The additional effects of dual-task training with core stability exercises versus general exercises on disability and pain in people with nonspecific chronic low back pain: A randomized controlled trial

Musculoskelet Sci Pract. 2026 Apr:82:103501. doi: 10.1016/j.msksp.2026.103501. Epub 2026 Jan 16.

Abstract

Background: Non-specific chronic low back pain (NSCLBP) is a prevalent musculoskeletal condition associated with disability, pain, and reduced quality of life. Core stability exercises combined with dual-task training may improve clinical outcomes; however, evidence is limited. This study compared the effectiveness of core stability exercises with dual-task training (CSD) versus general exercises with dual-task training (GED) on disability, pain, quality of life, fear-avoidance beliefs, and kinesiophobia in individuals with NSCLBP.

Methods: 47 participants with NSCLBP (40.27 ± 7.69 years) were randomized into CSD (n = 24) or GED (n = 23) groups. Both groups completed 16 supervised sessions. The primary outcome was disability (Oswestry Disability Index, ODI) assessed at baseline, post-intervention (5 weeks), and 18-week follow-up. Secondary outcomes included pain intensity (Visual Analog Scale, VAS) assessed at same time points, quality of life (Short Form-12 Health Survey: Mental Component Summary [MCS-12], Physical Component Summary [PCS-12]), fear-avoidance beliefs (Fear-Avoidance Beliefs Questionnaire for physical activity [FABQ-P] and work [FABQ-W]), and kinesiophobia (Tampa Scale for Kinesiophobia [TSK]) assessed at baseline and post-intervention.

Results: The CSD group showed greater improvement in ODI post-intervention (d = 0.78, p = 0.012) and at follow-up (d = 0.97, p = 0.002). Both groups improved over time in all outcomes, with CSD superior for VAS (post-intervention and follow-up), MCS-12, PCS-12, FABQ-P, FABQ-W, and TSK post-intervention (p < 0.05).

Conclusion: Core stability exercises combined with cognitive dual-task training appear to be more effective than general exercises combined with the same dual-task training in improving both physical and psychological outcomes in individuals with NSCLBP.

Clinical trial registration number: NCT05832918.

Trial registration: This trial was registered at https://www.

Clinicaltrials: gov/(Identifier: NCT05832918) on March 31, 2023.

Keywords: Dual-task training; Exercise therapy; Low back pain; core stability exercises.

Publication types

  • Randomized Controlled Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Pain* / therapy
  • Disability Evaluation
  • Dual-Task Tests
  • Exercise Therapy* / methods
  • Female
  • Humans
  • Kinesiophobia
  • Low Back Pain* / psychology
  • Low Back Pain* / rehabilitation
  • Low Back Pain* / therapy
  • Male
  • Middle Aged
  • Pain Measurement
  • Quality of Life
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT05832918