Core activation and strengthening in a physical therapy patient with chronic low back pain and lumbar instability: a case report




Vickers, Tyler

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Angelo State University. Department of Physical Therapy.


Background and Purpose: Using the treatment-based classification (TBC) system for the physical therapy management of subjects with low back pain, the following case report follows the physical therapy treatment of a 20-year-old female with chronic low back pain and lumbar instability in an outpatient physical therapy clinic. The primary focus of this case report is on the intervention decisions of the treating PTs. The outcome measures used in this case were the Oswestry Disability Index (ODI), Numerical Pain Rating Scale (0-10), Manual Muscle Testing (MMT), and Prone plank/Side plank endurance tests. Case Description: AR, a 20-year-old female with chronic low back pain and lumbar instability presents to physical therapy with chief complaint of low back pain when standing extended periods. Outcomes: Improvements were seen in all outcome measures despite infrequent attendance due to insurance authorization delays, work-schedule conflicts, and COVID-19 exposure. Most notable improvements were made in Prone/Side plank endurance testing (Prone plank: 48 seconds; Side plank: R 36 seconds, L 31 seconds) and ODI score (4/50, 8% impairment). Discussion: Based on this case report and previous evidence, the recommendations for physical therapy treatment for chronic low back pain with instability should incorporate global core stabilization exercise activities and cardiovascular exercise.



Chronic low back pain, lumbar instability, core activation, physical therapy