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MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
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Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

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Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


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Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
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Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2023 | Month : January | Volume : 17 | Issue : 1 | Page : RC05 - RC08 Full Version

Effect of Core Muscle Stabilisation Exercises on Disability Associated with Non Specific Low Back Pain in Postmenopausal Women: A Prospective Longitudinal Study


Published: January 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/60303.17264
Santosh Kumar Singh, Jigyasa Singh, Rahul Shankar, Snehashish Mukherjee, Rakesh Yadav

1. Specialist Orthopaedics, Department of Orthopaedics, ESIC Hospital, Jajmau, Kanpur, Uttar Pradesh, India. 2. Assistant Professor, Department of Obstetrics and Gynaecology, IMS BHU, Varanasi, Uttar Pradesh India. 3. Senior Physiotherapist, Department of Physiotherapy, ESIC Hospital, Jajmau, Kanpur, Uttar Pradesh, India. 4. Senior Resident, Department of Orthopaedics, ESIC Hospital, Jajmau, Kanpur, Uttar Pradesh, India. 5. IMO, Department of Orthopaedics, ESIC Hospital, Jajmau, Kanpur, Uttar Pradesh, India.

Correspondence Address :
Dr. Santosh Kumar Singh,
Specialist Orthopaedics, Department of Orthopaedics, ESIC Hospital, Jajmau, Kanpur-208010, Uttar Pradesh, India.
E-mail: dr.sandy03kgmc@gmail.com

Abstract

Introduction: Non Specific Low Back Pain (NSLBP) is a frequent problem faced by the majority of postmenopausal women at some stage of their lives, resulting in a significant level of disability.

Aim: To evaluate the effectiveness of core stabilisation exercises compared to traditional physical treatment in postmenopausal women with NSLBP.

Materials and Methods: A prospective longitudinal study was conducted from January 2022 to August 2022, including 50 postmenopausal women aged 45-60 years with NSLBP. They were placed into two groups. Conventional LBP physical therapy methods were administered to group 2. The identical traditional and Core muscle Stabilisation Exercises (CSE) were implemented in the group 1. The Modified Oswestry Disability Index (MODI) was used for the assessment of disability. The Mann-Whitney U test and Friedman Analysis of Variance (ANOVA) were conducted to analyse changes in disability scores across and among groups at the ends of the second, fourth, and sixth weeks of treatment.

Results: Of 50 patients initially enrolled in the study, 33 patients were available for the final follow-up. Group 1 consisted of 16 patients, while group 2 had 17 patients. Significant reduction in disability was found across the two groups at the second, fourth, and sixth weeks of treatment (p-value<0.05). In the sixth week of treatment, group 1 had a statistically greater decrease in ODI score (41.16±13.53) than group 2 (30.74±13.28) (p-value =0.003).

Conclusion: CSE were found to be more effective than conventional physical therapy in reducing disability associated with NSLBP in postmenopausal women.

Keywords

Conventional physical therapy, Menopause, Modified oswestry disability index

Modern women spend a third of their lives in menopause as their life expectancy rises (1),(2). Slower ovarian hormone production causes the transition from a premenopausal to a postmenopausal stage (3),(4). There are many signs and symptoms that occur during the postmenopausal stage. Physical symptoms may include stiffness and pain in the back and joints, hot flashes, night sweats, and persistent fatigue; psychological symptoms may include irritability and anxiety, mood swings, sadness, and sleep problems (5). The reviewed research revealed a link between the postmenopausal period and depression, heat flashes, heart disease, cancer and sleep disturbances, but little focus was given to pain (in the spine and peripheral joints) (6).

Despite appearing to be a benign condition, LBP has grown to be a significant global health issue. Many more years of impairment are now being attributed to it than to any other illness (7). LBP, which frequently results in significant loss of working hours and disability, affects about 80% of the population at some point in their lives (8). LBP primarily affects postmenopausal women between the ages of 45-60, and it causes distress on social and economic levels (9). About 10% of people with LBP also have a specific form of LBP caused by a condition like lumbar spinal stenosis, spondylolisthesis, a fractured spine, an inflammatory disease, or compressed nerve roots. However, NSLBP accounts for 90% of LBP diagnoses, since its underlying cause cannot be determined through clinical examination (10). On the other hand, NSLBP lacks a definitive pathology, but it has been speculated to be brought on by elements such as poor posture, reduced flexibility, a history of injury, heavy lifting, mental stress, obesity, weak deep trunk muscles, poor coordination, and muscular imbalances [9-11]. Postmenopausal women with NSLBP and decreased function often feel anxious and sad, which affects their work, sexual, and social lives (11),(12).

