High and low volume core stabilization training in chronic low back pain: randomized crossover study

Introduction: Core stabilization training is pointed as an effective option for pain relief chronic non-specific low back pain (CNLBP), however, the adequate training volume to induce analgesia is still unknown. Objective: To evaluate the effect of one session of high and low volume core stabilization training protocols on endogenous pain modulation in women with CNLBP. Methods: This is an evaluator-blinded randomized crossover trial. Eighteen volunteers participated of the study, whom performed two core stabilization training sessions: high and low training volume. The variables evaluated were the pressure pain thresholds (PPT) and temporal summation (TS) by digital pressure algometer, in addition to the conditioned pain modulation (CPM) using a pressure algometer and ischemic compression with sphygmomanometer as conditioned stimulus. A 2x2 repeated measures ANOVA was performed to compare training and time, Bonferroni's post hoc test for pairwise comparison from interactions (time and training). Data were expressed as mean ± standard deviation and the significance level established in 5%. Results: When comparing pre and post intragroup, low volume core stabilization training showed significant increase at the PPT in L5 (p < 0.05) and tibialis anterior (p < 0.01). High volume training not showed a significant increase in none of the PPT measures. However, none of the investigated protocols changed TS and CPM in women with CNLBP. Conclusion: Low volume core stabilization training produces local analgesia and remote hypoalgesia, demonstrated by increased PPT in L5 and tibialis anterior. However, none of the investigated protocols were effective to reduce the central sensitization assessed by CPM and TS.