Although current lumbar stabilization exercises are beneficial for chronic mechanical low back pain, further research is recommended focusing on global spinal alignment normalization. This randomized, controlled, blinded trial was conducted to determine the effects of adding cervical posture correction to lumber stabilization on chronic mechanical low back pain. Fifty adult patients (24 males) with chronic mechanical low back pain and forward head posture received 12 weeks treatment of either both programs (group A) or lumbar stabilization (group B). The primary outcome was back pain. The secondary outcomes included the craniovertebral angle, Oswestry Disability Index, C7-S1 sagittal vertical axis, and sagittal intervertebral movements. The multivariate analysis of variance indicated a significant group-by-time interaction (P = .001, partial η2 = .609). Pain, disability, C7-S1 sagittal vertical axis, and l2-l3 intervertebral rotation were reduced in group A more than B (P = .008, .001, .025, and .001). Craniovertebral angle was increased in A when compared to B (P = .001). However, there were no significant group-by-time interactions for other intervertebral movements. Within-group comparisons were significant for all outcomes except for craniovertebral angle within patients in the control group. Adding cervical posture correction with lumber stabilization for management of chronic low back pain seemed to have better effects than the application of a stabilization program only.
A.M. Elabd is with the Basic Science Department, Faculty of Physical Therapy, Pharos University, Alexandria, Egypt. Rasslan, Elhafez, and Elerian are with the Basic Science Department, Faculty of Physical Therapy, Cairo University, Dokki, Egypt. Elhafez is also with the Faculty of Physical Therapy, Suez University, Suez, Egypt. O.M. Elabd and Behiry are with the Department of Physical Therapy for Musculoskeletal Disorders, Faculty of Physical Therapy, Delta University for Science and Technology, Gamassa, Egypt.