Abstract
Background: Chronic low back pain (CLBP) is a leading cause of disability worldwide and is associated with impaired trunk muscle function and reduced spinal stability. Core-related exercise interventions are widely used in the rehabilitation of individuals with CLBP, but their effects across different clinical outcomes remain to be synthesized. Objective: This systematic review aimed to synthesize the evidence on the effects of core-related exercise interventions on pain, functional disability, physical function, core/trunk strength or stability, and quality of life in adults with chronic non-specific low back pain. Methods: The review was conducted in accordance with the PRISMA 2020 guidelines. A systematic search of Web of Science, PubMed, and Scopus identified randomized controlled trials published between 2016 and 2026. Eligible studies included adults with chronic non-specific low back pain. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, and findings were synthesized narratively due to substantial clinical and methodological heterogeneity. Results: Twenty-two randomized controlled trials involving 1151 participants were included. Core-related interventions, including stabilization and motor control exercises, were generally associated with reductions in pain intensity and disability and improvements in physical function. Additional benefits were reported for lumbar stability, postural control, and activation of deep trunk muscles, particularly the transversus abdominis and multifidus. Improvements in quality of life and selected psychosocial outcomes were also reported. Comparative findings were mixed, with no intervention demonstrating consistent superiority. Conclusion: Core-related exercise interventions appear to improve pain and functional outcomes in adults with chronic non-specific low back pain. However, substantial heterogeneity across interventions, outcome measures, and study protocols limits direct comparisons between specific exercise approaches.