ClinicalTrials.gg
RecruitingNCT05832918Updated May 7, 2025

Effects of Core Stability Exercises and Cognitive Tasks on Chronic Non-specific Back Pain

An interventional study of exercise therapy in Chronic Non-specific Low Back Pain, sponsored by Iran University of Medical Sciences. Recruiting at 1 site in Iran. Open to participants aged 18 Years to 55 Years. Per ClinicalTrials.gov, last updated 2025-05-07.

Sponsored by Iran University of Medical Sciences · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Nov 2025, 11 months ago, but the record still lists the study as recruiting.
  • Started May 2023; still recruiting 3 years 6 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
48
Allocation
Randomized
Ages
18 Years to 55 Years
Sex
All
01

Study summary

This randomized control trial study aims to compare the effect of core stability exercises and cognitive tasks with general exercises and cognitive tasks on pain, disability, and postural control strategies of chronic non-specific low back pain patients. The main questions are:

  1. Are core stability exercises and cognitive tasks more effective than general exercises and cognitive tasks in reducing the pain of chronic non-specific low back pain patients?
  2. Are core stability exercises and cognitive tasks more effective than general exercises and cognitive tasks in reducing the disability of chronic non-specific low back pain patients?
  3. Are core stability exercises and cognitive tasks more effective than general exercises and cognitive tasks in improving postural stability parameters of chronic non-specific low back pain patients?
  4. Are core stability exercises and cognitive tasks more effective than general exercises and cognitive tasks in improving stabilogram diffusion analysis parameters of chronic non-specific low back pain patients? This study is designed to apply two exercise protocols on two groups of 17 people with non-specific back pain. Group A will receive core stability exercises along with cognitive tasks, and group B will receive general exercises along with cognitive tasks.
Read the detailed description

Patients will be aged between 18-50 years. All patients meeting the inclusion criteria will receive 16 training sessions (thrice a week). The primary outcome measure will be pain and disability. Secondary outcome measures will be postural control strategies (including postural control stability and stabilogram diffusion analysis), quality of life, fear of movement, and fear-avoidance beliefs that will be assessed before and after training sessions and at 3-month follow-up; only primary outcomes will be evaluated in each group.

02

Conditions studied

  • Chronic Non-specific Low Back Pain

Browse trials for

Keywords

  • Low back pain
  • Disability
  • Postural control
  • Core Stability Exercise
  • cognitive task
03

In context

Low Back Pain

2,922 studies on the registry are indexed under Low Back Pain; 580 are open to participants now.

This study's planned enrollment of 48 is below the median of 60 across 2,364 interventional studies indexed under Low Back Pain.

Browse Low Back Pain studies →

Lead sponsor

Iran University of Medical Sciences is the lead sponsor of 25 studies on the registry; 7 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 55 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Orthopedist-confirmed diagnosis of chronic nonspecific low back pain that has lasted at least three months since its onset.
  • Pain score of 3 or more on a visual analog scale.
  • Pain during quiet standing.
  • Cognitive level above 24 based on (MMSE).

Exclusion criteria

Exclusion Criteria:

  • Radicular pain and any neurological signs.
  • Uncorrected vision impairment.
  • Hearing problems.
  • Vestibular dysfunctions.
  • Cognitive deficit.
  • Previous spinal surgery.
  • Severe deformity or injury to the lower extremities.
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
48 participants (estimated)

Study arms

  • Experimental
    core stability exercises with cognitive tasks group

    This research will use core stability exercises to strengthen local muscles (transversus abdominis and multifidus) based on the training program provided by Shamsi et al., which is modified from the exercise program of Koumantakis et al.. Participants will be treated for six weeks, three sessions a week, and 16 sessions. We will also combine stabilization exercises with cognitive tasks.

    Other: exercise therapy

  • Active comparator
    general exercises with cognitive tasks group

    This research will use general exercises to strengthen global muscles (abdominal flexor muscles and back extensor muscles) based on the training program provided by Shamsi et al.(110), which is modified by Koumantakis et al.. Participants will be treated for six weeks, three sessions a week, and 16 sessions. We will also combine general exercises with cognitive tasks.

