Prentice, Caitlin Lauren Siobhan, Flavell, Carol Ann, Massy-Westropp, Nicola, and Milanese, Steven (2025) Individualised exercise for patients with persistent low back pain and lateral abdominal muscle impairments: a randomised feasibility study. Pilot and Feasibility Studies. (In Press)

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Abstract

Background This parallel randomised control trial assessed feasibility of an exercise intervention for individuals with low back pain and maladaptive changes in lateral abdominal muscle contraction. Feasibility was assessed considering participant retention, program adherence and a preliminary evaluation of intervention efficacy.

Methods Sixty adults (40 female, 20 male, average 54.2 years of age) with persistent low back pain and maladaptive changes in lateral abdominal muscle contraction were randomly assigned to fully or partially individualised versions of the 12-week program. All participants received motor control and graded activity exercise individualised to their low back pain symptoms, impairments and functional goals. Additionally, participants in the fully individualised group were asked what types of exercise they enjoy, and this informed the graded activity prescription. Lateral abdominal outcome measures included endurance and ultrasound imaging (muscle thickness at rest and during contraction, transversus abdominis slide), manual palpation and pressure biofeedback unit measures of contraction. Clinical outcomes included pain intensity (Numeric Rating Scale), disability (Roland Morris Disability Questionnaire), function (Pain Specific Functional Scale), physical activity (International Physical Activity Questionnaire) and lumbar instability (Lumbar Instability Questionnaire). Outcomes were measured at baseline, at the end of the intervention and clinical outcomes were measured again three months after the intervention concluded. Linear mixed effects models were used to compare the effects of the intervention within and between groups.

Results Retention and exercise compliance rates were 81% and > 85% (86% control group, 87% experimental group) respectively. Participants in both groups achieved improved lumbar instability, disability, pain intensity, function, physical activity, lateral abdominal muscle endurance and contraction post intervention. The fully individualised group demonstrated greater between group improvements in function (mean [95%CI]: − 2.577 [− 3.239, − 1.915] 12 weeks, − 2.592 [− 3.254, − 1.930] 3 months) and physical activity (mean [95%CI]: − 790.834 [− 1712.05, 130.382] 12 weeks, − 1080.748 [− 2001.964, − 159.532] 3 months).

Conclusions The intervention demonstrated improvements in clinical outcomes, and acceptable exercise compliance. However, the intervention did not meet retention feasibility criteria to proceed to an adequately powered trial. Modifications to improve retention including incorporating group activities are required. Following modifications, an adequately powered trial is required to determine the efficacy of the intervention.

Item ID:	89641
Item Type:	Article (Research - C1)
ISSN:	2055-5784
Keywords:	lumbar, physical activity, motor control
Copyright Information:	Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Date Deposited:	17 Nov 2025 01:37
FoR Codes:	42 HEALTH SCIENCES > 4201 Allied health and rehabilitation science > 420106 Physiotherapy @ 100%
SEO Codes:	20 HEALTH > 2003 Provision of health and support services > 200301 Allied health therapies (excl. mental health services) @ 100%
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