Effect of Core Stability Exercise in Scoliosis-Induced Lumbar Disc Herniation: A Single-Case A–B–A Study

Abstract

Background: Lumbar disc herniation (LDH) associated with scoliosis can exacerbate biomechanical imbalance, neuromuscular dysfunction, and functional limitations, particularly in older adults. Impaired lumbopelvic stability and reduced core muscle control contribute to persistent disability in activities of daily living.

Objective: To evaluate the effect of core stability exercise on pain and functional activity in an elderly patient with scoliosis-induced LDH using a single-subject A–B–A design.

Methods: A 75-year-old female with LDH and moderate scoliosis (Cobb angle 30°) was treated using a 4-week physiotherapy program consisting of core stability exercises (pelvic tilt, bridging, dead bug, and bird dog) performed twice weekly. The study followed an A–B–A single-subject design (baseline–intervention–follow-up). Outcomes included pain intensity (Numeric Rating Scale [NRS]), functional disability (Oswestry Disability Index [ODI]), range of motion (ROM), and muscle strength (Manual Muscle Testing). Data were analyzed using visual analysis (level, trend, and overlap).

Results: Pain decreased from NRS 2 to 1 (Δ = −1; 50% reduction). Functional disability improved from ODI 38% to 30% (Δ = −8%; 21% relative improvement). Although slightly below the minimal clinically important difference (~10%), the change approached clinical relevance. Improvements in ROM and muscle strength were observed across intervention phases. Visual analysis demonstrated a stable baseline, a positive trend during intervention, and maintenance of improvement post-intervention.

Conclusion: Core stability exercise may improve pain and functional outcomes in elderly patients with scoliosis-associated LDH. However, findings should be interpreted cautiously due to the single-case design.