***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE : To contrast the efficacy of two exercise programs , segmental stabilization and strengthening of abdominal and trunk muscles , on pain , functional disability , and activation of the transversus abdominis muscle ( TrA ) , in individuals with chronic low back pain . DESIGN : Our sample consisted of 30 individuals , r and omly assigned to one of two treatment groups : segmental stabilization , where exercises focused on the TrA and lumbar multifidus muscles , and superficial strengthening , where exercises focused on the rectus abdominis , abdominus obliquus internus , abdominus obliquus externus , and erector spinae . Groups were examined to discovere whether the exercises created contrasts regarding pain ( visual analogical scale and McGill pain question naire ) , functional disability ( Oswestry disability question naire ) , and TrA muscle activation capacity ( Pressure Biofeedback Unit = PBU ) . The program lasted 6 weeks , and 30‐minute sessions occurred twice a week . Analysis of variance was used for inter‐ and intra‐group comparisons . The significance level was established at 5 % . RESULTS : As compared to baseline , both treatments were effective in relieving pain and improving disability ( p<0.001 ) . Those in the segmental stabilization group had significant gains for all variables when compared to the ST group ( p<0.001 ) , including TrA activation , where relative gains were 48.3 % and ‐5.1 % , respectively . CONCLUSION : Both techniques lessened pain and reduced disability . Segmental stabilization is superior to superficial strengthening for all variables . Superficial strengthening does not improve TrA activation capacity STUDY DESIGN R and omized clinical trial . OBJECTIVES To determine the efficacy of trunk balance exercises for individuals with chronic low back pain . BACKGROUND The majority of exercises focusing on restoring lumbopelvic stability propose targeting the feedforward control of the lumbopelvic region . Less attention has been paid to feedback control during balance adjustments . METHODS Seventy-nine patients were r and omly allocated to 2 different groups . The experimental group performed trunk balance exercises in addition to st and ard trunk flexibility exercises . The control group performed strengthening exercises in addition to the same st and ard trunk flexibility exercises . The primary outcome measures were pain intensity ( visual analogue scale ) , disability ( Rol and -Morris Question naire ) , and quality of life ( 12-Item Short-Form Health Survey ) . Secondary outcomes were painful positions , use of analgesic drugs , and referred pain . Analysis of variance and relative risk were used to analyze the data for the primary and secondary outcome measures , respectively . The number of participants reaching the minimal clinical ly important difference in the 2 groups for each outcome measure was compared using relative risk . RESULTS A significant difference in scores on the Rol and -Morris Question naire ( P = .011 ) and the physical component of the 12-Item Short-Form Health Survey ( P = .048 ) , and in the number of participants reaching the minimal clinical ly important difference for the Rol and -Morris Question naire ( relative risk , 1.79 ; 95 % confidence interval [ CI ] : 1.05 , 3.04 ) and the secondary outcome of painful positions ( relative risk , 1.37 ; 95 % CI : 1.03 , 1.83 ) were found in favor of the experimental treatment . CONCLUSIONS Trunk balance exercises combined with flexibility exercises were found to be more effective than a combination of strength and flexibility exercises in reducing disability and improving the physical component of quality of life in patients with chronic low back pain [ Purpose ] The purpose of this study was to compare two methods for the muscle stabilization of the trunk of patients with chronic low back pain . The methods comprised combination patterns of proprioceptive neuromuscular facilitation ( PNF ) and ball exercise . [ Subjects and Methods ] The subjects were 40 volunteers who had low back pain . All subjects were r and omly assigned to either a group which received proprioceptive neuromuscular facilitation or a group which performed ball exercise . Measurements were taken four times in total , at pre-intervention , two weeks later , four weeks later , and six weeks later . The main measurement methods used were the visual analogue scale ( VAS ) for pain and