Effect Of Combined Ergonomic Intervention And Core Stability Exercises Versus Ergonomic Intervention Alone On Pain, Lumbar Mobility, And Disability In Dental Students With Low Back Pain: A Randomized Controlled Trial

Abstract

Background: Low back pain (LBP) is a frequent musculoskeletal complaint among dental students, arising from prolonged static postures, forward trunk flexion, and limited ergonomic awareness during pre-clinical and clinical training. Whether adding a structured core stability exercise programme to ergonomic education produces additional benefit over ergonomic education alone remains unclear in this population.

Objective: To compare the effect of a combined ergonomic intervention and core stability exercise programme with ergonomic intervention alone on pain intensity, lumbar mobility, and functional disability in dental students with LBP.

Methods: Sixty dental students (18–25 years) with LBP of more than one month's duration were allocated to Group A (ergonomic intervention alone, n = 30) or Group B (ergonomic intervention plus a progressive six-week core stability exercise programme, n = 30). Pain intensity (Numeric Pain Rating Scale, NPRS), lumbar mobility (Modified Schober Test), and disability (Oswestry Disability Index, ODI) were recorded at baseline and after six weeks. Within-group change was analysed with paired t-tests and between-group differences with independent-samples t-tests; significance was set at p < 0.05.

Results: Both groups improved significantly from baseline to week six on all three outcomes (p < 0.001 for all within-group comparisons). Mean pain reduction was 2.97 ± 1.22 points in Group A versus 2.43 ± 1.07 points in Group B; the between-group difference approached but did not reach conventional significance (t = −1.80, p = 0.077), while post-intervention pain scores were significantly lower in Group A (3.27 ± 1.28) than Group B (4.13 ± 1.70; p = 0.030). Gains in lumbar mobility (1.19 ± 0.39 cm vs 1.04 ± 0.31 cm; p = 0.096) and reduction in ODI scores (−12.13 ± 4.67% vs −12.07 ± 6.10%; p = 0.962) were statistically comparable between groups.

Conclusion: Both a stand-alone ergonomic education programme and a combined ergonomic-plus-core-stability programme produced large, clinically meaningful improvements in pain, lumbar mobility, and disability over six weeks in dental students with LBP. The addition of core stability exercises did not yield a statistically significant incremental benefit over ergonomic intervention alone within this short intervention window, and pain relief was numerically greater with ergonomic intervention alone. These findings should be interpreted cautiously given the small sample and short follow-up, and warrant confirmation in adequately powered trials with longer follow-up.