The most cutting-edge conservative approach for treating LBP is still physical therapy (12). As it promotes proximal stability and distal mobility, CSE are becoming a more significant part of the sports realm of treatments (13). The use of CSE is promoted as a general physical therapy approach for NSLBP. Overtime, CES have improved, focusing more and more on maintaining spinal stability. Theoretical ideas for the treatment of spinal ailments that aid in reducing pain and enhancing function in patients with LBP significantly support the use of CSE (13),(14). CSE trains muscle activity patterns without unnecessarily overloading the tissue, enhances aerobic fitness, spinal mobility, muscle strength, motor coordination, and can help to stabilise the spine at a quite cost affordable price (14). Different exercises, such as intense dynamic back extensor exercises, motor control exercises, yoga, and aerobic workouts have all been recommended for persistent LBP but the majority of studies have shown that CSE are more efficient than general exercises (15),(16). Exercises for core stabilisation focus on the Transversus Abdominis (TrA), lumbar multifidi, as well as other paraspinal, abdominal, diaphragmatic, and pelvic musculature.

Although conventional physical therapy (application of moist heat packs, transcutaneous electrical nerve stimulation applied to the lumbar area, and stretching exercises) is routinely performed in clinical settings, CSE have received limited scholarly attention so far, but it has been advocated as a form of rehabilitation, a way to improve performance, and a way to avoid injuries to the musculoskeletal system and the lumbar spine (17). Both treatment modalities appear to be effective; nevertheless, there is still debate in both groups due to a lack of sufficient information.

The primary objective of this study was to evaluate the effectiveness of CSE compared to traditional physical treatment protocol in reducing the average disability associated with NSLBP in postmenopausal women.

Material and Methods

This prospective longitudinal study was conducted at the Department of Orthopaedics ESIC Hospital Jajmau, Kanpur, Uttar Pradesh, India from January 2022 to August 2022, including a follow-up period of six weeks. All participants gave informed consent to participate in the study.

Based on the history and radiological imaging, the organic causes of LBP were ruled out. A non-probability purposive sampling technique was used to collect the sample.

Inclusion criteria: All postmenopausal women between the ages of 45 and 60 years who had NSLBP for more than three months and are willing to participate in the study were included in the study.

Exclusion criteria: Women with spinal cord injuries, disc disease, lumbar canal stenosis, and severe degenerative arthritis of the spine were excluded from the study.

A total of 50 patients were enrolled in this study, but 11 subjects were excluded from the study (eight patients did not fulfill the inclusion criteria and three patients refused to give consent). Six patients lost the follow-up (three in each group). In light of this, 33 individuals were assessed throughout the 6th week of treatment (Table/Fig 1).

With the help of the computer-generated numbers, the participants were divided into two groups, experimental (group-1), and convention therapy (group-2). Conventional LBP physical therapy methods, including moist heat packs, Transcutaneous Electrical Nerve Stimulation (TENS) applied to the lumbar area, and strengthening exercises, were administered to the control (group-2). The identical traditional and CSE exercises were implemented in the experimental group (Group-1). The method adopted was described by Kisner (2012) (18), for CSE focusing on the deep group of abdominal muscles (Table/Fig 2). For six weeks, each patient received treatment three days a week, with the physical therapy session usually lasting upto 30 minutes a day (Table/Fig 3).

A physical therapist monitored both exercise programs. The MODI (19) was used for the assessment of disability due to NSLBP impacting the functional activities of the patients.The MODI consists of 10 patient-completed questions with six-point Likert scales as the response options. Each item consists of six statements with values ranging from 0 to 5, where a score of 0 represents the least level of disability and a statement with a score of 5 suggests the highest level of disability. A total score of 0-20% means the patient has only a mild disability; a score of 21-40% means they have a moderate disability; a score of 41-60% means they have a severe disability; a score of 61-80% means they are crippled; and a score of 81-100% means the patient is bedridden. Baseline data and data at the ends of the second, fourth, and sixth weeks of treatment wascollected by a research assistant from each patient.

