The effect of integrating pain neuroscience education with stabilization exercises using a flexi-bar on functional disability, pain, and geometry of abdominal and multifidus muscles in patients with chronic non-specific low back pain.

Study Summary

52 patients with chronic non-specific low back pain (LBP) were randomized to receive pain neuroscience education (PNE) combined with Flexi-Bar stabilization exercises or Flexi-Bar stabilization exercises alone, with 48 patients completing the trial. The primary outcome of interest was functional disability assessed using the Roland-Morris Questionnaire (RMQ). Secondary outcomes included pain intensity measured using the visual analogue scale (VAS), kinesiophobia, pain catastrophizing, fear-avoidance beliefs, and ultrasound-assessed thickness and cross-sectional area of the abdominal and lumbar multifidus muscles. Clinical outcomes were assessed at baseline, 6 weeks, and 10 weeks, while muscle geometry was assessed at baseline and 6 weeks. Overall, the results of the study revealed that PNE combined with stabilization exercises significantly improved functional disability, pain intensity, and pain-related psychological outcomes compared with exercises alone (p < 0.05). Greater improvements in deep trunk muscle geometry were also observed with the combined intervention. These findings suggested that integrating PNE into stabilization rehabilitation may enhance clinical recovery and neuromuscular adaptations in patients with chronic LBP.