Diaphragmatic breathing and core stability in low back pain: a scoping review of combined exercise approaches, mechanisms and clinical outcomes Doi: https://doi.org/10.55522/jhpo.V3I2.0081

Abstract

Low Back Pain is among the most common musculoskeletal disorders associated with persevering pain, disability and impaired neuromuscular control. Ailment of deep core musculature together with altered breathing patterns may compromise spinal stability. Combined diaphragmatic breathing with core stabilization exercises may enhance postural control and augment clinical outcomes. This review aimed to explore and summarize the existing evidence on the use of integrated diaphragmatic breathing with core stabilization exercises in individuals with LBP, emphasizing on intervention characteristics, mechanisms and clinical outcomes. A scoping review was conducted in accordance with recognized methodological frameworks. Electronic databases such as PubMed, Scopus, Cochrane, Web of Science, PEDro, CINAHL, Google Scholar were searched for the studies published from 2000 to 2025. Eligible literature included RCTs, narrative reviews, systematic reviews and meta-analyses involving adults with acute or chronic LBP. Interventions combining diaphragmatic breathing with core stabilization exercises were selected. Outcomes of interest comprised pain intensity, disability, functional integrity, trunk muscle activation, respiratory parameters, postural stability and psychological factors. Study selection entailed title and abstracts screening followed by full-text review, and findings were synthesized descriptively. The reviewed evidence demonstrated that combined interventions resulted in greater improvements in outcomes compared to core stabilization alone. Proposed mechanisms include improved intra-abdominal pressure regulation, enhanced neuromuscular coordination and better lumbopelvic stability. This review underscores the clinical importance of incorporating diaphragmatic breathing and core stability interventions into comprehensive LBP management pathways to optimize pain reduction, functional recovery and long-term clinical outcomes.