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Review
. 2025 Apr 22;13(9):960.
doi: 10.3390/healthcare13090960.

Pain and Disability Therapy with Stabilization Exercises in Patients with Chronic Low Back Pain: A Meta-Analysis

Vanja Dimitrijević  1 , Bojan Rašković  1   2 , Nikola Jevtić  3 , Siniša Nikolić  4 , Dejan Viduka  5 , Borislav Obradović  1
Affiliations
Review

Pain and Disability Therapy with Stabilization Exercises in Patients with Chronic Low Back Pain: A Meta-Analysis

Vanja Dimitrijević et al. Healthcare (Basel). .

Abstract

Background: Chronic low back pain is a leading cause of disability worldwide, necessitating effective interventions to alleviate pain and improve function. This meta-analysis aimed to evaluate the effectiveness of stabilization exercises for pain relief and disability reduction in patients with chronic low back pain.

Methods: A meta-analysis was conducted following PRISMA and Cochrane guidelines. Randomized controlled trials evaluating stabilization exercises for chronic low back pain were included. Subgroup analyses were performed based on treatment duration, type of pain (specific vs. non-specific), study quality, and exercise type. Effect sizes were calculated using standardized mean differences (SMD), and evidence quality was assessed using the GRADE tool.

Results: A total of 23 studies involving 1132 participants were included. The meta-analysis revealed that longer treatment durations (8-12 weeks) showed the strongest effects on pain reduction (SMD = -0.88) and disability improvement (SMD = -0.85). For pain type, non-specific low back pain responded better (SMD = -0.81 for pain, -0.73 for disability) compared to specific LBP (SMD = -0.61 and -0.42, respectively). The 6-week duration also demonstrated moderate effects (SMD = -0.72 for pain). Core stability exercises had superior pain reduction (SMD = -0.90, large effect) compared to spinal stability exercises (SMD = -0.57), while spinal stability exercises showed higher-quality evidence for disability improvement (SMD = -0.56, high-quality) versus core stability (SMD = -0.62, low-quality).

Conclusion: Stabilization exercises are a highly effective intervention for chronic low back pain, offering significant pain relief and functional improvement. They outperform other common interventions and should be prioritized in clinical practice, particularly in longer-duration, supervised programs. These findings provide strong evidence to guide treatment protocols and improve outcomes for patients with chronic low back pain.

Keywords: back pain; conservative treatment; exercise therapy; low back pain.

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Conflict of interest statement

The authors declare no conflicts of interest. Funders had no role in any part of the study or publication process.

Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
Forest plot for outcome pain—subgroup treatment duration.
Figure 3
Figure 3
Forest plot for outcome pain—subgroup type of pain.
Figure 4
Figure 4
Forest plot for outcome pain—subgroup exercise type.
Figure 5
Figure 5
Forest plot for outcome disability—subgroup treatment duration.
Figure 6
Figure 6
Forest plot for outcome disability—subgroup type of pain.
Figure 7
Figure 7
Forest plot for outcome disability—subgroup exercise type.
See this image and copyright information in PMC

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