[Mobilizing or stabilizing exercise in degenerative disk disease in the lumbar region?]

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Degenerative disc disease (DDD) can cause premature disc degeneration, affecting younger and middle-aged individuals.
• Many low back pain patients with DDD are not surgical candidates and require conservative treatment options.
• Instability theory is a key consideration in understanding DDD and developing effective interventions.

Purpose of the Study:

• To compare the effectiveness of stabilizing versus mobilizing exercises for treating low back pain in patients with DDD.
• To evaluate the impact of structured exercise programs on pain intensity, physical signs, functional status, and analgesic use.

Main Methods:

• A controlled clinical trial randomized 27 low back pain patients (mean age 40) with chronic symptoms (mean 7.4 years) into two groups.
• One group performed daily 30-minute stabilizing exercises; the other performed mobilizing exercises for eight weeks.
• A Clinical Overall Score (COS) integrated Visual Analog Scale (VAS) for pain, physical signs, Oswestry Disability Index, and analgesic consumption.

Main Results:

• The stabilizing exercise group showed a 17% reduction in COS, indicating significant improvement.
• Conversely, the mobilizing exercise group experienced a 10% increase in COS, suggesting worsening symptoms.
• The difference in outcomes between the groups was statistically significant (p = 0.02).

Conclusions:

• Stabilizing exercises appear more effective than mobilizing exercises for managing low back pain associated with degenerative disc disease.
• These findings support the role of stabilizing exercises within a structured conservative treatment framework for DDD.
• The results align with the instability theory, suggesting that targeted stabilization can mitigate symptoms of disc degeneration.