Lumbar Extension Exercise Research Articles

Resistance exercise training and alendronate reverse Glucocorticoid-Induced osteoporosis in heart transplant recipients

Background: Immunosuppression therapy with bolus glucocorticoids causes regional osteoporosis in the axial skeleton of heart transplant recipients (HTR). No preventive strategy is generally accepted for steroid-induced bone loss. Methods: To determine the efficacy of an anti-osteoporosis regimen that combined a bisphosphonate agent (alendronate sodium) with the osteogenic stimulus of mechanical loading, 25 HTRs were randomly assigned either to a group that received alendronate (10 mg/day) for 6 months (ALEN; n = 8), a group that received alendronate (10 mg/day) and performed specific resistance exercises for 6 months (ALEN + TRN; n = 8) or to a non-intervention control group (CONTR; n = 9). Alendronate was initiated at 2 months after transplantation. Bone mineral density (BMD) of the total body, femur neck and lumbar spine (L-2 and L-3) was measured by dual-energy X-ray absorptiometry before and 2, 5 and 8 months after transplantation. Resistance training consisted of lumbar extension exercise (MedX) performed 1 day/week and 8 variable resistance exercises (MedX) performed 2 days/week. Results: Pre-transplantation BMD values did not differ among the 3 groups. BMD of the total body, femur neck and lumbar vertebra were significantly decreased below baseline at 2 months after transplantation in CONTR (−2.6 ± 0.9%, −5.1 ± 1.8%, −12.5 ± 4.2%, respectively), ALEN (−2.8 ± 0.8%, −5.3 ± 1.6%, −12.0 ± 3.9%) and ALEN + TRN groups (−2.7 ± 1.0%, −5.6 ± 2.1%, −11.2 ± 3.7%). CONTR had further significant losses of BMD after 3 and 6 months. ALEN had no further regional BMD losses after initiation of alendronate therapy. ALEN + TRN restored BMD of the whole body, femur neck and lumbar vertebra to within 0.9%, 2.1%, and 3.4% of pre-transplantation levels, respectively. Conclusions: Resistance exercise plus alendronate was more efficacious than alendronate alone in restoring BMD in HTRs. Our results indicate that anti-osteoporosis therapy in this population should include both an anti-resorptive agent as well as an osteogenic stimulus, such as mechanical loading.

Therapeutic Exercises of the Patients with Low-Back-Pain: Lumbar Extension Exercises for the Patients with Lumbar Herniated Nucleus Pulposus

Therapeutic Exercises of the Patients with Low-Back-Pain: Lumbar Extension Exercises for the Patients with Lumbar Herniated Nucleus Pulposus

Pelvic restraint effect on lumbar gluteal and hamstring muscle electromyographic activation

Objective: To evaluate the influence of pelvic restraint on electromyographic activation (neural drive) of the lumbar extensor, gluteal, and hamstring muscles during submaximal dynamic lumbar extension in an upright seated position. Design: Randomized, balanced, crossover trial comparing the electromyographic activation of the lumbar, gluteal, and hamstring muscles during dynamic lumbar extension exercise with and without pelvic restraint. Setting: Research laboratory at a private research university. Subjects: Twelve apparently healthy men (ages 18 to 50yrs). Intervention: Dynamic lumbar extension exercises. Main Outcome Measure: Electromyographic recordings. Results: Pelvic restraint did not influence the relative activation of the lumbar, gluteal, or hamstring muscle groups ( p ≤ .05) during submaximal dynamic lumbar extension exercise. The relative activation of the gluteal muscles was significantly lower than that of the lumbar extensor and hamstring muscle groups. Conclusions: Pelvic restraint is not a requirement to promote neural drive to the lumbar musculature during submaximal dynamic lumbar extension exercise performed in an upright seated position. Submaximal lumbar extension exercise reduces the relative contribution of the gluteal muscles compared with a maximal voluntary isometric contraction.

Low back strengthening for the prevention and treatment of low back pain.

Chronic low back pain (CLBP) remains one of the most difficult and costly medical problems in the industrialized world. A review of nineteenth and early twentieth century spine rehabilitation shows that back disorders were commonly treated with aggressive and specific progressive resistance exercise (PRE). Despite a lack of scientific evidence to support their efficacy, therapeutic approaches to back rehabilitation over the past 30 yr have focused primarily upon passive care for symptom relief. Recent spine rehabilitation programs have returned to active reconditioning PRE centered around low back strengthening to restore normal musculoskeletal function. Research has shown that lumbar extension exercise using PRE significantly increases strength and decreases pain in CLBP patients. It appears that isolated lumbar extension exercise with the pelvis stabilized using specialized equipment elicits the most favorable improvements in low back strength, muscle cross-sectional area, and vertebral bone mineral density (BMD). These improvements occur with a low training volume of 1 set of 8 to 15 repetitions performed to volitional fatigue one time per week. CLBP patients participating in isolated lumbar extension PRE programs demonstrate significant reductions in pain and symptoms associated with improved muscle strength, endurance, and joint mobility. Improvements occur independent of diagnosis, are long-lasting, and appear to result in less re-utilization of the health care system than other more passive treatments. Low back strengthening shows promise for the reduction of industrial back injuries and associated costs.