    Other: exercise therapy

Interventions

  • Otherexercise therapy

    Exercise therapy is one of the rehabilitation methods that is defined as a regimen or plan of physical activities designed and prescribed to facilitate the patient's recovery from diseases and any conditions which disturb their movement and activity of daily life or maintain a state of well-being through neuro re-education, gait training, and therapeutic exercises.

06

What researchers measure

Primary outcomes

  1. Oswestry Disability Index

    Questionnaire evaluating the level of disability. Total score range from 0-100 (higher scores mean more disability)

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks ", "change from baseline at three months "

Secondary outcomes

  1. Center of pressure (COP) sway range for anteroposterior (AP range)

    AP range is one kind of COP displacement evaluation method characterized as traditional linear measures for evaluating postural control stability.

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks "

  2. COP sway range for mediolateral (MA range)

    MA range is one kind of COP displacement evaluation method characterized as traditional linear measures for evaluating postural control stability.

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks "

  3. COP sway velocity

    COP sway velocity is one kind of COP displacement evaluation method characterized as traditional linear measures for evaluating postural control stability.

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks "

  4. Sway area

    Sway area is one kind of COP displacement evaluation method characterized as traditional linear measures for evaluating postural control stability.

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks "

  5. Short-term diffusion coefficient of stabilogram diffusion plot

    The short-term diffusion coefficient is the slope of the open-loop part of the stabilogram diffusion plot, indicating stochastic activity in open loop control phase in a quiet standing position.

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks "

  6. Long-term diffusion coefficient of stabilogram diffusion plot

    The long-term diffusion coefficient is the slope of the close loop part of the stabilogram diffusion plot, indicating stochastic activity in the immediate loop control phase in the quiet standing position.

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks "

  7. Critical point coordinates.

    Critical point coordinates are the estimated values of the time intervals and mean square displacements defining the stabilogram-diffusion critical points (the point that open-loop control changed to close loop control)

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks "

  8. 12-item short form health survey

    Questionnaire evaluating the quality of life. Total score range from 0-100 (higher scores mean better quality of life)

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks "

  9. Tampa scale for kinesiophobia

    Questionnaire evaluating the kinesiophobia because of feeling re-injury. Total score range from 17-68 (higher scores mean more kinesiophobia)

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks "

  10. Fear-avoidance beliefs questionnaire

    Questionnaire evaluating fear of pain and consequent avoidance of physical activity because of their fear. Total score range from 0-66 (higher scores mean more fear of pain)

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks "

  11. Visual analog scale

    Questionnaire evaluating pain intensity. Total score range from 0-10 (higher scores mean more pain)

    Time frame: "Baseline (pre-intervention)", "change from baseline immediately after the intervention at five weeks ", "change from baseline at three months "

