# Lumbar Stabilization and Gluteal Strengthening Exercises Versus Health Education for Chronic Low Back Pain: A Retrospective Observational Study

## TL;DR

A study compared two treatments for chronic low back pain and found that combining gluteal and lumbar exercises was more effective than health education alone.

## Contribution

The study provides evidence that combined gluteal and lumbar exercises outperform health education in reducing disability for chronic low back pain.

## Key findings

- Combined exercises reduced disability scores by 8.92 points, significantly better than health education's 5.68-point reduction.
- 80% of the exercise group achieved a 50% or greater disability reduction, compared to 48% in the education group.
- The exercise group had a higher rate of complete functional recovery (48%) than the education group (28%).

## Abstract

Background and aim

Chronic low back pain represents a substantial global health burden with escalating prevalence rates and significant disability implications. Contemporary clinical practice guidelines emphasize exercise-based interventions as first-line conservative management strategies. However, optimal exercise prescription protocols remain under investigation. This study aimed to compare functional disability outcomes between patients receiving combined gluteus muscle strengthening with lumbar stabilization exercises versus those receiving spine-neutral health education alone for chronic low back pain management, utilizing the Oswestry Disability Index (ODI) as the primary outcome measure.

Methodology

This retrospective, observational, comparative study was conducted at a tertiary care teaching hospital, analyzing treatment outcomes in 50 participants aged 18-45 years with chronic low back pain and ODI scores of 5 or higher who received physiotherapy management between August 2023 and February 2024. Patients were stratified into group A (n = 25), who received spine-neutral health training, or group B (n = 25), who received combined gluteus muscle strengthening and lumbar stabilization exercises plus health education, based on initial clinical assessment and therapeutic protocol assignment during routine clinical practice. Treatment protocols were implemented over four weeks with alternate-day exercise sessions for group B participants. Baseline and post-intervention assessments included demographic characterization, occupational classification, educational attainment, and ODI scoring. Statistical analysis employed independent samples t-tests, paired-samples t-tests, and chi-square tests with significance established at an alpha level of 0.05.

Results

Baseline demographic characteristics demonstrated homogeneity between groups, with mean ages of 28.48 years in group A and 27.80 years in group B without statistically significant differences. Both intervention modalities achieved significant within-group ODI reductions, with group A demonstrating a mean decrease from 12.28 to 6.60, representing a reduction of 5.68 points, and group B showing a mean decrease from 13.68 to 4.76, representing a reduction of 8.92 points, both achieving statistical significance with probability values below 0.0001. Between-group comparison revealed statistically significant superiority of the combined exercise protocol, with post-intervention ODI scores of 6.60 in group A compared to 4.76 in group B, with a probability value of 0.0433. Clinical success rates, defined as 50% or greater disability reduction, were achieved by 12 participants (48.00%) in group A compared to 20 participants (80.00%) in group B, with statistical significance. Complete functional recovery was attained by seven participants (28.00%) in group A compared to 12 participants (48.00%) in group B. Severe disability classification was completely eliminated across both intervention groups.

Conclusion

Combined gluteus muscle strengthening and lumbar stabilization exercises demonstrated superior therapeutic efficacy compared to spine-neutral health education alone, achieving significantly greater functional disability reduction and clinical success rates. Both interventions produced clinically meaningful improvements, supporting conservative management approaches as first-line treatment strategies for chronic low back pain rehabilitation.