Effects of Whole-Body Vibration and Pilates on Pain, Dynamic Balance, and Functional Performance in Chronic Non-Specific Low Back Pain

Experimental: Whole Body Vibration

Participants in this group will receive Whole Body Vibration training using a vibration platform. Sessions will be conducted 3 times per week for 4 weeks, lasting approximately 20-30 minutes per session. The protocol will include static and dynamic postures designed to activate lower and upper limb musculature, with incorporated upper limb movements and a 2:1 work-rest ratio

Otro: Whole body vibration

Whole-body vibration therapy will be delivered using a side-alternating vibration platform under the supervision of a trained physiotherapist. The intervention will be performed 3 sessions per week for 4 weeks. Each session will last 30 minutes, consisting of 10 bouts of 2 minutes vibration followed by 1 minute rest.

Vibration parameters will include a frequency of 18 Hz and an amplitude of 2 mm. Participants will maintain a static standing posture with slight knee flexion, slight lumbar lordosis, and head erect. No additional exercises will be performed on the platform to isolate the effect of vibration. Participants will wear socks during the intervention.

All participants will also receive conventional physiotherapy, including:

Transcutaneous Electrical Nerve Stimulation (TENS): 100 Hz frequency, 200 µs pulse duration, 10 minutes Joint mobilization: oscillations at 1-2 Hz applied for approximately 5 minutes to hypomobile or painful lumbar segments

Comparador activo: Pilates

participants in this group will receive a supervised mat-based Pilates program conducted by a trained physiotherapist. The intervention will be carried out 3 times per week for 4 weeks, with each session lasting approximately 30 minutes. Exercises will focus on core stability, postural alignment, controlled breathing, and upper limb engagement, performed using an intermittent 2:1 work-rest ratio.

Otro: Pilates

Mat-based Pilates exercises will be performed under the supervision of a trained physiotherapist. The intervention will be conducted 3 sessions per week for 4 weeks, with each session lasting approximately 30 minutes, using a 2:1 work-rest ratio similar to the WBV group.

The program will include:

Diaphragmatic breathing: 2 min activity + 1 min rest The Hundred: 2 sets of 2 min with 30 sec rest Roll Up: 5 cycles (40 sec activity + 20 sec rest) Single Leg Circles: small and large circles (40 sec each + 20 sec rest), bilaterally Spine Stretch: 5 cycles (40 sec activity + 20 sec rest) Single Leg Stretch: 4 cycles (40 sec activity + 20 sec rest) Diaphragmatic breathing (cool-down): 2 min activity + 1 min rest

Exercises will be performed at low to moderate intensity, focusing on core stabilization, breathing control, flexibility, and controlled movement.

All participants will also receive conventional physiotherapy, including TENS (100 Hz, 200 µs, 10 minutes) and lumbar joint mobilizatio

Pain intensity

Outcome Measure: Change in dynamic balance measured using the Y-Balance Test. Description: Dynamic balance will be assessed using the Y-Balance Test. Reach distances in the anterior, posteromedial, and posterolateral directions will be normalized to limb length, and a composite score (%) will be calculated. Higher composite scores indicate better dynamic balance.

Dynamic Balance

Dynamic balance will be assessed using the Y-Balance Test Composite Reach Distance, normalized to limb length. Composite scores range from 0% to 100%. Higher scores indicate better dynamic balance.

Unit of Measure: Percent (%)

Functional performance

Outcome Measure: Change in functional performance measured using the Progressive Isoinertial Lifting Evaluation (PILE).

Description: Functional performance will be assessed using the Progressive Isoinertial Lifting Evaluation (PILE), which measures lifting capacity during a standardized lifting task. The primary outcome will be the maximum weight lifted (kg) and the number of completed lifting stages. Higher values indicate better functional performance.