Statistical Analysis

Data are presented as measures of mean and standard deviation. Data analysis was done with Statistical Package for the Social Sciences (SPSS) version 22.0. The independent t-test was used to evaluate the demographic data to see if there were any statistically significant differences between the two groups. Non parametric tests, the Mann-Whitney U test, and Friedman ANOVA were conducted to analyse changes in disability scores across and among groups. The p-values, the significance level was set at <0.05. By calculating mean differences between the baseline and final measurements, the pre-post difference was analysed.

Results

In terms of socio-demographic characteristics, the subjects in both groups were quite comparable (Table/Fig 4). All the patients were married. Thirteen patients in group 1 and 14 patients in group 2 were housewives while three patients in both groups were doing other jobs. The mean age of group 1 patients was 53.31±7.11 years, while it was 54.40±6.31years in group 2.

The results of the second, fourth, and sixth weeks of treatment showed that the MODI scores in both groups had a statistically significant decrease (Table/Fig 5). At the end of week six, there was a statistically significant difference between the pretreatment baseline disability score and the post-treatment disability score in both treatment groups (p<0.05).

Group 1 had a statistically greater decrease in MODI score (41.16±13.53) than did Group 2 (30.74±13.28) (p<0.05). At the second, fourth, and sixth weeks, respectively, the mean difference between the two groups’ MODI scores was 8.69±1.37, 7.71±1.63, and 9.12±1.82, with a p value< 0.05 (Table/Fig 6).

Discussion

The disability scores of both groups in the current study decreased statistically significantly from baseline to the end of the second, fourth, and sixth weeks of treatment. Both treatment groups showed a statistically significant decline from the pretreatment baseline disability score and the post-treatment disability score (at the end of the sixth week). However, the extent of disability reduction was testgreater in group 1 (CSE) than in group 2 (conventional therapy group). CSE have a strong theoretical basis in the treatment and prevention of LBP and other musculoskeletal conditions, as evidenced by their widespread clinical application (19). According to different studies (13),(15),(17), these treatments may aid people with LBP in reducing pain and enhancing function. In a systematic review, Alhakami AM et al., also demonstrated that stabilisation exercises was better than conventional exercise programs in reducing functional disability in patients with chronic NSLBP (20). In a randomised clinical study Abdel-Aziem AA et al., revealed significant improvements in pain intensity and functional disability scores in the women with NSLBP (21).

The results of the present study have similar outcomes compared with other studies. In a research article by Franca FR et al., a greater reduction in the MODI score was seen with the spinal stabilisation exercises in contrast to strengthening exercises in subjects with LBP (22). Wang XQ et al., conducted a meta-analysis and found that CSE decreased pain and improved physical function significantly more than general physical exercises in patients with LBP in the short term (23). A randomised clinical trial conducted by Inani SB and Selkar SP, also reported that, in comparison to conventional exercises, core CSE were found to be more effective at reducing pain and improving functional status in patients with NSLBP (24). Kanwal S et al., conducted a comparative study including 24 postmenopausal women with back pain and reported that CSE had the ability to reduce pain and disability and improve strength and quality of life (25).

Hsu WH et al., conducted a prospective study of 408 postmenopausal women. They observed that with age, sit-ups, back strength, grip strength, side steps, trunk extension, and agility all deteriorated. They also reported that back strength significantly contributed to the physical component of quality of life (26). In the present study, authors also found similar results as the disability score was significantly decreased in the CSE-group. Bhadauria EA and Gurudut P, conducted a randomised clinical trial comparing three different forms of exercise, lumbar stabilisation, dynamic strengthening, and pilates, on chronic LBP in terms of pain, range of motion, core strength, and function (27). Lumbar stabilisation was found to be superior to dynamic strengthening and pilates in chronic NSLBP.

Limitation(s)

The sample size was small and the rate of dropouts was high. A bigger sample size is required in future studies for generalisation of results. Patient adherence should be maintained in future research, and treatment duration should also be lengthened.

Conclusion

Following the intervention, the disability levels in both groups significantly improved. Compared to the group that did traditional physical therapy exercises, the CSE group showed a significant reduction in the disability caused by NSLBP in postmenopausal women.

