Author(s): BEINERT, K., KEINER, M., TAUBE, W., Institution: GERMAN UNIVERSITY OF HEALTH AND SPORTS, Country: GERMANY, Abstract-ID: 1013

INTRODUCTION:
Chronic low back pain (CLBP) is one of the leading causes of years lived with disability worldwide, as shown in the Global Burden of Disease Study [1]. Recent evidence indicates that CLBP is highly prevalent among older adults, with reported rates ranging from 21% to 75%.[2]. In this population, CLBP is frequently accompanied by sensorimotor impairments such as reduced postural control [3] and sleep disturbance[4]. These sensorimotor impairments are also related to an increase risk of falling in elderly [5]. Exercise therapy is considered a first line treatment for CLBP, aiming to improve the function of back extensor and abdominal muscles. Given the strong association between balance impairments and fall risk in older adults, balance exercises are recommended as an effective intervention to reduce the likelihood of falling. This study aimed to determine whether adding balance exercises to a trunk muscle training program reduces pain, improves sleep quality, and enhances sensorimotor control in older adults with chronic low back pain, compared to trunk training alone.
METHODS:
A single blinded randomized controlled trial with 40 participants (mean age 65, 16 men ) with chronic low back pain was conducted. The experimental group received trunk muscle and balance exercises, and the control group received trunk muscle exercises over a period of six weeks. Both groups exercised 2 times a week for one hour. Primary outcomes were pain and quality of sleep . Secondary outcomes were pressure pain threshold, back extensor muscle strength and balance performance measured with the y-balance test.
RESULTS:
Repeated measures ANOVA revealed significant time × group interactions for present pain [F (1,38) = 7.93, p < 0.01, partial η² = 0.08] and days without pain [F (1,38) = 3.91, p = 0.05, partial η² = 0.03], favouring the experimental group. Further, a significant time effect without a time*group effect [F (1,38) = 4.62, p = 0.04, partial η² = 0.003] was observed for sleep quality with lower mean values in the experimental group. However, exploratory within group analyses showed that sleep quality improved significantly in the experimental group (p <0.02), whereas no significant change was observed in the control group. Secondary outcomes (pressure pain threshold, Y balance performance and back extensor strength) showed significant time × group interactions, all favouring the experimental group [PPT: F(1,38) = 14.56, p < 0.01, η² = 0.04; Y balance: F(1,38) = 63.72, p < 0.01, η² = 0.05; back extensor strength: F(1,38) = 15.88, p < 0.01, η² = 0.01].
CONCLUSION:
Adding balance to trunk training reduces pain and improves sensorimotor control in older adults with chronic low back pain. The selective pain reduction and sleep improvement in the balance group may relate to GABA‑mediated effects on postural control and sleep regulation. Overall, combined training shows clinically meaningful potential.