Lumbar Stabilization Research Articles

Effect of Lumbar Spinal Stabilization Exercises Along With Neural Tissue Mobilization on Pain and Spinal Dysfunction in Failed Back Surgery Syndrome.

Background Failed back surgery syndrome (FBSS) mainly involves back pain radiating to the lower limb after back-related surgeries. It can develop various complications around the operation site and its surrounding area. This study evaluates the effect of lumbar spinal stabilization exercises and neural tissue mobilization on pain and spinal dysfunction in FBSS. Objectives To study the impact of lumbar spinal stabilization exercises and neural tissue mobilization on pain and spinal dysfunction in FBSS. To compare the impact of lumbar spinal stabilization exercises and neural tissue mobilization with conventional therapy on pain and spinal dysfunction in FBSS. Methods The study included 76 participants aged 45-60 with back pain radiating to lower limbs after back-related surgeries within the past six months. Participants were randomly assigned to either a conventional treatment group (Group A) or an experimental exercise program group (Group B). The treatment duration was six weeks and data were analyzed by a paired t-test for within-group analysis and an unpaired t-test for between-group analysis. Results Both groups A and B showed significant differences in all three outcome measures. However, Group B showed extremely significant improvement (<0.0001) in outcome measures, including pain, lumbar muscle strength by manual muscle testing, and modified Oswestry index assessment compared to Group A. Conclusion Both conventional and experimental groups showed a significant impact on the pain and level of function in failed back surgery syndrome patients. However, lumbar stabilization exercises along with neural tissue mobilization (Group B) showed a more pronounced impact on all outcomes such as pain reduction and improvement in lumbar flexor, rotator, and extensor muscle strength and modified Oswestry index compared to the conventional treatment group (Group A).

Comparison of Differences in Kinetics of Elderly Women at Risk of Falling during Lumbar Stabilization Exercise per Obstacle Height

This study was performed to identify the kinetic and kinematic effects of the lumbar stabilization exercise on obstacle gait(5.2cm,15.2cm) among elderly women at risk of falls. The study subjects were 32 women aged 65 and over with a risk of falls identified by the Tinetti test. They were randomly allocated into 2 groups: the experimental group and the control group, and the lumbar stabilization exercise program was given to the experimental group for 12 weeks. The chi-square test and t-test were used to test homogeneity and compare baseline results of kinetic measurements on obstacle gait between the experimental and control groups. To identify the effects of the lumbar stabilization exercise program among study subjects, repeated measures of analysis of variance (ANOVA) were performed. Regarding kinetic variables, the knee joint angle of the propulsion foot significantly increased when overcoming a 5.2cm obstacle. When overcoming a 15.2cm obstacle, the obstacle overcoming speed and the knee joint angles of the support and propulsion feet significantly increased. However, the shortest vertical distance between the support and propulsion feet was reduced considerably. Our findings suggest that lumbar stabilization exercises could be a promising therapeutic exercise method for fall prevention and management in elderly women at risk of falling, providing reassurance about the effectiveness of our study's findings and the potential benefits for the elderly and other patients requiring trunk stability.

A M-PEEK rod system to stabilize spinal motion after graded facetectomy: a finite element study

BackgroundResecting the facet joint to relieve nerve pain can lead to spinal instability, deformity, and abnormal pressure on the anterior of the intravertebral disc. To mitigate these issues, surgeons often limit the amount of bone removed during facetectomy or stabilize the spine by fusion to maintain lumbar stability. This study aimed to assess how a M-PEEK rod system influenced the stability of the lumbar spine during graded facetectomy.MethodsFacetectomy was performed on a validated L1-L5 finite element model which was then simulated both with and without the M-PEEK rod system.ResultsIn extension, models implanted with M-PEEK in the interspinous space of L3/L4 experienced a 35.2% decrease in range of motion (ROM) at L3/L4, while others saw an 8.4–24.8% increase. For axial rotation, the ROM at L3/L4 increased by 2.2–5.4% in models with the M-Rod, and by 4.9–12.9% in models without the implant. In lateral flexion, the ROM at L3/L4 increased by 8.4–14.3% in models without a PEEK M-Rod (facetectomy only), with adjacent segments experiencing a 6.5% decrease in ROM in the implanted models. Overall, the difference in ROM between the intact and implanted models was minimal.ConclusionsFacetectomy involving the removal of 50% or more of the facet joint significantly increases range of motion and maximum intradiscal pressure, potentially accelerating disc degeneration, as shown in our finite element study. Stabilizing the segment with an M-PEEK rod may limit excessive motion, providing stability and maintaining intradiscal pressure closer to that of an intact model.

