The latest craze in exercise programs is core training, also known as core stabilization or lumbar stabilization. But what does it do? And does it really work? Doctors and physiotherapists at the University of Washington in Seattle reviewed available research to find out some answers.

Core training or lumbar stabilization is aimed at the muscles of the trunk, abdomen, and pelvis. The goal is to improve motor control, strength, and endurance.

Specific muscles targeted include the transverse abdominis (TrA), lumbar multifidi, and iliopsoas (hip flexor). Other spinal abdominal, and pelvic muscles are also affected by core training.

The basis of core training is the contraction (at the same time) of the deep trunk muscles. This concept is called co-contraction. Applied appropriately, co-contraction leads to core stability. In the patient with low back pain (LBP), this can mean less pain and more function.

Many studies and reviews have been published on the topic of lumbar stabilization exercises. The focus is on patients with low back pain. The results show no significant differences in long-term outcomes for patients treated with stabilization versus other treatment choices.

One reason for these results may be that all of the studies used a mixed group of patients with nonspecific chronic low back pain. The next step is to see if a specific subgroup within the patient groups would benefit from stabilization exercises more than other subgroups.

This idea of treatment based on subclassification has become well understood. Researchers looking for answers to the problem of chronic LBP are taking this approach now. Until we know exactly which patients to apply spinal stabilization exercises to, this treatment will persist as a popular approach to all patients with acute and chronic episodes of LBP.

Christopher J. Standaert, MD, et al. Evidence-Informed Management of Chronic Low Back Pain with Lumbar Stabilization Exercises. In The Spine Journal. February 2008. Vol. 8. No. 1. Pp. 114-120.