This randomized, controlled, five-arm, parallel-group trial will evaluate the effects of 8 weeks of supervised resistance training and developmental position-based exercise, with or without real-time non-invasive intra-abdominal pressure biofeedback, in adults aged 40 to 60 years with chronic low back pain. The trial will compare supervised gym-based agonist-antagonist paired set resistance training with OHMTRACK, supervised gym-based resistance training without OHMTRACK, supervised physiotherapy-based developmental exercise with OHMTRACK, home-based developmental exercise with OHMTRACK, and an active control condition. Primary outcomes will assess changes in pain and physical function after the intervention. Secondary outcomes will include neuromuscular coordination, postural stabilization, cardiovascular, respiratory, metabolic, behavioral, feasibility, and follow-up outcomes.
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Change in Trunk Flexor and Extensor Muscle Function
Timeframe: Baseline, Week 8, Week 12, and Week 16
Short-Form McGill Pain Questionnaire (SF-MPQ) Total Score
Timeframe: Baseline to Week 16 (1x every week)
Change in DNS-Based Functional Postural Stabilization Performance
Timeframe: Baseline, Week 8, Week 12, and Week 16