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Comparative Effectiveness of Core Strengthening Combined with TENS versus Conventional Physical Therapy among Individuals with Anterior Pelvic Tilt Associated with Non-Specific Low Back Pain: A Randomized Controlled Trial
Background: Non-specific low back pain (NSLBP) affects up to 80% of adults, impairing daily function and quality of life while burdening healthcare systems. Core stability exercises target deep trunk muscles to enhance spinal mobility and pelvic alignment, while Transcutaneous Electrical Nerve Stimulation (TENS) offers non-invasive neuromodulation for pain relief. Their combination may yield superior therapeutic outcomes.
Objective: To compare Core Strengthening exercises with TENS versus conventional physiotherapy in reducing pain, correcting anterior pelvic tilt (APT), and improving balance in NSLBP patients.
Methods: A single-blinded randomized controlled trial, conducted from 15th June 20225 till 30th August 2025, included 40 participants (mean age: 29.0 ± 5.45 years; 47.5% male), equally allocated to intervention (Core Strengthening + TENS) and control groups. Pain (Numeric Pain Rating Scale), APT angle (digital photography via MicroDicom), and Y-Balance were assessed pre- and post-intervention. ANCOVA adjusted for baseline values. The clinical trial has already been registered at the PRS clinical trial registry USA on 01 August 2025 (ID: NCT07098741).
Results: Groups were comparable at baseline (p > 0.05). Post-intervention, pain scores were significantly lower in the intervention group (0.99, 95% CI: 0.42–1.55) than controls (6.31, 95% CI: 5.75–6.88; mean difference = −5.33, p < 0.001, partial η² = 0.828, d = −4.29). APT angle decreased more with intervention (14.61°, 95% CI: 14.33–14.89) versus controls (16.16°, 95% CI: 15.87–16.44; mean difference = −1.54°, p < 0.001, partial η² = 0.605, d = −1.78). Y-Balance improved significantly (96.72 vs. 94.28; mean difference = 2.43, p < 0.001, partial η² = 0.354, d = 1.11).
Conclusion: Core strengthening with TENS is significantly more effective than conventional physiotherapy in reducing pain, correcting APT, and enhancing balance in NSLBP patients.
Clinical Trial Registration:
Keywords: Non-Specific Low Back Pain, Anterior Pelvic tilt, MicroDicom, Y-Balance Test
