مقايسه تأثير هشت هفته تمرينات ثبات دهنده مركزي و تمرينات عمومي فيزيوتراپي برثبات عصبي عضلاني پويا، استقامت ناحيه مركزي، درد، ناتواني عملكردي و ترس ازحركت در زنان داراي كمردرد مزمن به علت فتق ديسك

Introduction and objective: Chronic low back pain (CLBP) is a pervasive and debilitating musculoskeletal disorder with a global preva‎lence that affects a large number of population in the world. Disc herniation is the most common cause of specific chronic low back pain. In addition to the pain caused by this problem, which is a major complication, the reduction and impairment of physical performance in daily life is another major concern which leads to employee absence from work. Physical therapy programs are often recommended to treat pain and restore function and neurological deficits associated with herniated disc patients. Active exercise therapy, which is a type of physical therapy program, is usually preferred over passive modalities. There are a number of exercise programs for the treatment of herniated discs. The present study was conducted with the aim of comparing the effect of core stability exercises and special physical therapy general exercises on dynamic neuromuscular stability, core endurance, balance, pain, functional disability and fear of movement in women with chronic back pain due to disc herniation. Materials and methods: The present study is a semi-experimental study with a non- randomized controlled clinical trial design. The sample of the current study was made up of 64 female patients between the ages of 30 to 50 who had been referred to the physiotherapy clinic in Khomeini Shahr due to disc herniation. The sample was purposefully selected and thenrandoLMy divided into two equal groups. Subjects of both groups of exercise protocol (core stability exercises and general exercises protocol) performed selected exercises during 8 weeks. Three sessions were held each week and each session lasted for about 30-45 minutes. Before and after the training period, the variables of pain, functional disability, dynamic neuromuscular stability, core endurance, balance and fear of movement were measured through employing Quebec questionnaire, Oswestry questionnaire, 11-step kolar DNS test, McGill endurance test, Y balance test and Tempa questionnaire. To investigate the difference in mean within groups, ANOVA statistical test was used for repeated measurements. Moreover, SPSS 27 software was used for data analysis at p≤ 0.05 level. Findings: The results showed that both types of exercises decreased the amount of pain, functional disability and fear of movement for patients in both groups (p≤ 0.05). However, the group of core stabilizing exercises, compared to the group of general exercises, showed more significant level of decrease in terms of pain (p≤ 0.05), functional disability (p≤ 0.05) and fear of movement (p≤ 0.05). Moreover, regarding dynamic neuromuscular stability, pre-test/ post-test comparison revealed higher level of improvement in the stabilization exercises group than the general exercises group (p≤ 0.05). Furthermore, core endurance increased more significantly among stabilizing exercises group compared to their counterparts in the general exercises group (p≤ 0.05). The results of the McGill test demonstrated that the improvement in core stability exercises group was more evident than in the general exercises group (p≤ 0.05). Finally, with regards to the dynamic balance, comparison of pre-test with post-test scores showed that women with chronic low back pain due to disc herniation in the core stability exercises group showed higher level of improvement compared to their counter parts in the general exercises group (p≤ 0.05).

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