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Frizziero A, Pellizzon G, Vittadini F, Bigliardi D, Costantino C. Efficacy of Core Stability in Non-Specific Chronic Low Back Pain. J Funct Morphol Kinesiol. 2021 Apr 22;6(2):37. doi: 10.3390/jfmk6020037. PubMed 33922389 ↗
  • Agnus Tom A, Rajkumar E, John R, Joshua George A. Determinants of quality of life in individuals with chronic low back pain: a systematic review. Health Psychol Behav Med. 2022 Jan 5;10(1):124-144. doi: 10.1080/21642850.2021.2022487. eCollection 2022. PubMed 35003902 ↗
  • van Tulder M, Becker A, Bekkering T, Breen A, del Real MT, Hutchinson A, Koes B, Laerum E, Malmivaara A; COST B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care. Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J. 2006 Mar;15 Suppl 2(Suppl 2):S169-91. doi: 10.1007/s00586-006-1071-2. No abstract available. PubMed 16550447 ↗
  • Lamoth CJ, Stins JF, Pont M, Kerckhoff F, Beek PJ. Effects of attention on the control of locomotion in individuals with chronic low back pain. J Neuroeng Rehabil. 2008 Apr 25;5:13. doi: 10.1186/1743-0003-5-13. PubMed 18439264 ↗
  • Kanekar N, Aruin AS. Aging and balance control in response to external perturbations: role of anticipatory and compensatory postural mechanisms. Age (Dordr). 2014 Jun;36(3):9621. doi: 10.1007/s11357-014-9621-8. Epub 2014 Feb 16. PubMed 24532389 ↗
  • Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine (Phila Pa 1976). 1996 Nov 15;21(22):2640-50. doi: 10.1097/00007632-199611150-00014. PubMed 8961451 ↗
  • Bussey MD, Aldabe D, Shemmell J, Jowett T. Anticipatory postural control differs between low back pain and pelvic girdle pain patients in the absence of visual feedback. Hum Mov Sci. 2020 Feb;69:102529. doi: 10.1016/j.humov.2019.102529. Epub 2019 Nov 11. PubMed 31726292 ↗
  • Hodges PW. Changes in motor planning of feedforward postural responses of the trunk muscles in low back pain. Exp Brain Res. 2001 Nov;141(2):261-6. doi: 10.1007/s002210100873. PubMed 11713638 ↗
  • Mitchell SL, Collins JJ, De Luca CJ, Burrows A, Lipsitz LA. Open-loop and closed-loop postural control mechanisms in Parkinson's disease: increased mediolateral activity during quiet standing. Neurosci Lett. 1995 Sep 8;197(2):133-6. doi: 10.1016/0304-3940(95)11924-l. PubMed 8552278 ↗
  • Collins JJ, De Luca CJ. Open-loop and closed-loop control of posture: a random-walk analysis of center-of-pressure trajectories. Exp Brain Res. 1993;95(2):308-18. doi: 10.1007/BF00229788. PubMed 8224055 ↗
  • Collins JJ, De Luca CJ, Burrows A, Lipsitz LA. Age-related changes in open-loop and closed-loop postural control mechanisms. Exp Brain Res. 1995;104(3):480-92. doi: 10.1007/BF00231982. PubMed 7589299 ↗
  • Wong JJ, Cote P, Sutton DA, Randhawa K, Yu H, Varatharajan S, Goldgrub R, Nordin M, Gross DP, Shearer HM, Carroll LJ, Stern PJ, Ameis A, Southerst D, Mior S, Stupar M, Varatharajan T, Taylor-Vaisey A. Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur J Pain. 2017 Feb;21(2):201-216. doi: 10.1002/ejp.931. Epub 2016 Oct 6. PubMed 27712027 ↗
  • Owen PJ, Miller CT, Mundell NL, Verswijveren SJJM, Tagliaferri SD, Brisby H, Bowe SJ, Belavy DL. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med. 2020 Nov;54(21):1279-1287. doi: 10.1136/bjsports-2019-100886. Epub 2019 Oct 30. PubMed 31666220 ↗
  • Koumantakis GA, Watson PJ, Oldham JA. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther. 2005 Mar;85(3):209-25. PubMed 15733046 ↗
  • Hlaing SS, Puntumetakul R, Khine EE, Boucaut R. Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC Musculoskelet Disord. 2021 Nov 30;22(1):998. doi: 10.1186/s12891-021-04858-6. PubMed 34847915 ↗
  • Coulombe BJ, Games KE, Neil ER, Eberman LE. Core Stability Exercise Versus General Exercise for Chronic Low Back Pain. J Athl Train. 2017 Jan;52(1):71-72. doi: 10.4085/1062-6050-51.11.16. Epub 2016 Nov 16. PubMed 27849389 ↗
  • Saragiotto BT, Maher CG, Yamato TP, Costa LOP, Costa LCM, Ostelo RWJG, Macedo LG. Motor Control Exercise for Nonspecific Low Back Pain: A Cochrane Review. Spine (Phila Pa 1976). 2016 Aug 15;41(16):1284-1295. doi: 10.1097/BRS.0000000000001645. PubMed 27128390 ↗
  • Ganesh GS, Kaur P, Meena S. Systematic reviews evaluating the effectiveness of motor control exercises in patients with non-specific low back pain do not consider its principles - A review. J Bodyw Mov Ther. 2021 Apr;26:374-393. doi: 10.1016/j.jbmt.2020.08.010. Epub 2020 Sep 6. PubMed 33992272 ↗
  • Remy F, Wenderoth N, Lipkens K, Swinnen SP. Dual-task interference during initial learning of a new motor task results from competition for the same brain areas. Neuropsychologia. 2010 Jul;48(9):2517-27. doi: 10.1016/j.neuropsychologia.2010.04.026. Epub 2010 Apr 29. PubMed 20434467 ↗