Effects of Lumbar Stabilization on Scapular Muscle Activity, Activation Onset Time, and Kinematics in Individuals with Scapular Dyskinesis.

This study aimed to investigate the effects of lumbar stabilization on muscle activity, muscle onset time, and scapular kinematics in individuals with scapular dyskinesis. Fourteen participants with scapular dyskinesis were recruited. Scapular muscle activity and activation onset time were measured by electromyography (EMG), and scapular upward rotation was measured by two-dimensional (2-D) Kinovia software, under two conditions: with and without abdominal bracing. There was a significant increase in the activity of the serratus anterior, middle trapezius, and inferior trapezius muscles between the conditions (p < 0.001, p = 0.045, and p < 0.001, respectively). During abdominal bracing, the activation onset time of the serratus anterior and lower trapezius was noticeably shorter (p = 0.041 and p = 0.011, respectively). Scapular upward rotation at 30°, 60°, 90°, and 120° of shoulder abduction was significantly greater (p = 0.027, p = 0.003, p = 0.003, and p = 0.030, respectively). Increased scapular muscle activation, early activation onset time, and increased scapular upward rotation were also noted. These changes have an impact on the scapulohumeral rhythm.

Effect of William Exercise and Blackburn Exercise in Patients with Chronic Low Back Pain: A Randomized Control Trial

Background: Low back pain (LBP) physiotherapy treatment, mostly focuses on low back area and lower limb. Fewer physiotherapists and studies correlate the upper back and LBP. The present study was conducted to see the effect of lumbar stabilization (William) exercise and scapular stabilization (Black burn) exercise in chronic low back pain (CLBP) patients. Methods: Total 28 subjects were allocated randomly by the lottery method in two different treatment groups, Group-A (William exercise + black burn exercise group) and Group-B (William exercise). Pain intensity was measured by numeric pain rating scale (NPRS), and functional disability score by Roland - Morris disability questionnaire (RMDQ). Statistical analysis was done using SPSS V.20. Result: Within group analysis showed statistically significant difference in NPRS score(Z =-3.320, p &lt; 0.001), RMDQ score(Z = -3.300, p &lt; 0.001) in group A. Whereas NPRS score (Z = -3.341, p &lt; 0.001), RMDQ score (Z = -3.202, p &lt; 0.001) in group B. Comparison of baseline data showed no statistically significant difference in NPRS score (U=89, p=0.668) and RMDQ score (U=84, p=0.518) in both the groups. At the end of 4 weeks of intervention, data showed statistically significant difference in NPRS score (U=51.5, p=0.024) and RMDQ score (U=52.5, p=0.035) between both the groups. Conclusion: This study concludes that William exercise is good for the CLBP patients but William exercise and Blackburn exercise shows superior results in pain reduction and also reduced back related disability and restored functioning in CLBP patients. Keywords: Low back pain, William exercise, Scapular stabilization, black burn exercise

Possible effects of lumbar stabilization surgery on sagittal alignment, disability and quality of life

BackgroundIn order to restore the individual's health in lumbar stabilization surgeries, it is aimed to bring the sagittal alignment closer to normal values, to eliminate the findings, and thus to increase the quality of life of the individual by reducing the disability level. The aim of this study is to measure the effects of lumbar region stabilization surgeries performed in our clinic on some angular values in the spine, disability and quality of life. Preoperative (preop) and postoperative (postop) radiographs of 30 individuals over the age of 40 who applied to our clinic with various lumbar region complaints and underwent lumbar stabilization surgery between the years 2020–2022 were taken. Lumbar lordosis, pelvic tilt, sacral slope and pelvic inclination angles were measured from the images obtained. The Visual Analog Scale was used to measure the pain of individuals, the Oswestry Disability Index to measure the disability level, and the Nottingham Health Profile questionnaire to measure the quality of life. Preop and postop data were analyzed with the SPSS 23.0 program and p < 0.05 was considered significant.ResultsThe lumbar lordosis angles of individuals who underwent lumbar stabilization surgery approached normal values and the difference between preop–postop lumbar lordosis angle averages was significant (p < 0.05); It was observed that the harmony between the lumbar lordosis and pelvic inclination angles increased, the pain decreased and the difference between preop–postop pain values was significant (p < 0.05), disability levels decreased and quality of life increased.ConclusionsThe decrease in the level of disability and the increase in the quality of life seen in individuals who underwent lumbar stabilization surgery were associated with the decrease in pain; The changes in angular values are considered to be clinically significant.

