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Effectiveness of Combined Diaphragm Strengthening and Core Stability Exercises in Individuals With Lumbar Instability

25. juli 2026 opdateret af: Ahmed Hesham abd el-Mawgoud, Cairo University
The purpose of this study is to compare the effect of combining diaphragmatic strengthening with core stability exercises versus core stability exercises alone on recovery time, pain, and stability in lumbar instability individuals.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Lumbar instability is a common medical problem. There is a 50-70% chance of a person suffering from LBP during his or her lifetime having lumbar instability. It is often referred to as clinical spinal instability. Clinical spinal instability is controversial and poorly understood. Properly conducted clinical studies of patients with spinal pain and documented clinical instability would be good to explore this concept. However, pursuing such a course is difficult.

The diaphragm has a dual role in respiration and postural control. Evidence suggests that current core stability exercises for low back pain are superior to minimal or no treatment, however, no more beneficial than general exercises and/or manual therapy. There appears to be a higher focus on the transverses abdominis and multifidi muscles and minimal attention to the diaphragm.

We propose that any form of core stabilization exercises for low back pain rehabilitation should consider the diaphragm. Core stabilization program could commence with facilitation of normal breathing patterns and progressive systematic restoration of the postural control role of the diaphragm muscle.

So, the aim of this trial is to determine whether combining diaphragmatic strengthening exercises with core stability training leads to faster improvements in pain and instability in individuals with lumbar instability, compared to traditional core exercises alone.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

30

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

  • Navn: Mona AbdelRaouf Moursy, PhD

Studiesteder

      • Cairo, Egypten
        • Outpatient clinic of the faculty of physical therapy, Cairo University
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Age between 25 and 35 years.
  • Positive prone instability test.
  • Straight leg raising >90 degrees.
  • Pain assessment on VAS >5/10.
  • All patients will suffer from clinical lumber instability (characterized by excessive movement in specific segments during active movement and posterior-anterior spring test causing large movements and pain)

Exclusion Criteria:

  • Patients with cardiovascular diseases.
  • Patients with cerebrovascular diseases.
  • Patients with neurological diseases.
  • Patients with any attention disorders or physical disability.
  • Patients with any diseases/conditions preventing physical activity participation.
  • Patients with history of back surgery, inflammatory spinal disorder, deformed vertebrae, fracture, or neurological radiating pain.
  • Patients with central obesity (A waist to hip ratio >0.90 in males or > 0.85 in females).

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Combined diaphragm strengthening + Core stability exercises
It will include patients that will perform combined diaphragm strengthening and core stability exercises. The treatment program will be 45 minutes, 3 times a week, for 8 weeks.
Participants will receive supervised diaphragm strengthening exercises combined with core stability training, three sessions per week for 8 weeks (45 minutes/session). Diaphragm strengthening will be performed using an elastic TheraBand wrapped around the thoracolumbar junction to provide progressive inspiratory resistance, with intensity progressed according to the Borg Rating of Perceived Exertion (RPE: 11 during weeks 1-2, 13 during weeks 3-5, and 15 during weeks 6-8).
Participants will receive supervised core stability exercises only, three sessions per week for 8 weeks (45 minutes/session). The exercise program includes the abdominal drawing-in maneuver (ADIM), side-bridge, and quadruped exercises, with progressive increases in exercise difficulty every two weeks. Participants will perform the same exercise progression as the intervention group but without diaphragm strengthening or TheraBand resistance.
Aktiv komparator: Core stability exercises
It will include patients that will perform core stability exercises alone. The treatment program will be 45 minutes, 3 times a week, for 8 weeks.
Participants will receive supervised core stability exercises only, three sessions per week for 8 weeks (45 minutes/session). The exercise program includes the abdominal drawing-in maneuver (ADIM), side-bridge, and quadruped exercises, with progressive increases in exercise difficulty every two weeks. Participants will perform the same exercise progression as the intervention group but without diaphragm strengthening or TheraBand resistance.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Pain intensity assessed using the Visual Analogue Scale (VAS)
Tidsramme: 8 weeks
Pain intensity will be evaluated using a 10-cm Visual Analogue Scale (VAS), with scores ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity.
8 weeks
Pressure pain threshold assessed by pressure algometry
Tidsramme: 8 weeks
Pressure pain threshold will be measured over the lumbar paraspinal muscles using a handheld pressure algometer. Higher values indicate reduced pain sensitivity.
8 weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Core muscle stability assessed using a Pressure Biofeedback Unit (PBU)
Tidsramme: 8 weeks
Core muscle stability will be assessed using a Pressure Biofeedback Unit during abdominal drawing-in tasks. Improved pressure control indicates better activation of the local stabilizing muscles.
8 weeks
Functional disability assessed using the Oswestry Disability Index (ODI)
Tidsramme: 8 weeks
Functional disability related to low back pain will be evaluated using the Oswestry Disability Index (ODI). Scores range from 0 to 100%, with higher scores indicating greater disability.
8 weeks

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Studiestol: Ahmad Mahdi Ahmad, PhD, Professor, Cairo University
  • Studieleder: Maged Mohamed Samy Abouelsoud, PhD, Professor, Ain Shams University
  • Studieleder: Mona AbdelRaouf Moursy, Assist. Professor, Cairo University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

5. august 2026

Primær færdiggørelse (Anslået)

5. december 2026

Studieafslutning (Anslået)

12. december 2026

Datoer for studieregistrering

Først indsendt

25. juli 2026

Først indsendt, der opfyldte QC-kriterier

25. juli 2026

Først opslået (Faktiske)

29. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

29. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. juli 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • P.T.REC/012/006064

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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