  • Burcal CJ, Needle AR, Custer L, Rosen AB. The Effects of Cognitive Loading on Motor Behavior in Injured Individuals: A Systematic Review. Sports Med. 2019 Aug;49(8):1233-1253. doi: 10.1007/s40279-019-01116-7. PubMed 31066022 ↗
  • Hemmati L, Piroozi S, Rojhani-Shirazi Z. Effect of dual tasking on anticipatory and compensatory postural adjustments in response to external perturbations in individuals with nonspecific chronic low back pain: Electromyographic analysis. J Back Musculoskelet Rehabil. 2018;31(3):489-497. doi: 10.3233/BMR-170992. PubMed 29332033 ↗
  • Wang XQ, Zheng JJ, Yu ZW, Bi X, Lou SJ, Liu J, Cai B, Hua YH, Wu M, Wei ML, Shen HM, Chen Y, Pan YJ, Xu GH, Chen PJ. A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One. 2012;7(12):e52082. doi: 10.1371/journal.pone.0052082. Epub 2012 Dec 17. PubMed 23284879 ↗
  • Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture. 2002 Aug;16(1):1-14. doi: 10.1016/s0966-6362(01)00156-4. PubMed 12127181 ↗
  • Sherafat S, Salavati M, Takamjani IE, Akhbari B, Rad SM, Mazaheri M, Negahben H, Lali P. Effect of dual-tasking on dynamic postural control in individuals with and without nonspecific low back pain. J Manipulative Physiol Ther. 2014 Mar-Apr;37(3):170-9. doi: 10.1016/j.jmpt.2014.02.003. Epub 2014 Mar 15. PubMed 24636612 ↗
  • Akhtar MW, Karimi H, Gilani SA. Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial. Pak J Med Sci. 2017 Jul-Aug;33(4):1002-1006. doi: 10.12669/pjms.334.12664. PubMed 29067082 ↗
  • Shamsi MB, Rezaei M, Zamanlou M, Sadeghi M, Pourahmadi MR. Does core stability exercise improve lumbopelvic stability (through endurance tests) more than general exercise in chronic low back pain? A quasi-randomized controlled trial. Physiother Theory Pract. 2016;32(3):171-8. doi: 10.3109/09593985.2015.1117550. Epub 2016 Feb 11. PubMed 26864057 ↗
  • Ghorbanpour A, Azghani MR, Taghipour M, Salahzadeh Z, Ghaderi F, Oskouei AE. Effects of McGill stabilization exercises and conventional physiotherapy on pain, functional disability and active back range of motion in patients with chronic non-specific low back pain. J Phys Ther Sci. 2018 Apr;30(4):481-485. doi: 10.1589/jpts.30.481. Epub 2018 Apr 13. PubMed 29706690 ↗
  • Collins JJ, De Luca CJ. The effects of visual input on open-loop and closed-loop postural control mechanisms. Exp Brain Res. 1995;103(1):151-63. doi: 10.1007/BF00241972. PubMed 7615030 ↗
  • Cano-de-la-Cuerda R, Molero-Sanchez A, Carratala-Tejada M, Alguacil-Diego IM, Molina-Rueda F, Miangolarra-Page JC, Torricelli D. Theories and control models and motor learning: clinical applications in neuro-rehabilitation. Neurologia. 2015 Jan-Feb;30(1):32-41. doi: 10.1016/j.nrl.2011.12.010. Epub 2012 Feb 18. English, Spanish. PubMed 22341985 ↗
  • Shamsi MB, Sarrafzadeh J, Jamshidi A. Comparing core stability and traditional trunk exercise on chronic low back pain patients using three functional lumbopelvic stability tests. Physiother Theory Pract. 2015 Feb;31(2):89-98. doi: 10.3109/09593985.2014.959144. Epub 2014 Oct 15. PubMed 25317504 ↗
  • Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B. The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine (Phila Pa 1976). 2006 Jun 15;31(14):E454-9. doi: 10.1097/01.brs.0000222141.61424.f7. PubMed 16778675 ↗
  • Rostami M, Noorian N, Mansournia MA, Sharafi E, Babaki AE, Kordi R. Validation of the Persian version of the fear avoidance belief questionnaire in patients with low back pain. J Back Musculoskelet Rehabil. 2014;27(2):213-21. doi: 10.3233/BMR-130439. PubMed 24254494 ↗
  • Vlaeyen JWS, Seelen HAM, Peters M, de Jong P, Aretz E, Beisiegel E, Weber WEJ. Fear of movement/(re)injury and muscular reactivity in chronic low back pain patients: an experimental investigation. Pain. 1999 Sep;82(3):297-304. doi: 10.1016/S0304-3959(99)00054-8. PubMed 10488681 ↗
  • Abedi M, Manshadi FD, Khalkhali M, Mousavi SJ, Baghban AA, Montazeri A, Parnianpour M. Translation and validation of the Persian version of the STarT Back Screening Tool in patients with nonspecific low back pain. Man Ther. 2015 Dec;20(6):850-4. doi: 10.1016/j.math.2015.04.006. Epub 2015 Apr 15. PubMed 25925506 ↗
  • Raoufi Z, Tabatabaei A, Dadgoo M, Takamjani EE, Salehi R, Sanjari MA. The additional effects of dual-task training with core stability exercises versus general exercises on disability and pain in people with nonspecific chronic low back pain: A randomized controlled trial. Musculoskelet Sci Pract. 2026 Apr;82:103501. doi: 10.1016/j.msksp.2026.103501. Epub 2026 Jan 16. PubMed 41633131 ↗