Exercise for patients with low back pain

Background: Low back pain (LBP) is a common symptom that imposes a significant socioeconomic burden. Appropriate exercises that enhance the recovery of anatomical structures using biomechanical methods and improve lumbar stability are recommended for patients with LBP. Therefore, clinicians should prescribe appropriate exercises to alleviate LBP, improve function, and prevent recurrence.Current Concepts: Individualized and structured multimodal exercises (strengthening, aerobic, core stability exercises, and stretching) under the supervision of healthcare professionals are recommended for patients with LBP. It is preferable to focus on isometric trunk muscle exercises for strengthening, and strengthening the large muscles (back and gluteal muscles) attached to the thoracolumbar fascia is recommended rather than exercises that involve repeated extension and flexion of the trunk muscles. Individualized aerobic and core stability exercises are recommended, and stretching exercises focusing on extension movements are preferred. It is also important to educate patients regarding the etiology of LBP, harmful postures for LBP, and methods to maintain lumbar lordosis in daily life.Discussion and Conclusion: An appropriate exercise prescription can contribute to better clinical outcomes in patients with LBP. Although exercise is important for recovery and prevention of recurrence, inappropriate exercise can potentially exacerbate LBP; therefore, careful consideration is required.

Two-Stage Lumbar Dynamic Stabilization Surgery: A Comprehensive Analysis of Screw Loosening Rates and Functional Outcomes Compared to Single-Stage Approach in Osteopenic and Osteoporotic Patients.

Dynamic lumbar stabilization aims to preserve spinal movement, offering stability and controlled motion. However, screw loosening, especially in patients with osteopenia and osteoporosis, remains challenging. Between 2018 and 2022, a retrospective analysis was conducted on a total of 119 patients diagnosed with osteopenia and osteoporosis who underwent spinal dynamic instrumentation surgery. These patients were categorized into two groups: single-stage surgery (n = 67) and two-stage surgery (n = 52). Over the 48-month follow-up period, the occurrence and percentage of screw loosening were examined at each surgical level per patient, as well as by screw location (pedicular, corpus, tip). Clinical outcomes were evaluated using Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores. Total screw loosening rates were significantly lower in the two-stage group (2.83%) compared to the single-stage group (14.63%, p < 0.001). Patient-based loosening occurred in 5 patients (9.6%) in the two-stage group and 16 patients (23.9%) in the single-stage group. Loosening rates were lower in the two-stage group at L2 (7.78%, p = 0.040), L3 (5.56%, p < 0.001), L4 (8.89%, p = 0.002), and L5 (10.00%, p = 0.006), but higher at S1 (21.11%, p = 0.964), T12 (15.56%, p = 0.031), and iliac levels (15.56%, p = 0.001). Pedicular section exhibited the highest loosening (37 cases). VAS and ODI scores improved significantly in both groups, with better outcomes in the two-stage group at the 48. months (p < 0.001). The two-stage surgical approach significantly reduces screw loosening in patients with osteopenia and osteoporosis undergoing dynamic stabilization surgery, offering enhanced stability and better clinical outcomes.

Comparison of Lumbar Stabilization Exercise and Flexibility Exercise on Lumbal Flexibility in Chronic Mechanical Lower Back Pain (Study on Online Motorcycle Drivers)

Comparison of Lumbar Stabilization Exercise and Flexibility Exercise on Lumbal Flexibility in Chronic Mechanical Lower Back Pain (Study on Online Motorcycle Drivers)

Effects of Lumbar Stabilization Exercise with Abdominal Strengthening Exercise in Improving Trunk Stability for Patients with Stroke

Effects of Lumbar Stabilization Exercise with Abdominal Strengthening Exercise in Improving Trunk Stability for Patients with Stroke

A Comparative Study to Analyze the Effect of Lumbar Stabilization and Conventional Back Extension Exercises on Mechanical Pain in Patients with Chronic Low Back Pain in Greater Noida

