Introduction: Chronic low back pain (CLBP) affects 69.1% of Egyptian physical therapists, causing discomfort and alterations in lung capacity and diaphragm mechanics. Previous studies show that core stability exercises and diaphragmatic release techniques can improve respiratory functions and manage low back pain. Objective: The objective of this study was to compare the effects of core stability exercises and diaphragmatic release techniques on respiratory functions in physical therapists suffering from chronic low back pain. Material and Methods: The study included 90 female physical therapists with CLBP who were randomly assigned to three equal groups: Group A (Core Stability Exercise), Group B (Diaphragmatic Release), and Group C (Control). All participants received a standard treatment protocol that included ultrasound, transcutaneous electrical nerve stimulation (TENS), and hot pack therapy. The primary outcome measures included pulmonary function tests, diaphragm excursion, diaphragm thickness, chest expansion and total faulty breathing scale (TFBS). The secondary outcome measure was the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index (ODI) and core muscles strength. These outcomes were assessed and compared before and after the intervention. Results: The results indicated a significant improvement in the primary outcomes for Groups A and B (p < 0.001). Specifically, Group B showed greater improvement in diaphragmatic excursion, while Group A demonstrated more significant improvement in diaphragm thickness. Additionally, all groups exhibited a significant reduction in Oswestry Disability Index scores (p < 0.001), with Groups A and B showing the most pronounced decreases. Core muscle strength showed significant improvements in groups A and B only(p < 0.001) and was more pronounced in group A. Conclusion: Combining core stability exercises with diaphragmatic release techniques is recommended for managing CLBP, enhancing respiratory functions, enhancing core muscle strength, and alleviating pain.

Background Neck pain is a common musculoskeletal complaint with tremendous impact on health and quality of life. Neck pain also leads to pulmonary function restrictive disorder. Aim This study aimed to investigate the effect of deep cervical muscle training using pressure biofeedback device on ventilatory functions in patients with chronic mechanical neck pain. Patients Forty patients of both sexes with mean age 24.8± 1.87 years were participated in this study. They were divided into two groups equal in number; the study group (A) and the control group (B) who were suffering from chronic mechanical neck pain. Methods Group A received deep cervical flexor strengthening exercises and traditional physical therapy modalities. Group B received only traditional physical therapy modalities. Both groups were assessed using the neck disability index questionnaire for functional disability, visual analogue scale for pain intensity, craniocervical flexion test for deep cervical flexor muscle strength and spirometric tests for ventilatory functions (forced vital capacity , forced expiratory volume in 1 second, maximum voluntary ventilation and peak expiratory flow rate). Patients were assessed before and after treatment. Results The results of this study showed that there was significant improvement in craniocervical flexion test, maximum voluntary ventilation and peak expiratory flow rate in the study group only (p = 0.0001). There was a statistically significant improvement in neck disability index (p = 0.0001) , visual analogue scale (p = 0.0001), forced vital capacity (p = 0.002) and forced expiratory volume in 1 second(p = 0.01) in both groups, however, there was no statistically significant difference between both groups. Conclusion It is concluded that deep cervical flexor strengthening exercise combined with traditional physical therapy modalities have better clinical effects on the mechanical neck pain and ventilatory function improvement, than traditional physical therapy modalities alone in patients with chronic mechanical neck pain.