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

Introduction
Chronic low back pain (CLBP) affects 69.1% of Egyptian physical therapists (PTs), causing discomfort, changes in lung capacity and diaphragm mechanics. Studies have indicated that core stability exercises and diaphragmatic release improve CLBP and respiratory functions. This comparative study examines which of these methods is more effective at restoring respiratory functions and CLBP management.

Material and methods
Ninety female PTs with CLBP were randomly assigned to three equal groups: Group A (Core Stability Exercise), Group B (Diaphragmatic Release), and Group C (Control). All participants received a standard protocol that included ultrasound, transcutaneous electrical nerve stimulation and hot pack. The primary outcome measures included pulmonary function tests assessed by spirometer, diaphragm excursion and thickness measured by diagnostic ultrasound. The secondary outcome measure, the Oswestry Disability Index (ODI), was determined using the Oswestry Disability Questionnaire. These outcomes were assessed and compared before and after the intervention.

Results
Groups A and B revealed significant improvements in the primary outcomes (p < 0.001), however, diaphragm excursion improved more in Group B, while diaphragm thickness was more enhanced in Group A. All groups exhibited a significant reduction in ODI scores (p < 0.001), with Groups A and B showing the most pronounced decreases.

Conclusions
The observed intergroup variation in diaphragm thickness and excursion, indicates that the combination of core stability exercises with diaphragmatic release techniques is the most effective approach to alleviate pain, enhance respiratory functions and core strength in CLBP subjects.