References

1.
Poomalar GK, Arounassalame B. The quality of life during and after menopause among rural women. J Clin Diagn Res. 2013;7(1):135-39.
2.
Braden JB, Zhang L, Fan MY, Unützer J, Edlund MJ, Sullivan MD, et al. Mental health service use by older adults: The role of chronic pain. Am J Geriatr Psychiatry. 2008;16(2):156-67. [crossref] [PubMed]
3.
Stang PE, Brandenburg NA, Lane MC, Merikangas KR, Von Korff MR, Kessler RC, et al., Mental and physical comorbid conditions and days in role among persons with arthritis. Psychosom Med. 2006;68(1):152-58. [crossref] [PubMed]
4.
Von Korff M, Crane P, Lane M, Miglioretti DL, Simon G, Saunders K, et al. Chronic spinal pain and physical-mental comorbidity in the United States: results from the national comorbidity survey replication. Pain. 2005;113(3):331-39. [crossref] [PubMed]
5.
Cray L, Woods NF, Mitchell ES. Symptom clusters during the late menopausal transition stage: Observations from the Seattle midlife women’s health study. Menopause. 2010;17(5):972-77. [crossref] [PubMed]
6.
Whelan TJ, Goss PE, Ingle JN, Pater JL, Tu D, Pritchard K, et al. Assessment of quality of life in MA.17: A randomized, placebo-controlled trial of letrozole after 5 years of tamoxifen in postmenopausal women. J Clin Oncol. 2005;23(28):6931-40. [crossref] [PubMed]
7.
Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(9995):743-800.
8.
Ahmed R, Shakil-Ur-Rehman S, Sibtain F. Comparison between specific lumber mobilization and core-stability exercises with core-stability exercises alone in mechanical low back pain. Pak J Med Sci. 2014;30(1):157-60. [crossref] [PubMed]
9.
Saragiotto BT, Maher CG, Yamato TP, Costa LOP, Costa LCM, Ostelo RWJG, et al. Motor control exercise for chronic non-specific low-back pain. Cochrane Database Syst Rev. 2016;2016(1):CD012004. Published 2016 Jan 8. [crossref]
10.
Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006;332(7555):1430-34. [crossref] [PubMed]
11.
Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJEM, Ostelo RWJG, J Guzman J, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ. 2015;350:h444. Published 2015 Feb 18. [crossref] [PubMed]
12.
Kozinoga M, Majchrzycki M, Piotrowska S. Low back pain in women before and after menopause. PrzMenopauzalny. 2015;14(3):203-07. Doi:10.5114/ pm.2015.54347. [crossref] [PubMed]
13.
Kato S, Demura S, Shinmura K, Yokogawa N, Kurokawa Y, Annen R, et al. Associations between abdominal trunk muscle weakness and future osteoporotic vertebral fracture in middle-aged and older adult women: A three-year prospective Longitudinal cohort study. J Clin Med. 2022;11(16):4868. Published 2022 Aug 19. [crossref] [PubMed]
14.
Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ, et al. Cardiac rehabilitation and secondary prevention of coronary heart disease: An American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation [published correction appears in Circulation. 2005;111(3):369-76. [crossref] [PubMed]
15.
Brumitt J, Matheson JW, Meira EP. Core stabilization exercise prescription, part 2: A systematic review of motor control and general (global) exercise rehabilitation approaches for patients with low back pain. Sports Health. 2013;5(6):510-13. Doi:10.1177/1941738113502634. [crossref] [PubMed]
16.
Hides JA, Jull GA, Richardson CA. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine (Phila Pa 1976). 2001;26(11):E243-48. [crossref] [PubMed]
17.
Akuthota V, Ferreiro A, Moore T, Fredericson M. Core stability exercise principles. Curr Sports Med Rep. 2008;7(1):39-44. [crossref] [PubMed]
18.
Kisner C, Colby L, Borstad J. eds. Therapeutic Exercise: Foundations and Techniques, 7e. McGraw Hill; 2018.
19.
Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000;25(22):2940-52. [crossref] [PubMed]
20.
Alhakami AM, Davis S, Qasheesh M, Shaphe A, Chahal A. Effects of McKenzie and stabilization exercises in reducing pain intensity and functional disability in individuals with nonspecific chronic low back pain: a systematic review. J Phys Ther Sci. 2019;31(7):590-97. Doi:10.1589/jpts.31.590. [crossref] [PubMed]