Related links

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started May 2023 (actual). Primary completion is estimated for Nov 2025, 30 months after the start.

Of 1,231 non-industry interventional studies with no phase under Low Back Pain, half reached primary completion within 11 months of starting (the median), counting those still running; a quarter within 5 and three quarters within 26. This study's planned 30 months is above that.

Counting every sponsor, half of 1,286 studies reached it within 11 months; a quarter within 5 and three quarters within 27.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 31, 2023
First posted
Apr 27, 2023
StartActual
May 2, 2023
Primary completionEst.
Nov 30, 2025
CompletionEst.
Dec 15, 2025
Last update
May 7, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 7, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05832918
Lead sponsor
Iran University of Medical Sciences
Responsible party
Reza Salehi (Iran University of Medical Sciences, Iran University of Medical Sciences) — Principal investigator
First posted
Apr 27, 2023
Start date
May 2, 2023
Primary completion
Nov 30, 2025 (estimated)
Completion
Dec 15, 2025 (estimated)
Last update
May 7, 2025

Study contacts

Zeinab Raoufi
Contact
zraoofi93@gmail.com
00982122222059
Reza Salehi
Contact
Salehi.re@iums.ac.ir
00982122222059
Zeinab Raoufi, PhD student
principal investigator · Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences
Reza Salehi, PhD
study director · Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion