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. 2024 Mar 12;16(3):e56013. doi: 10.7759/cureus.56013

Table 1. Summary of the articles reviewed.

RCT: randomized controlled trial; CLBP: chronic low back pain;  VAS: visual analogue scale; MODQ: modified oswestry disability questionnaire; RS: rhythmic stabilisation; LBP: low back pain; CLBP: chronic low back pain; CNSLBP: chronic nonspecific low back pain; MMST: modified-modified schober test; ODI: ODI: oswestry disability index; TENS: transcutaneous electrical nerve stimulation; NPS: numerical pain scale;  MPQ: McGill pain questionnaire; PPT: pain pressure threshold; CI: interferential current; CA: aussie current; IC: interferential current; PG: placebo group; NSCLBP: non-specific chronic low back pain; LROM: lumbar range of motion; CSE: core stabilization exercises; KT: kinesiology taping; PNRS: pain numeric rating scale; RMDQ: Roland-Morris disability questionnaire; SF-MPQ: short form - McGill pain questionnaire; MFI-20: multidimensional fatigue inventory; BDI: beck depression inventory; sEMG: surface electromyography; SSR: sympathetic skin response; HMG: heat massage group; PTG: physical therapy group; % MVC LM: percentage of the maximum voluntary contractions of lumbar multifidus; PNF: proprioceptive neuromuscular facilitation; LM: lumbar multifidus; TrA: transverse abdominis; MF: lumbar multifidus; PPCE: progressive postural control exercise; NPRS: numerical pain rating scale; TSK: tampa scale for kinesiophobia; , ROM: range of motion; QOL; quality of life; UST: ultrasound therapy; KT: kinesio taping; SMT: sensory motor training; LLLT: low-level laser therapy; SNAGs: sustained natural apophyseal glides; LSO: lumbosacral orthoses; IFT: interferential therapy.

Sr. No Authors and year Study type Outcome measures Intervention Results Conclusions Inference
1 Singh et al. 2023 [15] RCT (n=60 individuals with CLBP) VAS, MODQ Group A: Rhythmic stabilisation Group B: Back strengthening exercises LBP significantly p<0.001 enhanced with the experimental group, and the MODQ considerably reduced, while the control group showed no significant changes RS improves LBP and disability, with the experimental group showing greater improvement than the control group in the program. In the rehabilitation of CLBP and accompanying disability, physiotherapy approaches that include RS may be more beneficial than those that only use conventional treatments which include Stretches and core strengthening exercises to improve flexibility and core stability. Cat-camel stretch, single knee-to-chest stretches, abdominal curl-ups, and abdominal bridging followed by unilateral straight leg lowering for both legs.
2 Abdelhaleem et. al 2023 [16] RCT (n=60 individuals with CNSLBP) VAS, MMST, ODI Group A:  Traditional physical therapy. Group B: Conventional physiotherapy in addition to ankle stability exercises Group B showed a substantial reduction of ODI and VAS post-treatment compared to Group A (p < 0.05) and a significant increase of MMST (p < 0.05). Ankle stability exercises enhanced ODI, MMST, and pain when added to conventional therapy exercises: Hot pack, TENS, stretching exercises for the lower back and hamstrings, clamshell exercise for activation of gluteus medius muscles, and core strengthening. Enhancing results for people with persistent LBP with the inclusion of ankle stability exercises in physical therapy interventions highlights the possibility for a holistic approach aimed at reducing pain, improving disability and improving flexibility.
3 Paula et al.  2023 [17] RCT (n=125 individuals with CLBP) NPS, MPQ and PPT 5 groups: CI4kHz/100Hz, CI4kHz/2Hz, CA4kHz/100Hz, CA4kHz/2Hz and placebo.  For thirty minutes, each participant underwent a single session with either Aussie current or interferential current. Significant differences in NPS and MPQ groups (p<0.05) for IC 4 kHz/100 Hz and IC 4 kHz/2 Hz compared to PG. Interferential current, regardless of modulation had immediate analgesic effects in CLBP individuals, superior to Aussie current. The results indicate that for participants with CLBP, IC performed better compared to Aussie Current in terms of giving rapid reduction in pain, regardless of modulation. This emphasises how effective Interferential Current may be as a pain management technique for CLBP sufferers.
4 Ogunniran et al. 2023 [18] RCT (n=35 NSCLBP) Pain intensity, functional disability, psychological state, sleep disturbance, kinesiophobia and LROM had been evaluated. Three groups: Kinesio Taping + Core Stability Exercise, CSE and KT only. Pain reduction, improved function, better psychological state, reduced kinesiophobia, reduced disruption to sleep and improved LROM in all groups post-intervention. All participants improved, but the KT + CSE group had superior clinical outcomes When Kinesio Taping and Core Stability Exercise were combined, all participants to those having NSCLBP improved more significantly and comprehensively.