electromyography ( EMG ) for muscle activity . [ Results ] VAS and EMG activity were significantly reduced in the PNF combination pattern group and the ball exercise group . A comparison of the groups showed significant differences . In VAS and EMG activity ; in particular , the combination pattern group using PNF increased EMG activity more than the ball exercise group did after six weeks of intervention . [ Conclusion ] This study showed that PNF combination pattern training for six weeks was more effective for patients with low back pain than performing ball exercise Background : Lumbar segmental stability is an important biomechanical component that influences symptoms amongst patients with Mechanical low back pain . Aims : To compare the efficacy of segmental stabilization exercises utilizing multifidus and transversus abdominis muscles versus a placebo treatment in patients with lumbar segmental instability . Material s and methods : The study was an observer-blinded r and omized placebo-controlled cross-over study of 18 adults ( 12 men , 6 women ) , of mean age 22.5 ± 1.09 yrs who scored 7/13 in subjective aspects and 8/14 in objective aspects of Delphi criteria for lumbar segmental instability . The selected subjects were then r and omized to receive either placebo-control ( prone lying ) or experimental ( lumbar segmental stabilization ) as a first treatment . Each treatment was followed by a wash-out period of 24 hours . Outcomes were measured four times- pre- and post- first intervention , pre- and post- second intervention . The outcome measures used were pain on Visual analogue scale , Pressure pain threshold and Joint play grading scale ( 0 - 6 scale ) on that level . Results : Two-way analysis of variance and post-hoc analysis using Bonferonni test were used with level of significance set at p<.05 using Statistical package for social sciences version 12.0.1 for Windows . Visual analogue scale changed significantly in both the periods of intervention- in control ( P = .016 ) and experimental ( P = .000 ) periods . However this improvement was more significant in the experimental period . The Joint play grading scale scores improved only in the experimental condition compared to the control condition significantly . The Pressure pain threshold also improved significantly in the experimental condition ( P = .000 ) while the changes in control condition was not statistically significant ( P=.816 ) . Conclusion : Segmental stabilization exercise was more effective than placebo intervention in symptomatic lumbar segmental instability OBJECTIVE The purpose of this preliminary study was demonstrate if it was feasible to evaluate variations in acceleration of trunk movement , pain , and disability during an episode of acute nonspecific low back pain comparing regular trunk exercises to regular exercises in addition to core stability exercises . METHODS A pilot r and omized controlled trial was used to evaluate 33 participants recruited from a National Health Service physiotherapy musculoskeletal provider in the London district of Hillingdon . Participants were allocated to 2 groups ; a regular exercise group ( male , 2 ; female , 15 ) with a mean ( SD ) age of 35.8 ( 9.1 ) years and intervention group ( male , 3 ; female , 13 ) with a mean ( SD ) age of 36.2 ( 9.8 ) years . The regular exercise group received exercise that consisted of a core stability class including both specific and global trunk exercises . The intervention group , in addition to these core exercises , received further instruction on 8 specific stabilization muscles involving the transversus abdominis and the lumbar multifidus . Trunk sagittal acceleration , pain , and disability were measured using a Lumbar Motion Monitor , pain visual analog scale , and Rol and Morris Disability Question naire , respectively . Measures were taken at baseline , 3 and 6 weeks , and a 3-month follow-up . Multiple regression with adjustment for baseline value was used to analyze each outcome . All outcomes were log transformed to correct skewness and so presented as ratio of geometric means with 95 % confidence interval . RESULTS Differences in mean trunk sagittal acceleration between the regular exercise and intervention groups was not statistically significant at any time point ( ratio of means [ 95 % confidence interval ] : 3 weeks 1.2 [ 0.9 - 1.6 ] , P = .2 ; 6 weeks 1.1 [ 0.8 - 1.5 ] , P = .7 ; 3 months : 1.2 [ 0.8 - 1.9 ] , P = .9 ) . Similarly , the effects