Stabilization exercise shows moderate effect on dynamic balance versus conventional PT in chronic lumbopelvic pain

OBJECTIVE: To compare the effects of a stabilization exercise (SE) program with other conventional physical therapy (PT) interventions on improving balance in people with non-specific chronic lumbopelvic pain (NSCLPP). METHOD: Seven electronic databases were searched for randomized controlled trials (RCTs) from inception to October 2023 and updated in January 2025: Embase, PubMed, Web of Science, CINAHL, Cochrane, ClinicalTrials.gov, and the World Health Organization's International Clinical Trials Registry Platform. RCTs included individuals with NSCLPP receiving SE compared with a conventional PT program. Primary outcomes were static and dynamic balance. The Cochrane risk-of-bias tool for randomized trials (Rob 2) was used to assess study quality, while the Grading of Recommendations Assessment, Development and Evaluation framework assessed the certainty of evidence. RESULTS: We included 14 studies with 466 participants and conducted a meta-analysis on dynamic balance using seven of these studies. Only those evaluating dynamic balance with the Y balance test showed a moderate effect size favoring SE (SMD = 0.71, CI = 0.22, 1.19). There is low certainty evidence that SE has a clinically relevant effect on dynamic balance compared with conventional PT interventions. The certainty in the evidence was downgraded to two levels because numerous RCTs had a risk of bias and imprecision due to the small sample size. Additionally, most studies reported improved static balance using inconsistent measurement tools. CONCLUSIONS: Compared with conventional PT interventions, SE program appears more effective in engaging core muscles during functional activities, leading to improved static and dynamic balance performance, and in reducing pain and functional disability in people with NSCLPP. TRIAL REGISTRATION: PROSPERO: CRD42023482155.