Isometric Stability vs. Isotonic Mobility for Chronic LBP

Palestine Ahliya University

Status: Completed

Conditions: LBP

Treatments: Other: Isotonic exercises; Other: Isometric exercises

Study type: Interventional

Funder types: Other

Identifiers

NCT07382232

PAUB

Details and patient eligibility

About

Background: Low back pain (LBP) is a leading cause of disability, often requiring primary care management.

Objective: To compare the effectiveness of isometric versus isotonic exercise programs for LBP.

Methods: Sixty adults with LBP were randomly assigned to two groups. Group A (n=30) performed isometric exercises, infrared therapy, and TENS. Group B (n=30) performed isotonic exercises with the same adjunct therapies. Pain (VAS), disability (MODI), and abdominal endurance were measured pre- and post-intervention.

Keywords: Exercise therapy; low back pain; disability evaluation

Full description

Group-Specific Exercise Protocols:

• Isometric Exercise Group (IEG): This group performed a circuit of three core-stabilizing isometric exercises, each held for 10 seconds with brief rest intervals, for 5 complete repetitions. The exercises included: (a) Isometric Curl-Up, (b) Side Bridge, and (c) Bird Dog. The total dedicated exercise time was approximately 20 minutes per session.
• Isotonic Exercise Group (ITG): This group performed a circuit of three dynamic, strength-oriented isotonic exercises, each completed for 10 repetitions. The exercises included: (a) Bent Knee Sit-Up, (b) Cross Curl-Up, and (c) Prone Back Extension. The total dedicated exercise time was also approximately 20 minutes per session. All exercises were selected and adapted from previously published rehabilitation protocols for CLBP [13].

Adjunctive Therapies (Common to Both Groups):

1. Infrared (IR) Therapy: A standard therapeutic infrared lamp was positioned 50 cm from the participant's lumbar spine at a 90-degree angle. Heat was applied for 15 minutes per session to promote muscle relaxation and local blood flow.
2. Transcutaneous Electrical Nerve Stimulation (TENS): Electrodes were placed over the painful lumbar area. A low-frequency (<10 Hz) TENS unit was applied for 20 minutes per session. The analgesic mechanism of TENS is well-documented, involving the modulation of pain pathways via opioid and noradrenergic receptors in the central nervous system [16].

Both groups received a standardized four-week intervention program, consisting of three supervised sessions per week, totaling 12 sessions. Each 55-minute session included adjunctive therapies common to both groups, followed by the specific exercise protocol.

Enrollment: 60 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age between 18 and 60 years;
• Diagnosis of non-specific CLBP, defined as pain localized between the lower rib margin and the gluteal folds persisting for more than three months;
• Self-reported pain intensity score between 40 mm and 80 mm on a 100-mm Visual Analogue Scale (VAS), indicating moderate to severe pain;
• Pain experienced on at least three days in the month preceding enrollment, with documented interference in daily activities;
• A formal referral for physiotherapy management.

Exclusion criteria

• The presence of "red flag" pathologies (e.g., spinal tumor, infection, fracture); - Neurological signs or symptoms suggestive of radiculopathy or myelopathy;
• a history of spinal surgery or epidural steroid injections within the previous 12 months;
• Systemic inflammatory diseases (e.g., rheumatoid arthritis) or major neurological disorders;
• Pregnancy;
• Receipt of physiotherapy for low back pain within the last six months;
• Current use of non-steroidal anti-inflammatory drugs (NSAIDs) or inability to refrain from their use during the study period;
• Any diagnosed psychiatric condition.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

arm 1- Group A : Isometric Exercises

Experimental group

Description:

• Isometric Exercise Group (IEG): This group performed a circuit of three core-stabilizing isometric exercises, each held for 10 seconds with brief rest intervals, for 5 complete repetitions. The exercises included: (a) Isometric Curl-Up, (b) Side Bridge, and (c) Bird Dog. The total dedicated exercise time was approximately 20 minutes per session.

Treatment:

Other: Isometric exercises

arm2- Group B: Isotonic Exercises

Experimental group

Description:

Isotonic Exercise Group (ITG): This group performed a circuit of three dynamic, strength-oriented isotonic exercises, each completed for 10 repetitions. The exercises included: (a) Bent Knee Sit-Up, (b) Cross Curl-Up, and (c) Prone Back Extension. The total dedicated exercise time was also approximately 20 minutes per session. All exercises were selected and adapted from previously published rehabilitation protocols for CLBP

Treatment:

Other: Isotonic exercises