Effect of AI-Based Exercises on Pain, Function, Kinesiophobia, and Trunk Motor Control in Chronic Low Back Pain

Effect of AI Based Exercises on Pain, Function, Kinesophobia and Trunk Motor Control in Treatment of Chronic Non-Specific Low Back Pain

This study compares the effect of an artificial intelligence (AI)-generated exercise program with a traditional core stabilization exercise program in people with chronic non-specific low back pain.

Participants are assigned by chance to 1 of 2 groups:

• Group 1 receives an AI-generated therapeutic exercise protocol.
• Group 2 receives a traditional trunk stabilization exercise program supervised by a physical therapist.

Participants in both groups perform exercise sessions 3 times per week for 4 weeks.

The main goals are to find out if the AI-generated exercise program leads to:

• Better deep abdominal muscle control measured with a pressure biofeedback unit
• Reduced low back pain
• Improved daily physical function
• Less fear of movement

Study Overview

• Status: Active, not recruiting
• Conditions: Chronic Non-Specific Low Back Pain
• Intervention / Treatment: Other: AI-based Exercise Program; Other: Conventional Trunk Stabilization Exercises.

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Giza Governorate
    • Cairo, Giza Governorate, Egypt, 12613
      • Faculty of physical therapy - Cairo university

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 35 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Male and female participants aged between 20 and 35 years.
• Clinical diagnosis of CNSLBP persisting for more than 12 weeks, with a pain intensity score greater than 3 on the Visual Analog Scale (VAS).
• Demonstrated deficits in trunk motor control as assessed by Prone Instability Test (PIT).
• Patients with BMI < 30.

Exclusion Criteria:

• History of spinal or abdominal surgery.
• Structural spinal abnormalities (e.g., spondylolisthesis, spinal stenosis, or scoliosis).
• Neurological disorders affecting trunk control or balance.
• Acute injury or flare-up of back pain within the past month.
• Pregnancy.
• Participation in another physical therapy or rehabilitation program during the study period.
• Any contraindication to physical activity as per medical screening.
• Inability to understand and follow verbal and written instructions.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental group; This group will receive artificial intelligence (AI) based exercises specifically designed for chronic non-specific low back pain for 4 weeks.	Other: AI-based Exercise Program; Participants will perform a set of therapeutic exercises specifically generated by artificial intelligence (AI) algorithms to target trunk stabilization and motor control. The program consists of exercises tailored for chronic non-specific low back pain, performed for 40 minutes per session, 3 times a week, for a total duration of 4 weeks. All sessions will be conducted under the supervision of a physical therapist to ensure proper technique.
Active Comparator: Control Group; This group will receive conventional trunk stabilization exercises supervised by a physical therapist for 4 weeks.	Other: Conventional Trunk Stabilization Exercises.; Participants in the control group will perform a conventional trunk stabilization exercise program. The exercises are designed to improve core stability and motor control, conducted under the direct supervision of a physical therapist. The program consists of 40-minute sessions, 3 times a week, for a total of 4 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from Baseline in Trunk Motor Control at 4 Weeks.	Assessed using a Pressure Biofeedback Unit (Stabilizer) in the prone position to measure deep abdominal muscle activation (transversus abdominis) during the abdominal drawing-in maneuver (ADIM). Baseline pressure is set at 70 mmHg, and pressure reduction is recorded in mmHg (target reduction: 4 to 10 mmHg). Higher ability to achieve and maintain target reduction indicates better motor control.	Baseline and after 4 weeks of intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from Baseline in Pain Intensity at 4 Weeks	A 10-cm horizontal Visual Analogue Scale (VAS) used to measure low back pain intensity, ranging from 0 (no pain) to 10 (worst imaginable pain). Lower scores indicate less pain.	Baseline and after 4 weeks of intervention
Change from Baseline in Functional Disability at 4 Weeks	The Arabic version of the Oswestry Disability Index (ODI), a 10-item self-report questionnaire assessing the impact of low back pain on activities of daily living. Total scores range from 0% (no disability) to 100% (maximum disability). Lower percentage scores indicate better functional performance.	Baseline and after 4 weeks of treatment.
Change from Baseline in Fear-Avoidance Beliefs at 4 Weeks	The Arabic version of the Fear-Avoidance Beliefs Questionnaire (FABQ), consisting of 16 items divided into physical activity and work subscales. Scored on a 7-point Likert scale (0 = completely disagree to 6 = completely agree), with higher scores indicating greater fear-avoidance beliefs.	Baseline and after 4 weeks of treatment.
Change from Baseline in Dynamic Trunk Stability at 4 Weeks	Assesses the ability to control lumbopelvic movement during active limb motion in supine across 5 progressive levels using the Sahrmann Core Stability Test (Levels 1 to 5). The highest level successfully completed without lumbar movement is recorded. Higher levels indicate better dynamic stability.	Baseline and after 4 weeks of intervention
Lumbar Segmental Instability Status at 4 Weeks	A clinical screening test used to assess lumbar segmental instability and motor control using the Prone Instability Test (PIT). Recorded as either positive (reduction of pain when lifting legs) or negative (no reduction of pain).	Baseline and after 4 weeks of intervention

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Study Chair: Salwa F Abdelmajeed, Ph.D. (Professor), Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): January 20, 2026
• Primary Completion (Actual): September 1, 2026
• Study Completion (Estimated): November 20, 2026

Study Registration Dates

• First Submitted: November 7, 2026
• First Submitted That Met QC Criteria: November 7, 2026
• First Posted (Actual): November 13, 2026

Study Record Updates

• Last Update Posted (Actual): November 13, 2026
• Last Update Submitted That Met QC Criteria: November 7, 2026
• Last Verified: November 1, 2026

More Information

Terms related to this study

• Keywords: Artificial Intelligence; Chronic Low Back Pain; Motor Control; Kinesiophobia; Core Stabilization Exercises; Trunk Stability; Pressure Biofeedback Unit
• Additional Relevant MeSH Terms: Mental Disorders; Phobic Disorders; Anxiety Disorders; Kinesiophobia
• Other Study ID Numbers: P.T.REC/012/006291

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

IPD Plan Description

Individual participant data will not be shared publicly to maintain participant confidentiality and adhere to institutional data governance policies. Aggregated study results will be made available upon reasonable request to the corresponding author.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No