Effect of gluteal muscle endurance training and lumbar stabilization exercise on pain, lumbar extensor endurance, dynamic balance and EMG activity of gluteal muscle and multifidus on chronic low back pain in individuals with pronated feet:Randomized controlled trial

NEED FOR THE STUDY

There is a paucity of articles that address the biomechanical dysfunctions contributing to chronic low back pain (CLBP), particularly in individuals with pronated feet. In individuals with pronated feet, the internal rotation of the tibia and femur alters the pelvic tilt, which can lead to compensatory strain on the lumbar extensors and multifidus. While lumbar stabilization exercises are a gold standard, they may not be sufficient if the proximal stabilizers—the gluteal muscles—are fatigued or weak, as they fail to counteract the mechanical deviations caused by foot pronation. There is a lack of high-quality randomized controlled trials that specifically investigate whether combining gluteal endurance training with lumbar stabilization provides a superior effect on neuromuscular control and dynamic balance compared to traditional methods. This study aims to fill this gap by utilizing objective electromyographic (EMG) data to assess how the integrated approach affects muscle recruitment patterns in this specific population.

SIGNIFICANCE OF THE STUDYThe significance of this research lies in its holistic approach to musculoskeletal rehabilitation, moving beyond localized treatment to address the entire lower limb kinetic chain. By identifying the relationship between gluteal endurance and multifidus activity in patients with pronated feet, the findings could fundamentally change clinical assessment protocols for CLBP. If the intervention proves effective, it will provide physical therapists with a more comprehensive, evidence-based exercise framework that improves not just pain scores, but also functional dynamic balance and long-term spinal stability. Furthermore, the use of EMG provides a "window" into the neuromuscular changes occurring, offering objective proof of muscle recovery that can guide more precise rehabilitation timelines. Ultimately, this study aims to enhance the quality of life for individuals with CLBP by addressing the underlying biomechanical triggers often overlooked in standard care.