A systematic review protocol for chronic low back pain subjects with respiratory muscle involvement

Authors: Nagaraj Sibbala1, Dhanesh Kumar KU1, Pravin Aaron2



1 Nitte Institute of Physiotherapy, NITTE (DU), Deralkatte, Mangaluru, Karnataka, India

2 Padmashree Institute of Physiotherapy, Affiliated to Rajiv Gandhi University of Health Sciences,

Bangalore, Karnataka, India



Background. Numerous studies have found that various core muscles are involved in subjects with chronic low back pain. The evidence for profiles of respiratory muscle involvement in normal low backache subjects has not been reviewed explicitly for low back pain.

Aims. The study’s primary objective was to scientifically analyze, condense, and to evaluate the evidence for the involvement of respiratory muscles in subjects suffering from chronic low back pain.

Methods. This evaluation procedure will trail the guidelines of PRISMA and MOOSE. The assessors will use a custom-built tool to extract data from the studies, regardless of the methodology used. A modified Downs and Black index will be used to assess the superiority of the methods used in the selected studies.

Results. This index evaluates the characteristics of the subjects, the timing of the outcomes, and the characteristics of the interventions, and quantitative, formal analysis, so-called meta-analysis, is performed if necessary. The study’s effect, including the evidence, will be determined using the GRADE a framework for a systematic approach. Earlier research has found that core muscles are involved, and the interventions are tailored to include deficiencies and intrusions that target specific muscle groups.

Conclusion. As an additional component that can be targeted by clinical practitioners in their day-to-day practice and added to rehab programmes, this systematic review protocol will summarise the list of evidence available for the rehabilitation of low back ache and highlight the involvement of respiratory muscles in lowback ache subjects.


Key words: chronic low back pain, diaphragmatic breathing exercises, respiratory muscles.


A systematic review protocol for chronic low back pain subjects with respiratory muscle involvement