5 Kim et al. 2023 [19] Randomized Controlled Feasibility Trial (n=40 LBP participants) PNRS, ODI, RMDQ, SF-MPQ, MFI-20, BDI, sEMG, SSR HMG group: simultaneous heat massage therapy using a mechanical device PTG: conventional physical therapy In both groups, there was no significant improvement in PNRS, ODI, RMDQ or SF-MPQ. Prior to PTG, BDI in HMG improved. MFI-20 has improved, yielding superior HMG outcomes. It was demonstrated that both interventions were successful in reducing LBP and pain-related impairment. When compared to traditional physical treatment the benefits of simultaneous heat massage therapy are particularly noticeable in the alleviation of fatigue (MFI-20) and earlier improvement in depression (BDI).
6 Baig et al. 2022 [20] RCT (150 individuals with CLBP) VAS, MMST, ODI, sEMG, % MVC LM Intervention group: bilateral asymmetrical limb PNF, comparison group:  Swiss ball exercises Pain, ODI disability, and % MVC LM significantly improved (P < .001) in the PNF group compared to the comparison group.  Bilateral asymmetrical limb PNF exercises improved pain, disability, and LM activity in  CLBP patients more than Swiss ball exercises. PNF exercises were beneficial than standard Swiss ball exercises CLBP.
 7 Wang et al. 2022 [21] RCT (n=34 individuals with CLBP) VAS, ODI, RMDQ, contractility of TrA and MF, and the capacity to regulate an unchanged posture Exercise groups for core stability and progressive postural control group VAS, ODI, and RMDQ scores significantly decreased in both groups. Percentage change in TrA and left MF thickness increased and the sway area of the centre of pressure during static stance with eyes open decreased in both groups. For individuals with CLBP, PPCE has advantages equivalent to those of core stability exercises. Exercises for core stability and progressive postural control have comparable effective benefits. These advantages cover all outcomes. The adaptability of these therapy modalities which gives medical professionals choices when creating successful rehabilitation plans for CLBP patients.
8 Aguilar‑Ferrándiz et al. 2022 [22] RCT (n=58 individuals with NSCLBP) RMDQ, ODI, Tampa Scale for Kinesiophobia, Pittsburgh Sleep Quality Index, NPRS   Kinesio taping group and Transcutaneous electrical nerve stimulation group Statistically significant group differences in NPRS, ODI, TSK The analgesic current, kinesio taping and exercise therapy when combined together relieved pain, disability, anxiety, depression and improved sleep patterns. Exercises, kinesio taping and analgesic current when incorporated together yielded favourable results.
9 Rodríguez-Huguet et al. 2022 [23] A single blind RCT (n=50 individuals with NSCLBP) Pain, PPT, ROM, functionality and QOL Vacuum treatment combined with a group for core therapeutic exercises and a group for a physical therapy: supine bridge, prone bridge, side bridge, dead bug and bird dog Substantial variations were observed right after treatment in the physical therapy group. Myofascial vacuum therapy intervention improved pain, mobility, pressure pain threshold, functionality and quality of life. Though each intervention showed potential, myofascial vacuum therapy, in conjunction with core, therapeutic exercises can be thought of as a comprehensive, effective method for managing pain and improving multiple functional domains QOL in patients with persistent LBP that is not specific.
10 Fouda et al. 2021 [24] RCT (n=60 individuals with CLBP) Trunk endurance, spinal mobility, functional impairment Group A: conventional physical therapy + Rhythmic stabilisation training. Group B: traditional physical therapy + integrating of isotonic techniques. Group C: An integration of several isotonic workouts and training in rhythmic stabilisation.   Following treatment, there were significant differences (p < 0.05) in the outcomes evaluated across the groups. Rhythmic stabilisation training combined with isotonic exercises for PNF was better in treating the patient than any strategy by itself. When combating NSCLBP, an integrated approach that combines stability training and isotonic exercises may be more effective than utilising each technique separately.  