21.
Abdel-Aziem AA, Abdelraouf OR, El-Basatiny HMY, Draz AH. The effects of stabilization sxercises combined with pelvic floor exercise in women with nonspecific Low back pain: A randomized clinical study. J Chiropr Med. 2021;20(4):229-38. Doi:10.1016/j.jcm.2021.12.008. [crossref] [PubMed]
22.
França FR, Burke TN, Hanada ES, Marques AP. Segmental stabilization and muscular strengthening in chronic low back pain: a comparative study. Clinics (Sao Paulo). 2010;65(10):1013-17. [crossref] [PubMed]
23.
Wang XQ, Zheng JJ, Yu ZW, Bi X, Lou S, Liu J, et al. A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One. 2012;7(12):e52082. [crossref] [PubMed]
24.
Inani SB, Selkar SP. Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: A randomized clinical trial. J Back Musculoskelet Rehabil. 2013;26(1):37-43. [crossref] [PubMed]
25.
Kanwal S, Yaqoob I, Shakil-Ur-Rehman S, Ghous M, Ghazal J, Namroz N. Effects of core muscle stability on low back pain and quality of life in post-menopausal women: A comparative study. J Pak Med Assoc. 2021;71(1(A)):37- 40. doi:10.47391/JPMA.151. [crossref] [PubMed]
26.
Hsu WH, Chen CL, Kuo LT, Fan CH, Lee MS, Hsu RW, et al. The relationship between health-related fitness and quality of life in postmenopausal women from Southern Taiwan. Clin Interv Aging. 2014;9:1573-79. Published 2014 Sep 16. [crossref] [PubMed]
27.
Bhadauria EA, Gurudut P. Comparative effectiveness of lumbar stabilization, dynamic strengthening, and pilates on chronic low back pain: Randomized clinical trial. J Exerc Rehabil. 2017;13(4):477-85. Published 2017 Aug 29. [crossref] [PubMed]
1.
Poomalar GK, Arounassalame B. The quality of life during and after menopause among rural women. J Clin Diagn Res. 2013;7(1):135-39.
2.
Braden JB, Zhang L, Fan MY, Unützer J, Edlund MJ, Sullivan MD, et al. Mental health service use by older adults: The role of chronic pain. Am J Geriatr Psychiatry. 2008;16(2):156-67. [crossref] [PubMed]
3.
Stang PE, Brandenburg NA, Lane MC, Merikangas KR, Von Korff MR, Kessler RC, et al., Mental and physical comorbid conditions and days in role among persons with arthritis. Psychosom Med. 2006;68(1):152-58. [crossref] [PubMed]
4.
Von Korff M, Crane P, Lane M, Miglioretti DL, Simon G, Saunders K, et al. Chronic spinal pain and physical-mental comorbidity in the United States: results from the national comorbidity survey replication. Pain. 2005;113(3):331-39. [crossref] [PubMed]
5.
Cray L, Woods NF, Mitchell ES. Symptom clusters during the late menopausal transition stage: Observations from the Seattle midlife women’s health study. Menopause. 2010;17(5):972-77. [crossref] [PubMed]
6.
Whelan TJ, Goss PE, Ingle JN, Pater JL, Tu D, Pritchard K, et al. Assessment of quality of life in MA.17: A randomized, placebo-controlled trial of letrozole after 5 years of tamoxifen in postmenopausal women. J Clin Oncol. 2005;23(28):6931-40. [crossref] [PubMed]
7.
Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(9995):743-800.
8.
Ahmed R, Shakil-Ur-Rehman S, Sibtain F. Comparison between specific lumber mobilization and core-stability exercises with core-stability exercises alone in mechanical low back pain. Pak J Med Sci. 2014;30(1):157-60. [crossref] [PubMed]
9.
Saragiotto BT, Maher CG, Yamato TP, Costa LOP, Costa LCM, Ostelo RWJG, et al. Motor control exercise for chronic non-specific low-back pain. Cochrane Database Syst Rev. 2016;2016(1):CD012004. Published 2016 Jan 8. [crossref]
10.
Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006;332(7555):1430-34. [crossref] [PubMed]
11.
Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJEM, Ostelo RWJG, J Guzman J, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ. 2015;350:h444. Published 2015 Feb 18. [crossref] [PubMed]
12.
