Effects of a Core Stabilization Exercise Program with the Abdominal Drawing-In Maneuver Technique in Chronic Non-Specific Low Back Pain with Lumbar Instability Using Telerehabilitation: A Randomized Controlled Trial

Objective: Despite the increasing use of telerehabilitation, few studies have examined its effectiveness for core stabilization exercises in chronic non-specific low back pain (CNSLBP) with lumbar instability (LI). This study compared telerehabilitation-based versus clinic-based delivery of core stabilization exercise with abdominal drawing-in maneuver (CSE with ADIM) on pain, functional disability, lumbar joint repositioning error (LJRE), quality of life, and satisfaction in individuals with CNSLBP and LI.Material and Methods: A single-blind randomized controlled trial that included 30 participants with CNSLBP and LI, randomized to telerehabilitation-based (n=15) or clinic-based (n=15) groups. Both groups completed 7 weeks of CSE with ADIM; the telerehabilitation-based group received training via video calls, while the clinic-based group received in-person training. Pain, functional disability, quality of life, and LJRE were measured at baseline and post-intervention; satisfaction was assessed at completion.Results: Both groups demonstrated significant within-group reductions in pain (numerical rating scale [NRS]) and functional disability scores (Oswestry Disability Index [ODI] and Roland-Morris Disability Questionnaire [RMDQ]; p-value<0.05), with no significant between-group differences. Telerehabilitation-based delivery improved in most SF-36 domains except the social function domain, whereas clinic-based training improved in only the physical function domain. LJRE had no significant changes within and between groups. Training adherence was high (96%) with high satisfaction (telerehabilitation-based: 4.94±0.08; clinic-based: 4.87±0.20). No adverse events occurred.Conclusion: Telerehabilitation-delivered CSE-ADIM is an effective alternative to clinic-based care for reducing pain and improving functional disability and quality of life in CNSLBP with LI.