Resistance exercise training restores bone mineral density in heart transplant recipients

Objectives. This was a prospective, randomized, controlled study designed to determine the effect of resistance exercise traning on bone metabolism in heart transplant recipients.Background. Osteoporosis frequently complicates heart transplantation. No preventative strategy is generally accepted for glucocorticoid-induced bone loss.Methods. Sixteen male heart transplant recipients were randomly assigned to a resistance exercise group that trained for 6 months (mean [±SD] age 56 ± 6 years) or a control group (mean age 52 ± 10 years) that did not perform resistance exercise. Bone mineral density (BMD) of the total body, femur neck and lumbar spine (L2 to L3) was measured by dual-energy X-ray absorptiometry before and 2 months after transplantation and after 3 and 6 months of resistance exercise or a control period. The exercise regimen consisted of lumbar extension exercise (MedX) performed 1 day/week and variable resistance exercises (Nautilus) performed 2 days/week. Each exercise consisted of one set of 10 to 15 repetitions performed to volitional fatigue.Results. Pretransplantation baseline values for regional BMD did not differ in the control and training groups. Bone mineral density of the total body, femur neck and lumbar vertebra (L2 to L3) were significantly decreased below baseline at 2 months after transplantation in both the control (−3.3 ± 1.3%, − 4.5 ± 2.8%, −12.7 ± 6.2%, respectly) and training groups (−2.9 ± 1.1%, 5.9 ± 3.2%, −14.8 ± 3.1%, respectively). Six months of resistance exercise restored BMD of the whole body, femur neck and lumbar vertebra to within 1%, 1.9% and 3.6% of pretransplantation levels, respectively. Bone mineral density of the control group remained unchanged from the 2-month posttransplantation levels.Conclusions. Within 2 months after heart transplantation, ≈ 3% of whole-body BMD is lost, mostly due to decreases in trabecular bone (−12% to −15% of lumbar vertebra). Six months of resistance exercise, consisting of low back exercise that isolates the lumbar spine and a regimen of variable resistance exercises, restores BMD toward pretransplantation levels. Our results suggest that resistance exercise is osteogenic and should be initiated early after heart transplantation.

Lumbar Extension Exercise for Patients with Lumbar Disc Disorders

Lumbar Extension Exercise for Patients with Lumbar Disc Disorders

Lumbar Extension Exercise for Patients with Lumbar Disc Disorders : A Comparison of the Results of Outpatient used Extension Exercises and Inpatient given Classical Conservative Therapies

Lumbar Extension Exercise for Patients with Lumbar Disc Disorders : A Comparison of the Results of Outpatient used Extension Exercises and Inpatient given Classical Conservative Therapies

Lumbar Strengthening in Chronic Low Back Pain Patients|Physiologic and Psychological Benefits

The effects of exercise for isolated lumbar extensor muscles were examined in 54 chronic low-back pain patients. Subjects were randomly assigned to a 10-week exercise program (N = 31) or a wait-list control group (N = 23). Results indicated a significant increase in isometric lumbar extension strength for the treatment group and a significant reduction in reported pain compared with the control group (P 0.05). Treated subjects reported less physical and psychosocial dysfunction whereas the control group increased in pain, and physical and psychosocial dysfunction. There were no concomitant changes in reported daily activity levels. These results show that lumbar extension exercise is beneficial for strengthening the lumbar extensors and results in decreased pain and improved perceptions of physical and psychosocial functioning in chronic back pain patients. However, these improvements were not related to changes in activities or psychological distress.

Back Pain and the Exercise Prescription

Rationale for the use of exercise in the treatment and prevention of LBP and injury has been discussed. Current knowledge supports the use of individualized exercise programs that emphasize the restoration and maintenance of adequate lumbar-spinal function. When indicated, aerobic exercises to develop overall fitness and prevent deconditioning should be included in the exercise prescription. Several commonly used exercises for strengthening the lumbar extensor muscles have been reviewed. Lumbar extension exercises that stabilize the pelvis, provide a means for progressively increasing the resistance, and allow the exerciser to move through a full range of lumbar movement appear to offer the greatest benefit to the patient with LBP.

Effect of resistance training on lumbar extension strength

Development of a new testing machine, which stabilizes the pelvis, allowed us to evaluate the lumbar extensor muscles before and after training. Fifteen healthy subjects (29.1 +/- 8 years of age) trained 1 day per week for 10 weeks and 10 healthy subjects (33.7 +/- 16 years of age) acted as controls. Training consisted of 6 to 15 repetitions of full range of motion variable resistance lumbar extension exercise to volitional fatigue and periodic maximal isometric contractions taken at seven angles through a full range of motion. Before and after the 10 week training period, subjects completed a maximum isometric strength test at seven angles through a 72 degrees range of motion (0 degrees, 12 degrees, 24 degrees, 36 degrees, 48 degrees, 60 degrees, and 72 degrees of lumbar flexion). The training group significantly improved in lumbar extension strength at all angles (P less than or equal to 0.01). The result at 0 degrees (full extension) showed an increase from 180.0 +/- 25 Nm to 364.1 +/- 43 Nm (+102%) and at 72 degrees (full flexion) from 427.4 +/- 44.1 to 607.4 +/- 68 (+42%) Nm. Results from the control group showed no change (P greater than or equal to 0.05). The magnitude of gain shown by the training group reflects the low initial trained state of the lumbar extensor muscles. These data indicate that when the lumbar area is isolated through pelvic stabilization, the isolated lumbar extensor muscles show an abnormally large potential for strength increase.

More about McKenzie

To the Editor: I appreciate Mr. McKenzie's expressed need to write about his concepts and methods of spinal mechanical therapy. I wish to point out several areas of concern I have, however, about his recent letter to you in the June issue of Physical Therapy. He stated that in 1976 he introduced lumbar extension exercises for low back pain to the United States. I do not believe this is the case because others had advocated these exercises before that time. For example, in 1966 I began studies of these exercises at New York University and developed the extension-flexion techniques that I have reported on and have given to my patients since that time.1 In 1970, Dr. John Sarno and I documented the results of our work using various techniques.… [ ARTICLE][1] [1]: /lookup/volpage/65/965?iss=6