Does strengthening the abdominal muscles prevent low back pain - A randomized controlled trial

Objective. To investigate the effects of abdominal muscle strengthening exe rcise on low back pain (LBP)risk reduction. Methods. We compared the effects of abdominal muscle strength (AMS) exercis e and back education with back education only on 402 asymptomatic subjects with weak AMS, The primary outcome was the percentage of subjects with at l east one episode of LBP at 24 months. A diary was used to monitor complianc e. Results. There were no statistically significant differences between experi mental (E) and control (C) subjects at 24 months for LBP episodes (E: 34.7% , C: 30.4%; C - E = -4.2%, P2 = 0.481; 95% CI -16.1%, 7.6%). The LBP episod es were also not statistically significantly different at 6 months (E: 13.2 %, C: 16.1%; C - E: 2.9%, P2 = 0.493; 95% CI-5.3%, 11.0%) or at 12 months ( E: 24.8%, C: 23.6%; C - E = -1.2%, P2 = 0.818; 95% CI -11.6%, 9.2%). Adjust ing the data for strata and base line AMS did not alter the findings. Imput ed results for LBP episodes at 6 months (C - E: 4.8%, P2 = 0.191; 95% CI-2. 4%, 12.0%), 12 months (C - E: -1.0%, P2 = 0.821; 95% CI -9.5%, 7.6%), and 2 4 months (C - E: -3.3%, P2 = 0.483; 95% CI -12.6%, 5.9%) were also not stat istically significantly different, Conclusion. Back education and abdominal exercise instructions are similar to back education alone. There were no group differences in LBP episodes, p ossibly due to noncompliance with the exercise program. While the estimated benefit of 2.9% at 6 months from the complete data and 4.8% from the imput ed data were not statistically significant, a larger study or future metaan alyses may be needed to confirm whether there is a clinical benefit or whet her these results should be considered a chance finding.