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

This group will receive artificial intelligence (AI) based exercises specifically designed for chronic non-specific low back pain for 4 weeks.

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.

This group will receive conventional trunk stabilization exercises supervised by a physical therapist for 4 weeks.

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.

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.

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.

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.

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.

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.

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).