REVIEW article
Front. Physiol.
Sec. Exercise Physiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1672010
This article is part of the Research TopicNeurophysiological Basis of the Relationship between Core Stability and Human Movement: Implications for Sport and RehabilitationView all 12 articles
Effects of Different Types of Core Training on Pain and Functional Status in Patients with Chronic Nonspecific Low Back Pain: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Civil Aviation Flight University of China, Guanghan, China
- 2Yulin University, Yulin, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Chronic non-specific low back pain (CNSLBP) is a leading cause of global disability. While core training shows promise as a non-pharmacological intervention, the comparative effectiveness of different modalities remains unclear. This systematic review and meta-analysis compared three core training approaches—Pilates training, core stability training, and core resistance training—on pain intensity, functional status, and quality of life in adults with CNSLBP. Methods: We systematically searched four databases (Web of Science, PubMed, Cochrane Library, Scopus) from inception to May 2025, following PRISMA guidelines. Randomized controlled trials comparing core training modalities with controls in adults aged 18-65 years with CNSLBP ≥12 weeks were included. Primary outcomes were pain intensity (VAS/NRS) and functional disability (ODI/RMDQ). Random-effects meta-analysis was performed with standardized mean differences (SMD) calculated. Meta-regression identified optimal training parameters. Results: Fifty-seven trials involving 7,705 participants were included. All three modalities significantly improved pain relief compared to controls (SMD=0.70; 95% CI: 0.58-0.82; p<0.00001). Pilates training showed optimal pain relief (SMD=0.75; 95% CI: 0.58-0.92), followed by core resistance training (SMD=0.68) and core stability training (SMD=0.53). For functional improvement, core resistance training demonstrated the most stable effects (SMD=0.76; 95% CI: 0.55-0.97; I²=0%). Meta-regression identified optimal parameters: core resistance training 3-4 sessions/week (30-45 minutes), Pilates 2-3 sessions/week (50 minutes, 8-12 weeks), and core stability training 3-4 sessions/week (40-60 minutes, 6-8 weeks). All modalities showed limited effects on mental health quality of life. Conclusions: This study provides the first comprehensive comparison of core training modalities for CNSLBP. Pilates training demonstrates superior pain relief effectiveness, while core resistance training shows optimal functional improvement. The identification of optimal training parameters offers precise clinical guidance for individualized exercise prescription. Core training represents a safe, effective, evidence-based treatment approach requiring tailored selection based on patient-specific symptoms and objectives. Registration: PROSPERO CRD420251054431
Keywords: Low Back Pain, Exercise Therapy, Exercise Movement Techniques, Resistance Training, core stability, Systematic review
Received: 23 Jul 2025; Accepted: 12 Sep 2025.
Copyright: © 2025 Guo, Lan, Ding, Tang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lu Tang, Civil Aviation Flight University of China, Guanghan, China
Mingliang Yang, Civil Aviation Flight University of China, Guanghan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.