Core stability exercises versus diaphragmatic release on respiratory functions on physical therapists with low back pain

Sumaya Serageldin Abdel-Aziz; Nagwa Mohamed Hamed Badr; Hatem Mohamed El-Azizi; Rehab El Sayed El Sawy; Alaa Mohamed El-Moatasem

doi:10.5114/areh.2024.146098

Figures & Tables

CONSORT 2010 flow diagram of the three study groups

Subject characteristics

Demographic data	Core stability Group (n = 28)	Diaphragmatic Release Group (n = 27)	Control Group (n = 28)	Test value	p-value
Age (years)

Mean ± SD	29.80 ± 2.45	28.21 ± 4.12	29.93 ± 3.16	1.313	0.413
Range	25–35	25–35	25–35	1.313	0.413

BMI (kg/m²)

Mean ± SD	26.61 ± 2.19	25.19 ± 3.68	26.72 ± 2.82	1.791	0.386
Range	20–30	20–30	20–30	1.791	0.386

Intergroup comparison regarding primary and secondary outcomes pre-intervention

	Core stability Group (n = 28)	Diaphragmatic Release Group (n = 27)	Control Group (n = 28)	Test value	p-value
FVC (L) pre

Mean ± SD	3.42 ± 0.37	3.03 ± 0.36	3.37 ± 0.29	1.188	0.114
Range	2.69–4.3	2.39–4.1	3–4.12	1.188	0.114

FEV1 (L) pre

Mean ± SD	2.91 ± 0.24	2.60 ± 0.34	2.83 ± 0.25	1.047	0.297
Range	2.45–3.29	2.06–3.36	2.41–3.6	1.047	0.297

FEV1/ FVC (%) pre

Mean ± SD	85.40 ± 4.40	84.96 ± 4.55	84.21 ± 4.73	0.486	0.617
Range	76.3–95.9	76.79–94.31	78.14–94.04	0.486	0.617

PEF (L/min) pre

Mean ± SD	5.20 ± 0.83	4.79 ± 0.92	5.57 ± 0.86	1.437	0.112
Range	3.6–7.83	3.07–6.31	3.11–7.54	1.437	0.112

MVV (L/ min) pre

Mean ± SD	75.49 ± 11.35	73.96 ± 14.40	72.46 ± 11.32	0.419	0.659
Range	54.9–97.1	45.1–97.8	46.8–89.1	0.419	0.659

Diaphragmatic excursion QB (cm) pre

Mean ± SD	0.79 ± 0.50	0.81 ± 0.32	1.30 ± 0.79	2.032	0.172
Range	0.12–2.06	0.12–1.3	0.17–3.1	2.032	0.172

Diaphragmatic excursion DB (cm) pre

Mean ± SD	2.58 ± 0.64	2.27 ± 0.93	2.83 ± 0.82	2.322	0.112
Range	1.26–4.15	0.58–4.57	1.23–4.5	2.322	0.112

Diaphragm thickness change (%) pre

Mean ± SD	57.37 ± 24.03	58.67 ± 22.82	53.43 ± 17.32	2.637	0.098
Range	20–95.45	20–86.36	20–85.71	2.637	0.098

ODI% pre

Mean ± SD	21.71 ± 10.62	20.00 ± 5.17	23.36 ± 8.22	1.113	0.334
Range	12–52	10–36	12–38	1.113	0.334

Comparison of PFT among groups pre- and post-treatment

Pulmonary function tests	Core stability Group		Diaphragmatic Release Group		Control Group

	Pre	Post	Pre	Post	Pre	Post
FVC (Litres)

Mean ± SD	3.42 ± 0.37	4.46 ± 0.53^A	3.03 ± 0.36	4.14 ± 0.35^A	3.37 ± 0.29	3.40 ± 0.30^B
Range	2.69–4.3	3–5.82	2.39–4.1	3.52–5	3–4.12	3.02–4.16
Change	1.04 ± 0.24 (0.31–1.52)^A		1.10 ± 0.16 (0.87–1.48)^A		0.04 ± 0.02 (0–0.12)^B
T-test	−22.917		−36.633		−1.440
P-value	0.001		0.001		0.568

FEV1 (Litres)

Mean ± SD	2.91 ± 0.24	3.79 ± 0.35^A	2.60 ± 0.34	3.52 ± 0.29^A	2.83 ± 0.25	2.86 ± 0.25^B
Range	2.45–3.29	2.84–4.5	2.06–3.36	3.05–4.13	2.41–3.6	2.43–3.62
Change	0.89 ± 0.20 (0.26–1.22)^A		0.92 ± 0.13(0.58–1.14)^A		0.03 ± 0.02 (0–0.09)^B
T-test	−23.777		−36.620		−0.755
P-value	0.001		0.001		0.291

FEV1/ FVC (%)