11 Hlaing et al. 2021 [25] RCT (n=36 individuals with NSCLBP) Proprioception, standing balance, muscle thickness of TrA and LM, VAS, MODQ, Tampa Scale for Kinesiophobia Core stabilisation exercise group and strengthening exercise group Compared to the group that performed strengthening exercises, the CSE group showed considerably greater progress Core stabilisation exercise is superior to enhancing exercise The group that performed core stability exercises showed much superior results than the group that performed strengthening activities, as determined by a thorough assessment of multiple parameters, such as pain, disability, muscle thickness, and kinesiophobia
12 Otadi et al. 2021  [26] A randomised clinical trial (n=24 individuals with NSCLBP) Static stability, dynamic balance, pain and function The interventional group, TENS combined with diaphragm training and the control group: TENS alone The intervention group showed higher improvements in pain, static strength and dynamic balance than the control group. Both groups saw an improvement in function Compared to TENS alone, diaphragm training plus TENS resulted in larger gains in pain, static strength, and balance The fact that all groups' functions were improved suggests that the therapies were successful; nonetheless, the experimental group performed better in two important domains: pain and physical stability
13 Sipko et al. 2021 [27] A randomised control trial (n=53 individuals with CLBP) Centre of pressure, tandem and one-leg standing tests  The intervention group, PNF and control group In the leg stand test mediolateral plane, pain and sample entropy declined quickly following the exercise and either reached or even surpassed the baseline values For patients with CLBP, a single PNF exercise session may be helpful for pain management and regulating posture This indicates that PNF exercises could be a viable strategy for CLBP patients to enhance their postural stability and manage their pain
14 Nugraha et al. 2021 [28] RCT (n=20 individuals with NSCLBP NRS, Goniometer, ODI Control group:  UST + KT + PNF Experimental group:  UST + KT + sensory motor training The outcomes demonstrated that each group's low back disability, ROM and pain had improved When it comes to enhancing pain, ROM and disability, the UST + PNF + KT combined performs just as well as the UST+SMT+KT together The research's main conclusion showed that each of the treatment and control groups had improvements in low back impairment, ROM and disability
15 Seo et al. 2020 [29] RCT (49 participants with CLBP) VAS, MMST, RMDQ SNAGs with the LLLT group, the SNAGs group and the control group were segregated into three groups Following treatment in the SNAGs with the LLLT group and the SNAGs group, the VAS and MMST scores increased considerably. Following the treatment program, the RMDQ score of both the control group and the SNAGs with LLLT SNAGs increased substantially Combining LLLT with Mulligan’s mobilization therapy is a beneficial way to enhance ROM and function while lowering pain For those with CLBP, Mulligan’s mobilization in addition to LLLT is an efficient way to decrease pain and enhance ROM and function
16 Abass et al. 2020 [30] RCT (n=40 participants with NSCLBP) VAS, ODI, Tampa Scale of Kinesiophobia questionnaire, back muscle endurance Experimental group: Lumbar stabilisation + conventional therapy Control groups: Traditional therapy There was a significant reduction in pain intensity disability and an increase in back muscle endurance Augmenting conventional physiotherapy with lumbar stabilisation exercises achieved a better reduction in disability than conventional therapy alone For individuals with NSLBP, adding lumbar stability exercises to traditional therapy produced noteworthy improvements
17 Anggiat et al. 2020 [31] Quasi-experimental study (n=36 participants with NSCLBP) ODI Three groups: PNF, McKenzie and control group PNF demonstrated that its impact on the functional disability score is greater than that of the McKenzie technique Functional disability on NSLBP changed with the implementation of the PNF and McKenzie method, improving functional disability compared to McKenzie method In terms of disability, the PNF approach outperformed the McKenzie approach. This demonstrates how PNF may be useful in treating functional impairment brought on by NSLBP
18 Azadinia et al. 2019 [32] RCT (n=44 participants with LBP) At three different levels of difficulties for postural tasks - eyes open on a rigid surface, eyes closed on a rigid surface and eyes closed on a foam surface -the centre of pressure fluctuations were measured during standing Intervention group: LSO in addition to conventional physiotherapy and only conventional physiotherapy group LSO and conventional physical therapy techniques were used as an intervention, although in people experiencing LBP, this did not affect the temporal structures of postural sways Rehabilitation approaches that only address the correction of peripheral mechanics, such as LSO or conventional physiotherapy modalities, are unable to modify the way the postural control system behaves Both LSO and conventional physical therapy methods were effective in helping LBP patients manage their postural sways
19 Kotteeswaran et al. 2019 [33] RCT (n=60 participants with LBP) ODI Group A:  Mulligan’s  technique with IFT and Group B:  conventional physiotherapy abdominal strengthening exercise with IFT ODI values in Group B disability levels were much higher than those of Group A Better improvement in reducing LBP in Mulligan’s  technique than traditional abdominal strengthening exercise When it comes to lowering LBP related impairment, the Mulligan’s  technique works better than conventional physiotherapy methods
20 Malla et al. 2018 [34] RCT (n=30 participants with NSLBP) VAS, digital inclinometer, RMDQ Group A: Swiss ball exercises & Group B: PNF exercises Considerable improvements in both approaches Using a Swiss ball exercise for motor control and rhythmic stabilization approach, patients with NSLBP demonstrated substantial improvements in their ROM, pain, and disability This suggests that both strategies may be useful in the management of NSLBP, providing medical professionals with a multitude of choices for creating rehabilitation plans tailored to the specific requirements of each patient
21 Farajzadeh et al. 2017 [35] RCT (n=30 participants with NSLBP) VAS, Quebec LBP Disability Scale questionnaire, inclinometer and Biodex Balance System McGill stabilization exercises group and conventional physiotherapy group Comparing each of the groups, there were no appreciable variations in pain, disability, and ROM. Notably, among the dynamic postural stability variables, changes were observed In order to sustain balance during everyday tasks like walking, McGill stabilisation exercises might enhance improved dynamic postural balance variables Based on this, it appears that although there are some similarities between the two methods, McGill stabilizing exercises could be a more useful intervention for enhancing dynamic postural balance, especially when it comes to regular walking