نوع مقاله : مقاله پژوهشی
نویسندگان
1 گروه رفتار حرکتی، دانشکده علوم ورزشی، دانشگاه فردوسی مشهد، مشهد، ایران
2 گروه اطفال، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران
کلیدواژهها
موضوعات
عنوان مقاله English
نویسندگان English
Background and Purpose
Low back pain (LBP) is a significant public health concern affecting children and adolescents worldwide, with a notably high prevalence during school years. Epidemiological studies have reported that approximately 26.6% of elementary school students in Iran experience back pain, underscoring the widespread nature of this condition in young populations. Importantly, LBP during childhood and adolescence is a strong predictor of chronic low back pain in adulthood, suggesting that early onset pain may set the stage for long-term musculoskeletal dysfunction and disability.
LBP in young individuals can profoundly impact quality of life, limiting participation in daily activities, school attendance, and physical exercise. Moreover, research indicates that girls report back pain more frequently than boys during these formative years, potentially due to differences in physical development, hormonal changes, or psychosocial factors. Most pediatric LBP cases are classified as non-specific, meaning they lack a clearly identifiable pathological cause, which complicates diagnosis and treatment.
Given the high prevalence and potential long-term consequences of LBP in youth, there is an urgent need for effective interventions aimed at promoting spinal health and reducing pain intensity. Exercise programs have demonstrated promise in addressing physical risk factors associated with LBP, including poor posture, muscle weakness, and reduced endurance. Among these, core stability exercises have gained particular attention due to their role in strengthening deep trunk muscles that provide essential support and stabilization to the spine. This is especially critical during the adolescent growth spurt, a period characterized by rapid musculoskeletal changes that may predispose individuals to spinal instability and injury.
The present study aimed to investigate the effects of an eight-week core stability exercise program on pain intensity and trunk muscle endurance in children and adolescents with non-specific LBP. By examining these outcomes, the study sought to provide evidence for the incorporation of targeted core training in preventive and therapeutic strategies for young populations experiencing back pain.
Materials and Methods
A total of sixty female participants were recruited and divided equally into two age groups: children (n = 30, aged 9–10 years) and adolescents (n = 30, aged 14–15 years). Participants were randomly assigned to either an experimental group, which received the core stability intervention, or a control group, which did not engage in additional exercise beyond their usual activities. Maturity status was assessed using Tanner’s scale to account for developmental differences that could influence outcomes.
Pain intensity was measured using a 10-cm Visual Analogue Scale (VAS), a validated and widely used tool for quantifying subjective pain experience. Trunk muscle endurance was evaluated using the McGill functional tests, which include isometric holds such as the side plank, prone plank, back bridge, single-leg bridge, and bird dog exercises. These tests assess the endurance capacity of the core musculature, which is integral to spinal stability.
The experimental group participated in a structured core stability exercise program conducted three times per week over eight weeks. Each session involved performing 10 repetitions of each exercise, with an isometric contraction held for eight seconds followed by a short rest of three seconds between repetitions. After completing 10 repetitions of one exercise, participants rested for 60 seconds before proceeding to the next exercise. The intensity of the exercises was progressively increased by adding more sets, contingent upon the participant’s ability to maintain correct form and spinal stability.
Pre- and post-intervention assessments of pain intensity and trunk muscle endurance were conducted. Statistical analyses were performed using ANCOVA to control for baseline differences, with Bonferroni post-hoc tests applied to identify specific group differences. All analyses were conducted using SPSS version 27, with significance set at p < 0.05.
Findings
The experimental group demonstrated a statistically significant reduction in pain intensity compared to the control group (p < 0.001), indicating that core stability exercises effectively alleviate pain in children and adolescents with non-specific LBP. Additionally, trunk muscle endurance significantly increased in the experimental group (p < 0.001), highlighting enhanced muscular capacity to support spinal structures.
Comparing age groups, adolescents exhibited greater improvements in trunk muscle endurance than children (p < 0.001), with an average increase of 24.94 seconds more endurance time. However, no significant difference in pain relief was observed between children and adolescents, suggesting that the exercise program effectively reduces pain across developmental stages.
These findings align with previous research in adult populations, where core stability exercises have consistently shown benefits in reducing LBP and improving functional outcomes. The increase in trunk endurance likely contributes to improved spinal alignment and stability, which are critical for mitigating pain and preventing further injury.
Discussion
The results of this study underscore the importance of core stability exercises as both a preventive and therapeutic intervention for LBP in youth. The adolescent growth spurt presents unique challenges to spinal health due to rapid skeletal and muscular changes. Strengthening the deep stabilizing muscles during this period may counteract the increased risk of spinal dysfunction and pain.
The greater improvements observed in adolescents may be attributed to their more advanced neuromuscular development and greater capacity for muscular adaptation compared to younger children. Nonetheless, the significant benefits observed in both age groups support the inclusion of core stability training in physical education curricula and clinical rehabilitation programs.
Pain reduction following the intervention may be mediated by improved muscular support of the spine, enhanced proprioceptive feedback, and increased neuromuscular control. These mechanisms collectively contribute to decreased mechanical stress on spinal tissues and reduced nociceptive input.
Given the relatively short duration of the intervention (eight weeks), the observed changes are encouraging and suggest that even brief, consistent exercise programs can yield meaningful clinical benefits. Long-term adherence to core stability exercises may further enhance these outcomes and contribute to sustained spinal health.
Conclusion
Core stability exercises effectively reduce pain intensity and enhance trunk muscle endurance in children and adolescents with non-specific low back pain. The intervention is particularly beneficial during adolescence, a critical period for musculoskeletal development. Incorporating core stability exercises into school-based physical education and rehabilitation programs is recommended to promote spinal health, reduce injury risk, and improve quality of life.
Given the rapid improvements observed, regular engagement in such exercise programs could serve as a practical and accessible strategy for managing LBP in youth. Future research should explore the long-term effects of core stability training, its impact on other functional outcomes, and its applicability to diverse populations, including males and individuals with specific spinal pathologies.
Article Message
Core stability exercises should be integrated into daily exercise programs for students to prevent low back pain and enhance performance. For individuals experiencing low back pain, these exercises may provide significant pain relief and functional improvement.
کلیدواژهها English