Kozinoga M, Majchrzycki M, Piotrowska S. Low back pain in women before and after menopause. PrzMenopauzalny. 2015;14(3):203-07. Doi:10.5114/ pm.2015.54347. [crossref] [PubMed]
13.
Kato S, Demura S, Shinmura K, Yokogawa N, Kurokawa Y, Annen R, et al. Associations between abdominal trunk muscle weakness and future osteoporotic vertebral fracture in middle-aged and older adult women: A three-year prospective Longitudinal cohort study. J Clin Med. 2022;11(16):4868. Published 2022 Aug 19. [crossref] [PubMed]
14.
Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ, et al. Cardiac rehabilitation and secondary prevention of coronary heart disease: An American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation [published correction appears in Circulation. 2005;111(3):369-76. [crossref] [PubMed]
15.
Brumitt J, Matheson JW, Meira EP. Core stabilization exercise prescription, part 2: A systematic review of motor control and general (global) exercise rehabilitation approaches for patients with low back pain. Sports Health. 2013;5(6):510-13. Doi:10.1177/1941738113502634. [crossref] [PubMed]
16.
Hides JA, Jull GA, Richardson CA. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine (Phila Pa 1976). 2001;26(11):E243-48. [crossref] [PubMed]
17.
Akuthota V, Ferreiro A, Moore T, Fredericson M. Core stability exercise principles. Curr Sports Med Rep. 2008;7(1):39-44. [crossref] [PubMed]
18.
Kisner C, Colby L, Borstad J. eds. Therapeutic Exercise: Foundations and Techniques, 7e. McGraw Hill; 2018.
19.
Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000;25(22):2940-52. [crossref] [PubMed]
20.
Alhakami AM, Davis S, Qasheesh M, Shaphe A, Chahal A. Effects of McKenzie and stabilization exercises in reducing pain intensity and functional disability in individuals with nonspecific chronic low back pain: a systematic review. J Phys Ther Sci. 2019;31(7):590-97. Doi:10.1589/jpts.31.590. [crossref] [PubMed]
21.
Abdel-Aziem AA, Abdelraouf OR, El-Basatiny HMY, Draz AH. The effects of stabilization sxercises combined with pelvic floor exercise in women with nonspecific Low back pain: A randomized clinical study. J Chiropr Med. 2021;20(4):229-38. Doi:10.1016/j.jcm.2021.12.008. [crossref] [PubMed]
22.
França FR, Burke TN, Hanada ES, Marques AP. Segmental stabilization and muscular strengthening in chronic low back pain: a comparative study. Clinics (Sao Paulo). 2010;65(10):1013-17. [crossref] [PubMed]
23.
Wang XQ, Zheng JJ, Yu ZW, Bi X, Lou S, Liu J, et al. A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One. 2012;7(12):e52082. [crossref] [PubMed]
24.
Inani SB, Selkar SP. Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: A randomized clinical trial. J Back Musculoskelet Rehabil. 2013;26(1):37-43. [crossref] [PubMed]
25.
Kanwal S, Yaqoob I, Shakil-Ur-Rehman S, Ghous M, Ghazal J, Namroz N. Effects of core muscle stability on low back pain and quality of life in post-menopausal women: A comparative study. J Pak Med Assoc. 2021;71(1(A)):37- 40. doi:10.47391/JPMA.151. [crossref] [PubMed]
26.
Hsu WH, Chen CL, Kuo LT, Fan CH, Lee MS, Hsu RW, et al. The relationship between health-related fitness and quality of life in postmenopausal women from Southern Taiwan. Clin Interv Aging. 2014;9:1573-79. Published 2014 Sep 16. [crossref] [PubMed]
27.
Bhadauria EA, Gurudut P. Comparative effectiveness of lumbar stabilization, dynamic strengthening, and pilates on chronic low back pain: Randomized clinical trial. J Exerc Rehabil. 2017;13(4):477-85. Published 2017 Aug 29. [crossref] [PubMed]

DOI and Others

DOI: 10.7860/JCDR/2023/60303.17264

Date of Submission: Sep 18, 2022
Date of Peer Review: Nov 12, 2022
Date of Acceptance: Dec 10, 2022
Date of Publishing: Jan 01, 2023

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. No

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Sep 28, 2022
• Manual Googling: Dec 02, 2022
• iThenticate Software: Dec 09, 2022 (18%)

ETYMOLOGY: Author Origin

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