ObjectiveTo compare the effects of specific core muscle training modalities—core stability training, sling exercise therapy (SET), Pilates, and breathing training—vs. non-core-training controls on pain and function in patients with chronic nonspecific low back pain (CNLBP).MethodsRandomized controlled trials (RCTs) from PubMed, Web of Science, and Cochrane Library were systematically searched. Thirty-three RCTs involving 1,757 patients were analyzed using random-effects meta-analysis in RevMan, with subgroup analyses by training type, mode, and duration.ResultsCore stability training significantly reduced pain (SMD = −0.95, 95% CI: −1.35 to −0.55) and improved function (SMD = −1.09, 95% CI: −1.63 to −0.55), despite high heterogeneity (I2 = 93%–95%).For pain relief, SET (SMD = −1.43) and Pilates (SMD = −1.48) showed the strongest effects, followed by breathing training (SMD = −0.75); conventional core stability training was less effective (SMD = −0.36). For functional improvement, SET (SMD = −2.60) and combined interventions (SMD = −1.07) outperformed single training. Short-term (<8 weeks) SET yielded prominent benefits, while long-term (≥8 weeks) breathing training sustained effects.ConclusionCore muscle training alleviates pain and enhances function in CNLBP. SET and Pilates offer notable short-term analgesia, whereas combined interventions improve function more effectively. Clinical protocols should be individualized, and future studies must standardize parameters and examine multimodal synergies. Systematic Review Registration: identifier: CRD420251031252.
Liu et al. (Wed,) studied this question.