Core Stability in Physiotherapy: What Do Recent Scientific Advances Tell Us?
- cjouanneau
- Apr 6
- 4 min read
Why Physiotherapists Should Be Interested in Recent Advances in Core Stability
Core stability has long been a cornerstone of physiotherapy practice, particularly in the management of low back pain, balance disorders, and neurological conditions. However, recent research has significantly refined our understanding of what “core stability” truly involves.
Today, it is no longer viewed simply as muscle strengthening, but rather as a complex interaction between:
neuromuscular control,
anticipatory muscle activation,
breathing–posture coordination,
and motor control strategies.
For physiotherapists, staying up to date with these scientific advances is essential in order to:
refine clinical decision-making,
individualize rehabilitation programs,
and better align assessment findings with therapeutic interventions.
The Transversus Abdominis: A Key Muscle in Lumbopelvic Control
The transversus abdominis (TrA) is now widely recognized as a central muscle for lumbopelvic stability.
Scientific evidence highlights its role in:
feedforward activation prior to limb movement,
regulation of intra-abdominal pressure,
synergy with the diaphragm and pelvic floor muscles.
In patients with pain or neurological impairments, this anticipatory activation is often altered, which supports the use of targeted interventions aimed at restoring motor control, rather than focusing solely on muscle strength.
What Do Recent Studies (2024–2025) Tell Us About Core Stability?
1. Core Stabilization and Feedforward Activation in Chronic Low Back Pain
Desai R. et al., 2024 – Journal of Bodywork & Movement Therapies
This study compares core stabilization exercises with yoga-based interventions in patients with chronic mechanical low back pain. The results suggest improvements in anticipatory neuromuscular control, a key component of functional spinal stability.
👉 Clinical relevance: targeting the TrA and deep trunk muscles may help restore motor control strategies rather than merely reducing pain.
2. Core Stability, Respiration, and Postural Control
Tuncer D. et al., 2024
In children with hearing impairment, a trunk stabilization program led to improvements not only in postural control, but also in respiratory muscle strength and pulmonary function parameters.
👉 These findings reinforce the close relationship between trunk stability, diaphragm function, and postural control, supporting a global approach to rehabilitation.
3. Core Stabilization and Balance in Multiple Sclerosis
Choobsaz H. et al., 2024 – Systematic Review and Meta-analysis
This meta-analysis demonstrates that core stabilization exercises have a significant positive effect on balance performance in people with multiple sclerosis.
👉 The trunk is confirmed as a key “postural platform” for motor function, justifying targeted trunk training in neurological rehabilitation.
4. Sling Exercise Therapy and Chronic Low Back Pain
Drummond C. et al., 2024 – Journal of Strength & Conditioning Research
Suspension-based training (sling exercise therapy) shows beneficial effects on pain and functional outcomes in chronic low back pain.
👉 These exercises strongly challenge lumbopelvic control and TrA activation, but require careful patient selection and clinical supervision.
5. Core Stability and Motor Function in Pediatric Neurorehabilitation
Mohamed N. et al., 2025
In children with spastic diplegic cerebral palsy, adding core stability exercises to conventional physiotherapy improved balance, standing ability, and walking performance.
👉 Improving trunk control enhances force transmission to the lower limbs.
6. Core Stability vs Intrinsic Foot Muscle Training (Flatfoot)
Randomized Controlled Trial, 2025
This study compared trunk-focused stabilization training with intrinsic foot muscle exercises. Results suggest that proximal stability significantly influences distal motor control.
👉 Strong support for a “proximal-to-distal” rehabilitation approach.
7. Core Stabilization and Lumbar Multifidus Function
Study, 2025
The authors reported improvements in pain and function associated with morphological and functional changes in the lumbar multifidus, often working synergistically with the TrA.
👉 Particularly relevant for persistent low back pain and recurrence prevention.
Clinical Implications for Physiotherapists
Recent evidence highlights several key messages for clinical practice:
Core stability relies primarily on motor control, not just strengthening.
The transversus abdominis plays a central role in anticipatory spinal stabilization.
Integration of breathing, posture, and movement is essential.
Tools that help objectify deep muscle activation may improve assessment accuracy and treatment precision.
Within this framework, solutions such as Blueback Physio, which focus on the assessment and training of lumbopelvic control and TrA activation, align with modern evidence-based physiotherapy by supporting clinical decision-making, feedback, and progression.
Conclusion
Core stability remains a dynamic and evolving field in physiotherapy research.
👉 Trunk stability is no longer an abstract concept—it is a measurable, trainable, and central component of modern rehabilitation.
📚 References (Bibliography)
🧠 1. Trunk stabilization and feedforward activation
Desai R, et al. Core stabilization vs yoga and anticipatory activation: implications for neuromuscular control in chronic low back pain. Journal of Bodywork & Movement Therapies 2024.Available on PubMed: https://pubmed.ncbi.nlm.nih.gov/39593561/
🌬 2. Trunk stabilization, respiration, and posture
Mirtaleb A. The breath-back connection: review of the role of the diaphragm and abdominal muscles in lumbar stability. Journal of Back and Musculoskeletal Rehabilitation 2025; doi:10.3233/WOR-213557.
📌 DOI / PubMed:https://pubmed.ncbi.nlm.nih.gov/40954640/
🧩 3. Core stability and neuro-pediatrics
Mohamed N, et al. Core stability exercises improve balance, walking, and standing in children with spastic cerebral palsy. Journal of Pediatric Rehabilitation Medicine 2025.PubMed: https://pubmed.ncbi.nlm.nih.gov/40508909/
📊 4. Core stability vs Pilates in low back pain
Chughtai MDB, et al. Core stabilization exercises vs Pilates: effectiveness on pain, disability, and mobility in lumbar disc herniation. Journal of Health & Well-Being in Clinical Rehabilitation 2025.PubMed: https://pubmed.ncbi.nlm.nih.gov/38850684/
🧠 5. DNS (Dynamic Neuromuscular Stabilization) vs conventional core training
Study on DNS training and postural control, PubMed 2025.https://pubmed.ncbi.nlm.nih.gov/40025463/
🧠 6. Systematic effects of stabilization exercises
Dimitrijević V, et al. Meta-analysis on the effects of stabilization exercises on pain and disability in chronic low back pain. Healthcare (MDPI) 2025;13(9):960.
🔎 Additional references (high level of evidence)
📘 Core stability vs conventional strengthening
Hlaing SS, et al. Core stabilization superior to strengthening for improving proprioception, balance, and muscle thickness of the transversus abdominis and multifidus. PubMed 2021.https://pubmed.ncbi.nlm.nih.gov/34847915/
📘 Systematic review supporting stabilization exercises
Smrcina Z. Systematic review: stabilization exercises effective in reducing pain and improving function in non-specific low back pain. PubMed 2022.https://pubmed.ncbi.nlm.nih.gov/35949382/
📘 Clinical evidence on core stability and motor control
Wang XQ, et al. Core stability vs other modalities in the management of low back pain (exercise, stabilization). PubMed 2024.https://pubmed.ncbi.nlm.nih.gov/38317586/
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