{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T01:54:57Z","timestamp":1773453297994,"version":"3.50.1"},"reference-count":72,"publisher":"National Athletic Trainers' Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2]]},"abstract":"\n Context<\/jats:title>\n Trunk-stabilization exercises, especially when performed under unstable conditions, may be beneficial for low back pain (LBP) and related symptoms. However, more evidence is needed to determine whether adding a perturbation component to the training program contributes to greater improvement.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the effects of perturbation training on trunk-muscle endurance, disability, pain, functional mobility, quality of life, fear-avoidance beliefs, and satisfaction in patients with nonspecific LBP.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Randomized controlled clinical trial.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Physiotherapy laboratory.<\/jats:p>\n <\/jats:sec>\n \n Patients or Other Participants<\/jats:title>\n A total of 44 patients with nonspecific LBP (30 women, 14 men; age = 33.06 \u00b1 9.55 years) who had pain for at least 3 months (pain duration = 3.02 \u00b1 3.25 years) was randomly assigned to either the exercise group (EG) or the perturbation group (PG).<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n The EG received a 2-phase trunk-based exercise program, and the PG received a 4-phase training program with perturbations added to the exercises performed by the EG. All interventions were performed 2 days per week for 8 weeks.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure(s)<\/jats:title>\n Trunk endurance (McGill endurance tests) and LBP-related disability (Oswestry Disability Index) were the primary outcome measures. Pain intensity (visual analog scale), functional mobility (timed up-and-go test), quality of life (Short Form 12), fear-avoidance attitudes (Fear-Avoidance Beliefs Questionnaire), and patient satisfaction (Global Rating of Change) were the secondary outcome measures.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Both groups showed improvement in all variables (\n P<\/jats:italic>\n < .05). However, the PG was superior to the EG in improving trunk-muscle endurance (flexor:\n F<\/jats:italic>\n 1,41<\/jats:sub>\n = 12.24,\n P<\/jats:italic>\n = .001; extensor:\n F<\/jats:italic>\n 1,41<\/jats:sub>\n = 17.67,\n P<\/jats:italic>\n < .001; right lateral flexor:\n F<\/jats:italic>\n 1,41<\/jats:sub>\n = 12.93,\n P<\/jats:italic>\n = .001; left lateral flexor:\n F<\/jats:italic>\n 1,41<\/jats:sub>\n = 15.02,\n P<\/jats:italic>\n < .001) and the Oswestry Disability Index (\n P<\/jats:italic>\n = .005). Between-groups effect sizes were large (partial \u03b7\n 2<\/jats:sup>\n range, 0.18\u20130.30). The timed up-and-go test (\n F<\/jats:italic>\n 1,41<\/jats:sub>\n = 4.96,\n P<\/jats:italic>\n = .03) and Fear-Avoidance Beliefs Questionnaire total score improved more in the PG (\n F<\/jats:italic>\n 1,41<\/jats:sub>\n = 5.06,\n P<\/jats:italic>\n = .03), with a medium effect size (partial \u03b7\n 2<\/jats:sup>\n = 0.11), and satisfaction was also higher in the PG (\n \n = 4.46,\n P<\/jats:italic>\n = .03).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n An 8-week trunk-based exercise program, when combined with perturbation training, led to greater improvements in trunk-muscle endurance, function, total fear-avoidance belief scores, and satisfaction.<\/jats:p>\n <\/jats:sec>","DOI":"10.4085\/1062-6050-0020.25","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:31:07Z","timestamp":1755563467000},"page":"119-131","source":"Crossref","is-referenced-by-count":0,"title":["Perturbation Training for Nonspecific Low Back Pain: A Randomized Controlled Trial"],"prefix":"10.4085","volume":"61","author":[{"given":"Tu\u011fba Akg\u00fcller","family":"Eker","sequence":"first","affiliation":[{"name":"Institute of Graduate Studies, Istanbul University-Cerrahpa\u015fa, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasin","family":"Yeti\u015fyi\u011fit","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Prof. Dr. Cemil Ta\u015fc\u0131o\u011flu City Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y\u0131ld\u0131z Analay","family":"Akbaba","sequence":"additional","affiliation":[{"name":"Division of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpa\u015fa, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"issue":"5","key":"i1938-162X-61-2-119-b01","series-title":"Int J Sports Phys Ther","first-page":"766","article-title":"Systematic review of the effectiveness of core stability exercises in patients with non-specific low back pain","volume":"17","author":"Smrcina","year":"2022","unstructured":"Smrcina Z,\nWoelfel S,\nBurcal CA. 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