Comparison of Moderate Load Eccentric Core Exercises and Pilates in Patients With Non-Specific Low Back Pain

NCT07332390 | Recruiting

• 1 other identifier: FUI/CTR/2025/26
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

Low back pain (LBP) is a major global health concern, significantly affecting mobility, productivity, and quality of life. Non-specific low back pain (NSLBP), which accounts for most LBP cases, is associated with impaired proprioception, reduced lumbar range of motion (ROM), decreased muscular endurance, and altered neuromuscular control. Joint position error (JPE) is a key indicator of proprioceptive dysfunction, contributing to postural instability and movement impairments in NSLBP patients. Effective rehabilitation strategies are essential to improve functional outcomes and prevent recurrence. Exercise therapy, particularly core stabilization exercises, plays a crucial role in NSLBP management. Among various approaches, moderate-load eccentric core exercises and Pilates have gained attention for their potential benefits. Eccentric exercises improve neuromuscular control, proprioception, and endurance by emphasizing controlled muscle lengthening. Pilates, on the other hand, focuses on core activation, postural alignment, and flexibility to enhance spinal stability and movement efficiency. However, limited research directly compares their effects on joint position error, pain, lumbar ROM, and core endurance in NSLBP patients. This randomized controlled trial (RCT) will recruit 44 NSLBP patients from Fauji Foundation Hospital, Rawalpindi, using purposive sampling. Participants will be randomly assigned to either the moderate-load eccentric core exercise group or the Pilates group for an 8-week supervised intervention. Assessments will be conducted at baseline, the 4th week, and post-intervention using an inclinometer (JPE), NPRS (pain), an inclinometer (lumbar ROM), and McGill Torso Endurance Battery (core endurance). SPSS version 21.0 will be used to analyze the data, with normality assessed through the Shapiro-Wilk test or the Kolmogorov-Smirnov test. Group differences will be analyzed using an Independent Sample t-test for normally distributed data and Mann-Whitney U test in case of non-normally distributed data (p \< 0.05).

Conditions

Low Back Pain

Outcome Measures

Primary Outcomes (4)

• Pain intensity

  it will be assessed by Numeric Pain Rating Scale NPRS. 0 means no pain and 10 means worst pain.

  baseline , 4th week and 8th week.

• Lumber range of motion

  Lumber range of motion will be measured through dual inclinometer. Ranges include lumber flexion, lumber extension, right lateral flexion and left lateral flexion.

  Baseline , 4th week and 8th week.

• Core endurance

  It will be assessed through McGill core endurance battery. Core endurance will be assessed by measuring the time to hold a certain position. Time will be recorded. Core endurance include: Flexor trunk endurance Extensor trunk endurance Right side plank Left side plank

  baseline , 4th week and 8th week

• Inclinometer For Lumbar Joint Position Error

  Two inclinometers will be used for measuring JPE, one will be positioned at T12 spinous process and other will be placed at S1 spinous process. Participants will be blindfolded to eliminate visual cues and will memorize a target position by holding it for 5 seconds before returning to neutral. They will then attempt to reposition their spine into the target position in lumber flexion without visual feedback. The difference between the achieved and target positions will be recorded as the joint position error, measuring proprioceptive accuracy.

  BASELINE, 4th and 8th week

Study Arms (2)

Moderate load eccentric core exercises

EXPERIMENTAL

Participants will perform moderate load eccentric core exercises targeting trunk stabilizer and global core muscles, including eccentric back extensions, abdominal rollouts etc. Exercises will emphasize slow eccentric contractions (3-5 sec) at 50-70% 1RM or equivalent resistance, performed for 8-12 reps, 2-3 sets, three times per week. The protocol aims to enhance core strength, proprioception, neuromuscular control, and spinal stability, thereby reducing pain, disability, and recurrence in nonspecific low back pain.

Procedure: MODERATE LOAD ECCENTRIC CORE EXERCISES

Pilates

EXPERIMENTAL

Participants will undergo a Pilates-based exercise program focusing on core activation, controlled breathing, postural alignment, and trunk stability. The program will include mat-based Pilates movements such as pelvic tilts, bridging, hundred, leg stretch, and spine mobility exercises. Sessions will emphasize slow, controlled movements with deep stabilizer activation (transversus abdominis, multifidus), performed for 8-12 reps, 2-3 sets, three times per week. The aim is to improve core strength, posture, proprioception, flexibility, and overall functional control, leading to reduced pain and disability in nonspecific low back pain.

Procedure: Pilates

Interventions

Pilates PROCEDURE

Pilates description: participants will be enrolled in group B of the study and will follow a Pilates program designed to ensure progressive overload. The protocol will begin with foundational exercises focused on motor learning and core activation, progressing gradually to more advanced functional and load-bearing stability exercises. The primary focus will be on deep core recruitment, utilizing a beginner-level approach to avoid generalized movements and ensure targeted muscle activation. This structured progression will ensure that core stability remains the central focus, with each phase building upon the previous one. Warm up: Before starting the session, participants will perform warm up exercises for 10 minutes that include the following exercises: 1. Seated trunk rotation. 2. Standing trunk rotation 3. High knees 4. Standing side bends 5. Standing back stretch Each exercise will be performed 10 -12 times on each side. Cool down: Child's pose,Cat-cow stretch,Knee to chin

Pilates

MODERATE LOAD ECCENTRIC CORE EXERCISES PROCEDURE

MODERATE LOAD ECCENTRIC CORE EXERCISES: Eccentric training protocol will be incorporated in core strengthening regime . This will be conducted in two phases. Phase 1 will be the familiarization phase and phase 2 will be the acclimatization phase .

Moderate load eccentric core exercises

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Adults 18 to 45 years
• Both genders
• Low back (from T12 to buttock line) pain for more than 3 months
• Non-specific low back pain i.e. signs or symptoms not attributable to any specific structure
• Low back pain on 3-8 NPRS

You may not qualify if:

• Acute flare Low Back Pain
• Low back pain on NPRS (\>8)
• Thoracic pain
• Centralization and peripheralization of pain
• Leg symptoms when walking, eased in flexion (Signs of stenosis)
• Pain due to repetitive movement
• Paresthesia/numbness
• Structural deformity (scoliosis, spondylosis, spondylolisthesis)
• Curve reversal
• Pregnancy
• Post-surgery (within 6 months of abdominal, spinal, or lower limb surgery)
• Degenerative or inflammatory spinal diseases
• Malignancy

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University Islamabad

Islamabad, Punjab Province, 46000, Pakistan

RECRUITING

MeSH Terms

Conditions

Low Back Pain

Interventions

Exercise Movement Techniques

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Physical Therapy Modalities; Therapeutics

Central Study Contacts

Tehreem Zahra, DPT

CONTACT

0334-9709725; tehreemzahra2310@gmail.com

Ruqia Begum, MS-OMPT

CONTACT

03115532544; ruqia@fui.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: no masking
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 30, 2025
• First Posted: January 12, 2026
• Study Start: January 15, 2025
• Primary Completion: December 31, 2025
• Study Completion: January 15, 2026
• Last Updated: January 12, 2026

Record last verified: 2025-12

Locations

PA (1)