# Effects of lumbar stabilization exercises on serum biomarker levels and clinical outcomes in lumbar disc herniation: a subgroup analysis of a randomized controlled trial

## TL;DR

This study found that lumbar stabilization exercises did not significantly affect biomarker levels or pain/disability outcomes in patients with lumbar disc herniation, but they reduced anxiety more than general exercises.

## Contribution

The study provides new evidence on the effects of stabilization exercises on biomarkers and anxiety in LDH patients with and without neurological deficits.

## Key findings

- Lumbar stabilization exercises did not significantly alter serum levels of TNF-α, IL-1β, IL-6, IL-4, BE, AEA, or 2-AG.
- SE reduced anxiety more than general exercises in both patient groups.
- No significant differences in pain or disability outcomes were found between the exercise groups.

## Abstract

The aim of our study was to investigate the effectiveness of lumbar stabilization exercises on serum biomarker levels and clinical outcomes in lumbar disc herniation (LDH) patients with and without neurological deficit.

40 patients with neurological deficits (WND) and 34 patients without neurological deficits (WOND) diagnosed with LDH were included in this study. The patients’ WND and WOND were randomized into stabilization exercises (SE) and general exercises (GE) groups. Stabilization exercises or general exercises were applied for six weeks. Serum levels of tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, IL-6, IL-4, beta-endorphin (BE), anandamide (AEA), and 2-arachidonoylglycerol (2-AG) were measured using the enzyme-linked immunosorbent assay. All patients filled out the Visual Analog Scale, Oswestry Disability Index, Beck Depression Inventory, and Beck Anxiety Inventory.

In patients WND and WOND, SE did not show any statistically significant difference in relation to TNF-α, IL-1β, IL-6, IL-4, BE, AEA, and 2-AG (p > 0.05). There were no statistically significant differences between the SE and GE groups in pain intensity and disability outcomes in patients WND (p > 0.05). SE group showed greater reductions in depression and anxiety scores compared to the GE group (p < 0.05). In patients WOND, there were no differences in pain, disability, or depression results between the SE and GE groups (p>0.05), whereas the decrease in anxiety score was greater in the SE group (p < 0.05).

Our results demonstrate that no effect of lumbar stabilization exercise is seen on circulating levels of TNF-α, IL-1β, IL-6, IL-4, BE, AEA, and 2-AG. Further exercise trials are needed to investigate what type, duration, and intensity of exercise is relevant for biomarkers that may play a role in the immune process.