Effects of flossing technique and core stabilization exercise on the treatment of chronic non-specific low back pain - A randomized controlled trial

Abstract

Background: Flossing technique (FT) is used as an adjunct to traditional exercise interventions aiming to enhance neuromuscular activation, improve circulation, and increase the range of motion. This study aimed to determine core stabilization exercise (CSE) combined with the FT in improving muscle thickness, functional capacity, pain levels, and disability in individuals with chronic non-specific low back pain (CNSLBP). Methods: A total of 42 individuals with CNSLBP aged between 18 and 45 years were randomly assigned to one of three conditions: CSE-FT, CSE alone, or control (CON). Each intervention group performed exercises for six weeks, three times per week. Pain, Oswestry Disability Index (ODI), 2-Minute Step Test (2MST), 5-Time Sit-to-Stand Test (5TSST), and muscle thickness of transversus abdominis (TrA) and lumbar multifidus (LM) muscles were measured at baseline and 6 weeks. Results: Pain during aggravation significantly decreased in the CSE-FT and CSE groups compared to the control group (p < .001). The ODI scores, the CSE-FT group exhibiting the most notable reductions (p < .001). Significant improvements in the 2MST were noted in both intervention groups, with CSE-FT demonstrating superior results (p < .001), while the 5TSST did not exhibit significant improvements. The CSE-FT group showed significantly greater increases in TrA and LM thickness compared to the CSE and CON groups (p < .001). Conclusions: Adding FT to CSE enhances the effectiveness of core stabilization exercises by reducing pain and disability, improving functional capacity, and increasing muscle thickness in individuals with CNSLBP.