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 Jan 16;82:103501. doi: 10.1016/j.msksp.2026.103501. Online ahead of print.

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.

PMID:41633131 | DOI:10.1016/j.msksp.2026.103501