Lumbar stabilization exercise program (LSEP)

An eight-week individualized LSEP (two, 30-min sessions/week) was provided in local physiotherapy clinics. No co-intervention was allowed except medication. The exercise program has been thoroughly described elsewhere in a supplementary file linked to a previous publication ( [17]; see Additional file 1). Briefly, The LSEP comprised three distinct phases: (1) Pain Management. over a maximum period of two weeks: This involved isolated contractions of the transversus abdominis (TrA) and lumbar multifidus (LuM) muscles followed by gradual incorporation of TrA/LuM co-contractions during low-load exercises.; (2) Early Impairment and Functional Level: Exercises emphasized quality of movement control; (3) Moderate/Advanced Impairment and Functional Level: As patients progressed, the program shifted to muscle endurance. Exercises were designed with higher volume and intensity, all while maintaining co-contractions of TrA and LuM. All the participants reached the third (final) phase during the 8-week program. The participants were also encouraged to do the exercises at home.

In order to standardize the information given to participants on their condition, the Back Book booklet [18], or its French translation (Guide du dos : ISBN: 978-2-923465-03-6), was given to participants at their first clinical visit. The booklet aimed to change beliefs and behaviours (resuming activities) related to back pain.