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, alterations in lung capacity and diaphragm mechanics. Previously, studies declared that core stability exercises and diaphragmatic release improved CLBP and respiratory functions. This comparative study covers the research gap by demonstrating which of these methods is more effective regarding respiratory functions and CLBP management.

Material and methods
90 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 Oswestry Disability Questionnaire interpreted the secondary outcome measure; the Oswestry Disability Index (ODI).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, diaphragmatic 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. Clinically, this signifies the use of both therapeutic methods to optimize pain alleviation, pulmonary and diaphragmatic function in CLBP individuals.

Conclusions
The resulted intergroup variation regarding diaphragm thickness and excursion, endorses the combination of core stability exercises with diaphragmatic release techniques to alleviate pain, enhance respiratory functions and core strength in CLBP subjects.