Mean ± SD	85.40 ± 4.40	85.41 ± 4.01	84.96 ± 4.55	85.26 ± 4.08	84.21 ± 4.73	84.27 ± 4.68
Range	76.3–95.9	77.31–94.7	76.79–94.31	77.54–94.6	78.14–94.04	77.74–93.93
Change	0.01 ± 0.01 (−1.2–1.5)		0.30 ± 0.16 (−1–6.31)		0.06 ± 0.02 (−0.74–0.87)
T-test	−0.086		−1.146		−0.828
P-value	0.932		0.262		0.415

PEF (Litres/ min)

Mean ± SD	5.20 ± 0.83	7.01 ± 0.87^A	4.79 ± 0.92	6.72 ± 0.93^A	5.57 ± 0.86	5.60 ± 0.84^B
Range	3.6–7.83	5.11–8.28	3.07–6.31	5.42–8.04	3.11–7.54	3.31–7.57
Change	1.81 ± 0.47 (0.28–2.97)^A		1.93 ± 0.50 (1.2–3.01)^A		0.04 ± 0.01 (−0.23–0.43)^B
T-test	−14.039		−20.931		−1.675
P-value	0.001		0.001		0.105

MVV (Litres/min)

Mean ± SD	75.49 ± 11.35	99.24 ± 12.18^A	73.96 ± 14.40	96.76 ± 15.96^A	72.46 ± 11.32	73.03 ±11.41^B
Range	54.9–97.1	73.2–120	45.1–97.8	63.8–135.9	46.8–89.1	47.1–90.9
Change	23.75 ± 6.17 (15.6–34.4)^A		22.80 ± 5.93(5.8–38.1)^A		0.57 ± 0.15 (0.2–2.2)^B
T-test	−22.911		−19.157		−0.613
P-value	0.001		0.001		0.382

Comparison of ODI among groups pre- and post-treatment

ODI%	Core stability Group		Diaphragmatic Release Group		Control Group

	Pre	Post	Pre	Post	Pre	Post
Mean ± SD	21.71 ± 10.62	4.86 ± 3.59^B	20.00 ± 5.17	4.93 ± 2.67^B	23.36 ± 8.22	15.79 ± 6.14^A
Range	12–52	2–14	10–36	1–10	12–38	6–26
Change	−16.86 ± 4.38 (−40–−8)^B		−15.07 ± 3.92 (−26–−8)^B		−7.57 ± 1.97 (−14–−4)^A
T-test	10.988		18.584		2.229
P-value	0.001		0.001		0.024

Comparison of diaphragmatic ultrasound among groups pre- and post-treatment

Diaphragmatic Ultrasound	Core stability Group		Diaphragmatic Release Group		Control Group

	Pre	Post	Pre	Post	Pre	Post
Excursion QB (cm)

Mean ± SD	0.79 ± 0.50	1.73 ± 0.63^B	0.81 ± 0.32	2.55 ± 0.48^A	1.30 ± 0.79	1.32 ± 0.78^C
Range	0.12–2.06	0.63–3.1	0.12–1.3	1.84–3.43	0.17–3.1	0.18–3.1
Change	0.94 ± 0.24 (0.24–1.72)^B		1.74 ± 0.45 (1.16–2.3)^A		0.02 ± 0.01 (−0.13–0.21)^C
T-test	−12.222		−28.167		−1.933
P-value	0.001		0.001		0.064

Excursion DB (cm)

Mean ± SD	2.58 ± 0.64	3.71 ± 0.71^B	2.27 ± 0.93	4.88 ± 1.14^A	2.83 ± 0.82	2.92 ± 0.88^C
Range	1.26–4.15	2.42–5.36	0.58–4.57	3.44–8.52	1.23–4.5	1.26–4.93
Change	1.13 ± 0.29 (0.19–1.94)^B		2.62 ± 0.68 (1.36–3.95)^A		0.09 ± 0.02 (0.01–0.76)^C
T-test	−19.026		−22.779		−0.286
P-value	0.001		0.001		0.282

Diaphragm thickness change (%)

Mean ± SD	57.37 ± 24.03	254.11 ± 15.83^A	58.67 ± 22.82	157.01 ± 30.65^B	53.43 ± 17.32	54.86 ± 17.46^C
Range	20–95.45	215.39–287.5	20–86.36	100–192.86	20–85.71	21–86.21
Change	196.74 ± 51.15 (154.27–237.14)^A		98.34 ± 25.57 (32.54–162.5)^B		1.43 ± 0.37 (0–2.38)^C
T-test	−43.586		−16.307		−1.728
P-value	0.001		0.001		0.171

Core stability exercises versus diaphragmatic release on respiratory functions on physical therapists with low back pain

Figures & Tables

Figure 1.

Subject characteristics

Intergroup comparison regarding primary and secondary outcomes pre-intervention

Comparison of PFT among groups pre- and post-treatment

Comparison of ODI among groups pre- and post-treatment

Comparison of diaphragmatic ultrasound among groups pre- and post-treatment

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