Exploring EMG Biofeedback in Core Training – Bosu Ball vs Swiss Ball Efficacy for Collegiate Students with Mechanical Low Back Pain: A Randomized Controlled Trial

Anjali Khanduri,1 Pooja Sharma,1 Nitesh Malhotra,1 Divya Aggarwal,1 Irshad Ahmad,1 Zaheen Ahmed Iqbal,1 Mohammed Mansour Alshehri,2 Ahmad Sahely,2 Mohammad Abu Shaphe,2 Monira I Aldhahi3 1Department of Physiotherapy, School of Allied Health Sciences, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India; 2Physical Therapy Department, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia; 3Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi ArabiaCorrespondence: Zaheen Ahmed Iqbal, Department of Physiotherapy, School of Allied Health Sciences, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India, Tel +918447393967, Email [email protected]: Given the high prevalence of low back pain in this demographic group, effective management strategies are essential. This study aimed to compare the effects of EMG biofeedback-assisted core training using Bosu versus Swiss balls on mechanical low back pain in collegiate students.Methods: A randomized controlled trial was implemented with 36 participants aged 18– 25, randomly assigned to either the Bosu or Swiss ball group. Over four weeks, both groups engaged in specific core strengthening exercises three times a week. Pain intensity, core strength, and functional ability were assessed using the Numeric Pain Rating Scale, Oswestry Disability Index, and EMG analysis, respectively.Results: Both groups demonstrated significant improvements in pain, functional disability, core strength, and muscle activation following the intervention (p < 0.05). No statistically significant differences were observed between the Bosu ball and Swiss ball groups in the primary outcome measures, however, some enhancements were noted in range of motion, muscle activation and functional disability in the Bosu ball group.Conclusion: EMG biofeedback-assisted core training with Bosu balls is more effective than Swiss balls in managing mechanical low back pain in collegiate students. These findings suggest that incorporating Bosu ball exercises can enhance therapeutic outcomes, underscoring the need for tailored rehabilitation strategies to improve quality of life for young adults suffering from low back pain.Keywords: low back pain, core strengthening, EMG biofeedback, Bosu ball, Swiss ball