Compared to core stabilization exercises (CSE) alone, the combination of diaphragmatic breathing exercise (DBE) and CSE interventions showed better improvement in the measured parameters for patients with chronic low back pain (CLBP) in a randomized control trial published in "Journal of Chiropractic Medicine". Furthermore, integrating the use of DBE alongside CSE led to enhanced muscle activation and increased expansion of the chest. Researchers sought to assess the impact of incorporating DBEs alongside CSEs in CLBP sufferers.

Overall, 22 volunteers diagnosed with CLBP were divided into two groups: one received both DBE and CSE, while the other group received CSE alone. These patients underwent a 12-session treatment regimen, thrice a week, over a span of four weeks. Evaluations were conducted both pre and post-completion of these 12 sessions, utilizing various outcome measures including surface electromyography of transverse abdominis, Numeric Pain Rating Scale (NPRS), Pittsburgh Sleep Quality Index, Fear Avoidance Belief Questionnaire, Oswestry Disability Index, and chest expansion to assess sleep quality, disability, muscle activity, and pain.

The results indicated significant changes over time in chest expansion, fear-avoidance beliefs, pain score, disability score, sleep quality, and muscle activity. Additionally, there was a notable group effect on the physical activity parameter and Fear Avoidance Belief Questionnaire. An interaction effect between time and group was observed for muscle activity in the right transverse abdominis during the "tuck in" phase and chest expansion.

However, no discernable differences were detected in relation to the other parameters studied. Adding DBE to CSE was found to be more promising in improving CLBP compared to CSE alone, suggesting the potential benefits of incorporating DBEs into the CLBP treatment regimen.