Comparing the Effects of a Ten-week Combined Muscle Stabilization Training and Central Neurofeedback Stabilization on Pain in Patients with Non-Specific Chronic Lower Back Pain

Back pain is among the major health and socioeconomic problems and one of the most frequent musculoskeletal disorders in societies. Therefore, the present study aimed to compare the efficacy of 10 weeks of combined training of central muscle and Central Nervous System (CNS) stabilization on pain of patients with non–specific chronic Lower Back Pain (LBP).

This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of this study comprised all patients with non–specific chronic LBP. Among them, 60 subjects were selected as study samples and randomly assigned into 4 groups. The inclusion criteria were the age of 20 to 45 years, being diagnosed with a non–specific chronic LBP, experiencing the acute phase of LBP (minimum pain; <2weeks), not being a candidate for surgery, and so on. The exclusion criteria included not participating in 2 consecutive and 3 non–consecutive therapy sessions, dissatisfaction with participation in the training program, and the increased incidence of radicular pain in the lumbar nerves during treatment. After referring to the clinic, the selected patients were trained to determine the degree of LBP using the Visual Analogue Scale (VAS) for pain. After a definitive diagnosis, the research methods were described for patients, and their consent for study participation was obtained. The experimental group 1 was trained by the combination protocols of central muscle stabilization exercises and neurofeedback. The experimental group 2 practiced by the central muscle stabilization exercises protocol. Three groups of neurofeedback exercises were tested in the experimental group. The control group received no treatment. To reduce pain, a 2–channel neurofeedback device was used by the Alpha/Theta (A/T) protocol to reduce chronic pain (Katarina et al.; 2016); it would reduce the frequency from 4 to 7 Hz and amplify the frequency from 8 to 12 Hz in the O1 and O2 regions. This protocol implements an active electrode to be placed on the O1 or O2 and reference electrodes on the left ear and electrode on the right ear. First, the protocol instructions were explained to the study samples. Then, moving animations were presented at the intervention stage. As the brain wanders away from the target (i.e., no increase in A/T), the images stop moving. For re–routing, the authorities have to change their brain waves in the direction they set.

The obtained data suggested a significant difference between the effects of neurofeedback stabilization exercises on pain. Besides, blindness exercises had a greater effect on pain relief (p<0.001). There was a significant difference between the effect of neurofeedback and combined exercises; combined exercises had a greater effect on pain relief (p<0.001). However, there was no significant difference between the effect of corestabletic and combination exercises on pain.

Patients with chronic non–specific LBP, concerning the positive effects of 10 weeks of central muscle and neurofeedback stabilization exercises on reducing pain, could be advantageously benefited by the supervision of a specialist physician for pain relief. The obtained results indicated that muscle stability, neurofeedback, and combined exercises significantly reduced pain in patients with chronic LBP.