Low back pain is one of the most common musculoskeletal disorders [1]. Military personnel, due to repetitive movements, are particularly prone to movement disorders affecting the pelvic girdle and lumbar spine [4]. Postural issues in the spine can increase the risk of chronic back pain in this population [6]. Incorrect lifestyle habits leading to postural disorders and musculoskeletal abnormalities disrupt the body’s biomechanics [9]. Among these postural disorders, an increased lumbar lordosis (excessive curvature of the lower spine) can place additional stress on lumbar structures, potentially causing motor pain syndrome [9]. Back motor control exercises have been shown to improve movement quality, posture, and pain during functional activities in patients with chronic low back pain [10]. Sensorimotor exercises challenge the motor system by enhancing dynamic joint stability and reducing joint load [13]. This study aimed to investigate the effect of sensorimotor exercise training on lumbar spine condition, pain, and proprioception in military personnel with non-specific chronic low back pain.

Methods

This clinical trial involved 30 military conscripts from Urmia, Iran, who met the inclusion criteria, and they were purposively divided into two equal groups: sensorimotor exercise and control. Inclusion criteria were: male conscripts aged 20–50 years, BMI between 20 and 28, minimum 3 years of military service, diagnosis of chronic non-specific low back pain by a specialist, a Roland Morris Disability Questionnaire score above 4, and pain lasting at least 3 months. Exclusion criteria included history of fractures/dislocations, prior back surgery, other underlying conditions (orthopedic, rheumatologic, infections, or spinal injuries), severe acute pain (VAS >8), and irregular participation in exercises. Pain, proprioception, and lumbar spine status were assessed at baseline. The intervention group performed sensorimotor exercises for 8 weeks, while controls continued routine activities. Post-intervention assessments were repeated. The Shapiro-Wilk test assessed data normality; ANCOVA compared normally distributed variables, and the Mann-Whitney U test was used for non-normal variables, with a significance threshold of 0.05. Data analysis was conducted using SPSS version 24.

Results

Baseline demographic variables showed no significant differences between groups. Lumbar lordosis data were normally distributed, while pain and proprioception data were not. ANCOVA revealed a significant decrease in lumbar lordosis angle in the exercise group compared to controls (p = 0.001). Mann-Whitney U tests indicated a significant reduction in back pain in the training group compared to controls (p = 0.001). Additionally, proprioception showed a significant improvement following the exercise intervention (p = 0.001).

Discussion and Conclusion

The results of the present study demonstrated that sensory-motor training has a significant impact on lumbar spine posture, pain, and proprioception in military personnel. These findings are consistent with those of several previous studies [17–21]. However, they contrast with the results reported by Surtees and Heneghan, and Rüger et al. [22, 23]. Surtees and Heneghan, comparing two groups of chronic low back pain patients—with and without lower limb injury—found that sensory-motor training was more effective in the group with lower limb injury. In other words, sensory-motor training had a greater effect on chronic low back pain patients who also had lower limb injuries. Rüger et al. reported that sensory-motor training did not produce any change in postural control among patients with chronic low back pain.
Exercises involving lateral movements on a Swiss ball likely activated the abdominal oblique muscles. Emphasizing muscle balance around the pelvic girdle may explain the symptom improvements seen after sensorimotor training. Literature supports the key role of muscles in central spinal stability, providing local intervertebral control [24]. Our protocol prioritized these muscles throughout training to support trunk stability. Postural changes contribute to chronic low back pain development [6]. The significant lumbar spine improvements observed here may underlie the reduced pain in participants. Pain stimulates nerves and increases muscle spasm, which in turn amplifies pain receptor activation; thus, reducing pain receptor stimulation can normalize muscle tone [12]. Exercises such as abdominal bracing and lumbar curve reduction likely improved postural control in functional tasks. Proprioception also significantly improved, indicating sensorimotor exercises enhance proprioceptive input, thereby strengthening postural control and reducing pelvic girdle joint stress. Improved proprioception helps patients with chronic low back pain optimize movement strategies and reduce symptoms, consistent with findings by Nazarzadeh Dehbozori et al. who reported enhanced neuromuscular coordination following sensorimotor training [27]. Strengthening muscles via active, closed-chain sensorimotor exercises improves neuromuscular and motor control as well as posture [28].
Sensorimotor training leads to changes in the movement strategies of patients with chronic pain [26]. When proprioceptive input to the central nervous system is impaired, the motor system exhibits altered and often dysfunctional movement patterns [12]. Therefore, enhancing proprioceptive input through sensorimotor training can improve movement strategies and help alleviate symptoms in patients with chronic low back pain.
In conclusion, by stimulating the proprioceptive system and enhancing sensorimotor input, sensorimotor training can improve spinal alignment, reduce pain, and enhance proprioception in military personnel with nonspecific chronic low back pain. Based on these findings, the authors recommend sensorimotor-based exercises for both the prevention and treatment of chronic low back pain.

Ethical Considerations

Participation was voluntary with informed consent obtained. Confidentiality was assured, and participants were told that study results would not affect their military selection. The Urmia University Research Ethics Committee approved this study (IR.URMIA.REC.1402.031), and it is registered as a clinical trial (IRCT20250107064312N1).

Funding

There is no funding support.

Authors’ Contribution

Authors contributed equally to the conceptualization and writing of the article. All of the authors approved the content of the manuscript and agreed on all aspects of the work.

Conflict of Interest

Authors declared no conflict of interest.

Acknowledgments

We sincerely thank all participants and those who supported this research.