Lumbar stabilization exercise with and without real-time ultrasound imaging biofeedback in chronic low back pain patients: a randomized controlled trial
Issued Date
2025-12-01
Resource Type
eISSN
20452322
Scopus ID
2-s2.0-105019600712
Journal Title
Scientific Reports
Volume
15
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Scientific Reports Vol.15 No.1 (2025)
Suggested Citation
Sarafadeen R., Ganiyu S.O., Ibrahim A.A., Akindele M.O., Awotidebe A.W., Kaka B., Bello B., Wattananon P. Lumbar stabilization exercise with and without real-time ultrasound imaging biofeedback in chronic low back pain patients: a randomized controlled trial. Scientific Reports Vol.15 No.1 (2025). doi:10.1038/s41598-025-20942-6 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/112815
Title
Lumbar stabilization exercise with and without real-time ultrasound imaging biofeedback in chronic low back pain patients: a randomized controlled trial
Corresponding Author(s)
Other Contributor(s)
Abstract
Reduced lumbar multifidus (LM) cross-sectional area (CSA) has been linked with non-specific chronic low back pain (NCLBP); hence, lumbar stabilization exercise (LSE) is typically used as treatment. Real-time ultrasound imaging (RUSI) biofeedback can enhance performance and retention in LM activation. This study aimed to compare the effects of LSE with or without RUSI-biofeedback in patients with NCLBP. A single-blind, three-arm, parallel randomized controlled trial involving 90 participants, randomized into LSE<inf>RUSI-biofeedback,</inf> LSE<inf>no-biofeedback</inf>, or minimal intervention (n = 30 per group) was conducted. All interventions were administered twice weekly for 8 weeks, and outcomes (LM-CSA, pain, disability, and quality of life) were evaluated before and at 8-week and 20-week follow-ups. Compared to LSE<inf>no-biofeedback</inf> and minimal intervention, LSE<inf>RUSI-biofeedback</inf> demonstrated a greater increase (p < 0.05) in LM-CSA at 8 weeks (mean [95%CI] difference: 0.81 [0–1.62] and 1.79 [0.91–2.65], respectively) and at 20 weeks (1.61 [0.79–2.42] and 2.66 [1.79–2.53], respectively). LSE<inf>RUSI-biofeedback</inf> showed a greater improvement (p < 0.05) in mental health scores at 8 weeks (3.63 [0.32–6.94]) and 20 weeks (7.34 [4.03–10.60]) compared to LSE<inf>no-biofeedback</inf>. However, LSE<inf>no-biofeedback</inf> showed a greater physical health scores at 20 weeks (− 4.89 [− 7.92 to − 1.86]) compared to LSE<inf>RUSI-biofeedback</inf>. No significant differences (p > 0.05) were found between LSE<inf>RUSI-biofeedback</inf> and LSE<inf>no-biofeedback</inf> for pain or disability. The increase in LM-CSA significantly correlated with changes in pain (r = − 0.40 to − 0.50, p < 0.05) and disability (r = − 0.38 to − 0.42, p < 0.05). In conclusion, LSE with or without RUSI-biofeedback improved LM-CSA, pain, disability, and quality of life. However, LSE<inf>RUSI-biofeedback</inf> led to a greater increase in LM-CSA. Such an increase appears to be related to changes in pain and disability. Trial registration: The study was registered in the Pan African Clinical Trials Registry (16/01/2018; PACTR201801002980602).