on neither pain score nor disability score were significant ( pain score : 3 weeks 1.3 [ 0.8 - 2.2 ] , P = .3 ) ; 6 weeks 1.2 [ 0.7 - 2.0 ] , P = .6 ; 3 months 1.0 [ 0.5 - 1.9 ] , P = 1.0 ) ; disability score : 6 weeks 1.0 [ 0.7 - 1.5 ] , P = 1.0 ; 3 months 1.3 [ 0.8 - 1.9 ] , P = .3 ) . Outcome measures for both groups improved over time . CONCLUSIONS This pilot study demonstrated that a study of this nature is feasible . Both the regular exercise and the intervention groups demonstrated improvements in mean trunk sagittal acceleration at 3 , 6 , and 12 weeks . The preliminary findings showed that evidence was inconclusive for the beneficial effect of adding specific core stability exercises for acute low back pain . The results of this study demonstrated an increase in acceleration accompanied by a reduction in pain , which may suggest that acute nonspecific low back pain may induce the pain-spasm-pain model rather than the pain adaptation model Core training continues to be emphasized with the proposed intent of improving athletic performance . The purpose of this investigation was to discover if core isometric endurance exercises were superior to core isotonic strengthening exercises and if either influenced specific endurance , strength , and performance measures . Ten untrained students were r and omly assigned to core isometric endurance ( n = 5 ) and core isotonic strength training ( n = 5 ) . Each performed three exercises , two times per week for six weeks . A repeated measures ANOVA was used to compare the measurements for the dependent variables and significance by bonferroni post-hoc testing . The training protocol s were compared using a 2 × 3 mixed model ANOVA . Improvement in trunk flexor and extensor endurance ( p < 0.05 ) along with squat and bench press strength ( p < 0.05 ) occurred with the strength group . Improvement in trunk flexor and right lateral endurance ( p < 0.05 ) along with strength in the squat ( p < 0.05 ) were found with the endurance group . Neither training protocol cl aim ed superiority and both were ineffective in improving performance STUDY DESIGN Prospect i ve , single-group , repeated- measures design . OBJECTIVE To identify exercises that could be used for strength development and the exercises that would be more appropriate for endurance or stabilization training . BACKGROUND The exercises analyzed are often used in rehabilitation programs for the spine , hip , and knee . They are active exercises using body weight for resistance ; thus a clinician is unable to determine the amount of resistance being applied to a muscle group . Electromyographic ( EMG ) analysis can provide a measure of muscle activation so that the clinician can have a better idea about the effect the exercise may have on the muscle for strength , endurance , or stabilization . METHODS AND MEASURES  Surface EMG analysis was carried out in 19 males and 11 females while performing the following 9 exercises : active hip abduction , bridge , unilateral-bridge , side-bridge , prone-bridge on the elbows and toes , quadruped arm/lower extremity lift , lateral step-up , st and ing lunge , and using the Dynamic Edge .  The rectus abdominis , external oblique abdominis , longissimus thoracis , lumbar multifidus , gluteus maximus , gluteus medius , vastus medialis obliquus , and hamstring muscles were studied . RESULTS In healthy subjects , the lateral step-up and the lunge exercises produced EMG levels greater than 45 % maximum voluntary isometric contraction ( MVIC ) in the vastus medialis obliquus , which suggests that they may be beneficial for strengthening that muscle . The side-bridge exercise could be used for strengthening the gluteus medius and the external oblique abdominis muscles , and the quadruped arm/lower extremity lift exercise may help strengthen the gluteus maximus muscle . All the other exercises produced EMG levels less than 45 % MVIC , so they may be more beneficial for training endurance or stabilization in healthy subjects . CONCLUSION Our results suggest these exercises could be used for a core rehabilitation or performance enhancement program . Depending on the individual needs of a patient or athlete , some of the exercises may be more beneficial than others for achieving strength 
    Output:
    
According to the results of various scales and evaluation instruments ,  core strength training  is more effective than  typical resistance training  for alleviating chronic low back pain .