) is the most prevalent musculoskeletal condition worldwide, affecting an estimated 619 million people and ranking among the leading causes of disability across all ages. It reduces quality of life, productivity, and mental well-being, creating a major socioeconomic burden. The biopsychosocial model describes LBP as a multifactorial disorder influenced by biological, psychological, and social factors, emphasizing the need for interdisciplinary management. According to the WHO, LBP is defined as pain occurring between the 12th rib and inferior gluteal folds, with or without referred pain, and is classified as acute (<6 weeks), subacute (6-12 weeks), or chronic (>12 weeks).
Most LBP is nonspecific (≈90%), with no structural cause, and influenced by inactivity, obesity, smoking, and psychosocial stress. In 2019, LBP ranked 6th in DALYs for females, highlighting a greater burden among women. Impaired trunk muscle activation and proprioception contribute to motor control deficits, abnormal recruitment patterns, and recurrent pain. Core musculature plays a central role: Bergmark classified spinal muscles into deep stabilizers (e.g., multifidus, transversus abdominis) and superficial movers (e.g., extensors), both essential for spinal stability. Weakness of extensors predisposes to initial episodes of LBP, while dysfunction of deep stabilizers is associated with chronicity. Exercise therapy is a key intervention. Eccentric training has gained attention for superior neuromuscular adaptations, increasing strength, muscle fiber size, and coordination, with evidence from athletic populations showing functional benefits beyond concentric training. Pilates provides a holistic approach emphasizing controlled movement, breathing, and core activation, improving alignment, flexibility, proprioception, and quality of life. Core stabilization exercises (CSE) specifically target proprioception and motor control, reducing lumbar joint position error, pain, and disability.
Several randomized controlled trials support these interventions. Puntumetakul et al. reported that CSE significantly reduced lumbar JPE, pain, and disability compared to thermal therapy. Zirek et al. found that six weeks of Pilates decreased pain and disability and improved quality of life in chronic LBP. Su Su Hlaing et al. showed that core stabilization and strengthening improved proprioception and muscular thickness of TrA and multifidi. Antonelli et al. demonstrated that Pilates improved pelvic alignment, trunk stability, and reduced pain. Moradi et al. confirmed that modified Pilates led to greater improvements in motor control, pain, and functional recovery compared to traditional exercises.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Moderate load eccentric core exercises | Experimental | Procedure: MODERATE LOAD ECCENTRIC CORE EXERCISESParticipants will perform moderate load eccentric core exercises targeting trunk stabilizer and global core muscles, including eccentric back extensions, abdominal rollouts etc. Exercises will emphasize slow eccentric contractions (3-5 sec) at 50-70% 1RM or equivalent resistance, performed for 8-12 reps, 2-3 sets, three times per week. The protocol aims to enhance core strength, proprioception, neuromuscular control, and spinal stability, thereby reducing pain, disability, and recurrence in nonspecific low back pain. |
| Pilates | Experimental | Procedure: PilatesParticipants will undergo a Pilates-based exercise program focusing on core activation, controlled breathing, postural alignment, and trunk stability. The program will include mat-based Pilates movements such as pelvic tilts, bridging, hundred, leg stretch, and spine mobility exercises. Sessions will emphasize slow, controlled movements with deep stabilizer activation (transversus abdominis, multifidus), performed for 8-12 reps, 2-3 sets, three times per week. The aim is to improve core strength, posture, proprioception, flexibility, and overall functional control, leading to reduced pain and disability in nonspecific low back pain. |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- • Adults 18 to 45 years
Key exclusion criteria (13 listed)
- • Acute flare Low Back Pain
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 |
|---|---|---|
| MODERATE LOAD ECCENTRIC CORE EXERCISESMODERATE LOAD ECCENTRIC CORE EXERCISES: Eccentric training protocol will be incorporated in core strengthening regime . This will be conducted in two phases. Phase 1 will be the familiarization phase and phase 2 will be the acclimatization phase . | Procedure or surgery | Moderate load eccentric core exercises |
| PilatesPilates description: participants will be enrolled in group B of the study and will follow a Pilates program designed to ensure progressive overload. The protocol will begin with foundational exercises focused on motor learning and core activation, progressing gradually to more advanced functional and load-bearing stability exercises. The primary focus will be on deep core recruitment, utilizing a beginner-level approach to avoid generalized movements and ensure targeted muscle activation. This structured progression will ensure that core stability remains the central focus, with each phase building upon the previous one. Warm up: Before starting the session, participants will perform warm up exercises for 10 minutes that include the following exercises: 1. Seated trunk rotation. 2. Standing trunk rotation 3. High knees 4. Standing side bends 5. Standing back stretch Each exercise will be performed 10 -12 times on each side. Cool down: Child's pose,Cat-cow stretch,Knee to chin | Procedure or surgery | Pilates |
Primary outcome
Pain intensity
Time frame: baseline , 4th week and 8th week.
it will be assessed by Numeric Pain Rating Scale NPRS. 0 means no pain and 10 means worst pain.
Lumber range of motion
Time frame: Baseline , 4th week and 8th week.
Lumber range of motion will be measured through dual inclinometer. Ranges include lumber flexion, lumber extension, right lateral flexion and left lateral flexion.
Core endurance
Time frame: baseline , 4th week and 8th week
It will be assessed through McGill core endurance battery. Core endurance will be assessed by measuring the time to hold a certain position. Time will be recorded. Core endurance include: Flexor trunk endurance Extensor trunk endurance Right side plank Left side plank
Inclinometer For Lumbar Joint Position Error
Time frame: BASELINE, 4th and 8th week
Two inclinometers will be used for measuring JPE, one will be positioned at T12 spinous process and other will be placed at S1 spinous process. Participants will be blindfolded to eliminate visual cues and will memorize a target position by holding it for 5 seconds before returning to neutral. They will then attempt to reposition their spine into the target position in lumber flexion without visual feedback. The difference between the achieved and target positions will be recorded as the joint position error, measuring proprioceptive accuracy.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Jan 2026.
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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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing MODERATE LOAD ECCENTRIC CORE EXERCISES and Pilates in people with Low Back Pain, run by Foundation University Islamabad 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 13 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: looking for participants now, as of the sponsor's last update on 12 Jan 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Tehreem Zahra, DPT (0334-9709725, tehreemzahra2310@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain intensity (time frame: baseline , 4th week and 8th week.). The study lists 4 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 12 Jan 2026.