The Effect of Suspension and Conventional Core Stability Exercises on Characteristics of Intervertebral Disc and Chronic Pain in Office Staff Due to Lumbar Herniated Disc

Document Type : RESEARCH PAPER


1 Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran

2 Department of radiology, Medical Sciences University of Tehran , Tehran, Iran


Background: The purpose of this study was to identify the effects of eight weeks of conventional and suspension core
stability exercises by use of the designed device on characteristic of intervertebral discs in low back pain.
Methods: A total of 27 men with chronic low back (CLB) pain due to lumbar disc herniation in L4-L5 and L5-S1 regions
were enrolled in this quasi-experimental study. After assessing the pain intensity using a visual analog scale (VAS) and
determining the disc herniation index using MRI, each group of patients were asked to perform either conventional
or suspension exercises for eight weeks, each week consisting of three training sessions. The pain intensity was
assessed at the end of the first, second, third, fourth and eighth weeks and the disc hernia index was determined again
at the end of the eight weeks of exercises.
Results: The results indicated significant changes in the intensity of pain in both groups through the period of eight
weeks of exercise with a remarkable pain relief. In relation to the structural characteristics of the intervertebral disc, data
analysis did not reveal any significant change between the pre- and post-test.
Conclusion: Considering the beneficial effects of the stability exercises and specially suspension stability exercises
with respect to pain alleviation and reduced use of sedatives and anti-inflammatory drugs, this method can be helpful
at early stages of treatment for chronic pains.
Level of evidence: I


