Elastic resistance band vs. conventional weight-based exercises in chronic low back pain rehabilitation: a comparative analysis for functional recovery

Background: Globally, chronic non-specific low back pain (CNSLBP) is the most prevalent disability associated with musculoskeletal disorders, particularly in low-and middle-income countries, where access to equipment and supervised rehabilitation may be limited. Elastic resistance bands are an inexpensive, portable, and adaptable option to perform resistance training without conventional equipment; however, their comparative value in low back pain rehabilitation remains under researched. Methods: This randomized controlled trial recruited 60 participants with CNSLBP, randomly assigned to two groups: Group A, which performed elastic band resistance exercises, and Group B, which engaged in conventional resistance exercises using gym equipment. Both groups followed the same supervised exercise protocol, three days a week, for six weeks. Participants were assessed on the Visual Analogue Scale, Oswestry Disability Index, and plank hold time at baseline and post-intervention. Fifty-three participants completed the study (88.3% retention). Results: Both groups demonstrated significant and clinically meaningful improvements in pain intensity and functional disability with no significant between-group differences (p>0.05), indicating therapeutic equivalence. However, the elastic band group exhibited significantly better adherence to the program (92.2% vs 83.9%, p=0.01) and greater improvement in core endurance (p=0.03). Additionally, more participants in the elastic band group expressed intention to continue exercises beyond the study period (93% vs 77%, p=0.04). Conclusions: Elastic band exercises were found to be equally effective in CNSLBP management compared to conventional weight-based resistance exercises, with the added benefits of superior adherence, core endurance improvements, and greater intention for long-term continuation. These findings suggest elastic resistance training as a viable alternative for clinicians, particularly valuable in resource-constrained environments.