1. Chan SC, Ferguson SJ, Gantenbein-Ritter B. The
effects of dynamic loading on the intervertebral disc.
European Spine Journal. 2011;20(11):1796.
2. Choobineh A, Rajaeefard AR, Neghab M. Perceived
demands and musculoskeletal disorders among
hospital nurses. Hakim research journal. 2007;
3. Sokas RK, Levy BS, Wegman DH, Baron SL. Recognizing
and preventing occupational and environmental
disease and injury. Oxford University Press, New York;
4. Aghilinejad M, Choobineh AR, Sadeghi Z, Nouri MK,
Ahmadi AB. Prevalence of musculoskeletal disorders
among Iranian steel workers. Iranian Red Crescent
Medical Journal. 2012;14(4):198.
5. Oha K, Viljasoo V, Merisalu E. Prevalence of
musculoskeletal disorders, assessment of parameters
of muscle tone and health status among office
workers. Agron Res. 2010;8(1):192-200.
6. Das SM, Dowle P, Iyengar R. Effect of spinal
mobilization with leg movement as an adjunct to
neural mobilization and conventional therapy in
patients with lumbar radiculopathy: Randomized
controlled trial. J Med Sci Res. 2018;6(1):11-9.
7. Embleton J, Lines L. Spinal decompression therapy:
Vibroseis of the body. InSEG Technical Program
Expanded Abstracts 2018 (pp. 4787-4791). Society
of Exploration Geophysicists.
8. Koçak FA, Tunç H, Sütbeyaz ST, Akkuş S, Köseoğlu BF,
Yılmaz E. Comparison of the short-term effects of the
conventional motorized traction with non-surgical
spinal decompression performed with a DRX9000
device on pain, functionality, depression, and quality
of life in patients with low back pain associated with
lumbar disc herniation: A single-blind randomizedcontrolled
trial. Turkish Journal of Physical Medicine
and Rehabilitation. 2018;64(1):17.
9. Wegner I, Widyahening IS, van Tulder MW, Blomberg
SE, de Vet HC, Brønfort G, et al. Traction for low‐back
pain with or without sciatica. Cochrane Database of
Systematic Reviews. 2013(8).
10. Eklund JA, Corlett EN. Shrinkage as a measure of the
effect of load on the spine. Spine. 1984;9(2):189-94.
11. Sorkin JD, Muller DC, Andres R. Longitudinal change
in the heights of men and women: consequential
effects on body mass index. Epidemiologic reviews.
12. Weiner DK, Kim YS, Bonino P, Wang T. Low back pain
in older adults: are we utilizing healthcare resources
wisely?. Pain Medicine. 2006;7(2):143-50.
13. van Tulder MW, Malmivaara A, Esmail R, Koes
BW. Exercise therapy for low‐back pain. Cochrane
Database of Systematic Reviews. 2000(2).
14. Cleland J, Schulte C, Durall C. The role of therapeutic
exercise in treating instability-related lumbar
spine pain: a systematic review. Journal of back and 
musculoskeletal rehabilitation. 2002;16(2-3):105-15.
15. Kolar K. Lumbar-Disk Herniations: Conservative
Clinical Applications. Athletic Therapy Today. 2005;
16. Gibbs BB, Hergenroeder AL, Perdomo SJ, Kowalsky RJ,
Delitto A, Jakicic JM. Reducing sedentary behaviour
to decrease chronic low back pain: the stand back
randomised trial. Occupational and environmental
medicine. 2018;75(5):321-7.
17. Benoist M. The natural history of lumbar disc
herniation and radiculopathy. Joint Bone Spine.
18. Billy GG, Lemieux SK, Chow MX. Changes in lumbar
disk morphology associated with prolonged sitting
assessed by magnetic resonance imaging. PM&R.
20. Mens JM, Snijders CJ, Stam HJ. Diagonal trunk muscle
exercises in peripartum pelvic pain: a randomized
clinical trial. Physical Therapy. 2000;80(12):1164-73.
21. Kang JI, Jeong DK, Choi H. Effect of spinal decompression
on the lumbar muscle activity and disk height in
patients with herniated intervertebral disk. Journal of
physical therapy science. 2016;28(11):3125-30.
22. Fagerlund MK, Thelander U, Friberg S. Size of lumbar
disc hernias measured using computed tomography
and related to sciatic symptoms. Acta radiologica.
23. Ham P, Leiber JD. Chapter 11 - Physical Examination
of the Lumbar Spine. In: Seidenberg PH, Beutler
AI, editors. The Sports Medicine Resource Manual.
Philadelphia: W.B. Saunders; 2008. p. 100-9.
24. Huang YP, Bruijn SM, Lin JH, Meijer OG, Wu WH,
Abbasi-Bafghi H, et al. Gait adaptations in low
back pain patients with lumbar disc herniation:
trunk coordination and arm swing. Eur Spine J.
25. Jeong DK, Choi HH, Kang JI, Choi H. Effect of lumbar
stabilization exercise on disc herniation index, sacral
angle, and functional improvement in patients with
lumbar disc herniation. Journal of physical therapy
science. 2017;29(12):2121-5.
26. Van Deursen DL, Goossens RH, Evers JJ, Van der
Helm FC, Van Deursen LL. Length of the spine while
sitting on a new concept for an office chair. Applied
Ergonomics. 2000;31(1):95-8.
27. Lis AM, Black KM, Korn H, Nordin M. Association
between sitting and occupational LBP. European
Spine Journal. 2007;16(2):283-98.
28. Simmerman SM, Sizer PS, Dedrick GS, Apte GG,
Brismée JM. Immediate changes in spinal height and
pain after aquatic vertical traction in patients with
persistent low back symptoms: a crossover clinical 
trial. PM&R. 2011;3(5):447-57.
29. Boocock MG, Garbutt G, Linge K, Reilly T, Troup JD.
Changes in stature following drop jumping and postexercise
gravity inversion. Medicine and science in
sports and exercise. 1990;22(3):385-90.
30. Podein RJ, Iaizzo PA. Applied forces and associated
physiologic responses induced by axial spinal
unloading with the LTX 3000™ lumbar rehabilitation
system. Archives of physical medicine and
rehabilitation. 1998;79(5):505-13.
31. Krause M, Refshauge KM, Dessen M, Boland R.
Lumbar spine traction: evaluation of effects and
recommended application for treatment. Manual
therapy. 2000;5(2):72-81.
32. Janda V. Muscles, central nervous motor regulation
and back problems. InThe neurobiologic mechanisms
in manipulative therapy 1978 (pp. 27-41). Springer,
Boston, MA.
33. Jorgensson A. The iliopsoas muscle and the
lumbar spine. Australian Journal of Physiotherapy.
34. Hellsing A, Nordgren B, Schele R, Ahlborg B, editors.
Predictability of back pain around the age of 20.
Reproducibility of examination variables: Proceedings
of the Tenth International Conference of the World
Confederation for Physical Therapy Sydney; 1987.
35. Abbott EE, Lobo B, Benzel EC. Biomechanics of the
Lumbar Degenerative Intervertebral Disk. Advanced
Concepts in Lumbar Degenerative Disk Disease:
Springer; 2016. p. 305-10.
36. Gringmuth RH, Jackson C. Therapeutic exercise for
spinal segmental stabilization in low back pain:
scientific basis and clinical approach. The Journal of the
Canadian Chiropractic Association. 2000;44(2):125.
37. Oh HJ, Jeon CB, Jeong MG, Choi SJ. The Effects of Spinal
Decompression Therapy on Pain and Disability in
Patients with Chronic Low Back Pain. The Journal of
Korean Physical Therapy. 2017;29(6):299-302.
38. Steele J, Bruce-Low S, Smith D, Osborne N, Thorkeldsen
A. Can specific loading through exercise impart
healing or regeneration of the intervertebral disc?.
The Spine Journal. 2015;15(10):2117-21.
39. Marshall PW, Murphy BA. Core stability exercises on
and off a Swiss ball. Archives of physical medicine and
rehabilitation. 2005;86(2):242-9.
40. Karimi N, Akbarov P, Rahnama L. Effects of segmental
traction therapy on lumbar disc herniation in patients
with acute low back pain measured by magnetic
resonance imaging: A single arm clinical trial.
Journal of back and musculoskeletal rehabilitation.