Lumbar discomfort is a major problem due to its harmful effects on health and high frequency in the general population. Depending on where and how long the pain lasts, there are three general categorizations for Lumbar discomfort: acute less than 6 weeks, sub-acute 6 to 12 weeks, and chronic more than 12 weeks. Several theories concerning the cause of nonspecific LBP feature poor posture, low body mass, hamstring flexibility, psychological discomfort, diminished trunk extensor endurance, and faulty muscular control of trunk. Pain in the lower back is a challenging illness which can result from injuries pertaining to the muscles and ligaments providing support vertebral column or from overuse or strain. One common treatment method for Lumbar discomfort is exercise therapy. This includes diverse forms of therapies including muscular strengthening, several forms of flexibility and stretching, and cardiovascular exercise for overall physical fitness. Normally, the stabilization system's job is to give the spine enough stability to meet the demands of changing circumstances immediately due to the posture changes with static and dynamic loads. As Per traditional understanding, spinal stabilization primarily relies on spinal biomechanics, the intervertebral disc, spinal ligaments, and osseous components. The stabilization and mobility of the lumbar spine can be facilitated by any muscle that exits the lumbar region. However, according to certain research, the lumbar multifidus and transverses abdominis muscles are very crucial for the stability of the lumbar segment. There is preliminary data indicating that those with long-term Lumbar discomfort do not properly recruit their core muscles and display core weakness13. Standard Exercise for back extension and exercises for lumbar stability both are used to treat low back discomfort. Thus, an effort is undertaken to compare and investigate the benefits of traditional back extension exercises and lumbar stabilization activities in patients with chronic Lumbar discomfort.

Comparison of the Effects of Lumbar Stabilization Exercise According to the Presence or Absence of Gluteus Medius Muscle Weakness in Chronic Lower Back Pain Patients with Lumbar Instability

Comparison of the Effects of Lumbar Stabilization Exercise According to the Presence or Absence of Gluteus Medius Muscle Weakness in Chronic Lower Back Pain Patients with Lumbar Instability

Research Progress on the Effect of Unilateral Biportal Endoscopic on Lumbar Stability in the Treatment of Lumbar Disc Herniation

Research Progress on the Effect of Unilateral Biportal Endoscopic on Lumbar Stability in the Treatment of Lumbar Disc Herniation

Safety and feasibility of mini-open Wiltse approach in posterolateral lumbar stabilization and fusion: intra- and post-operative evaluation

BackgroundExpected operative challenges in minimally invasive spine surgeries as a result of restricted surgical field, unfamiliarity with surgical approaches and fear of complications are behind the preference of using traditional "open" spine surgery.ObjectivesTo evaluate the safety and feasibility of mini-open Wiltse approach in comparison with the conventional midline approach for posterolateral lumbar stabilization and fusion.Patients and methodsA retrospective comparative study conducted on 49 patients with low grade single level lumbar spondylolithesis who were surgically treated in our Department between May 2020 and May 2022. Patients who were surgically treated with traditional midline approach were included in group (A) and patients in whom the mini-open Wiltse approach was used, were assigned to group (B). The two groups were compared regarding various intra and postoperative parameters.ResultsGroup (A) included 27 patients (55.1%) operated upon with the classic midline approach and 22 patients (44.9%) were surgically treated using the Wiltse approach (group B). The mean patients' age (50.43 ± 5.538) years and L4-5 was the most commonly affected level (71.4%). The intra-operative parameters (operation time, blood loss and fluoroscopy time) showed significant lower results (P < 0.001) among patients of group (B). No cases in the group (B) required blood transfusion versus 5 cases in group (A) (P = 0.033). Postoperatively, the Oswestry Disability Index (ODI) and Visual analogue scale (VAS) scores were significantly improved in each group in comparison to the preoperative scores (P < 0.001). However, after 3 months the ODI score in group (B) was superior to that in group (A) (P = 0.045) and postoperative VAS score in group (B) was significantly improved compared to that in group (A) at discharge (P = 0.016), and also after 1 and 3 months (P < 0.001). Patients operated with Wiltse approach had a shorter duration of hospital stay but the difference was not statistically significant (P = 0.090).ConclusionsBecause of minimal trauma to the muscles and soft tissues, the mini-open Wiltse approach can be faster, safer and requires less recovery time as opposed to the classic midline approach.

The effects of lumbar stabilization exercises with and without jaw movements in non-specific low back pain (A randomized controlled trial).

This study aimed to investigate the added effect of jaw clenching on the efficacy of lumbar stabilization exercises to manage chronic non-specific low back pain. This randomized controlled trial was conducted at the Sindh Institute of Physical Medicine and Rehabilitation (SIPM&R) Karachi from April 2021 to April 2023. Eighty patients with chronic non-specific low back pain participated in this study. Forty patients each were randomly allocated to the lumbar stability exercise (LSE) group' and the lumbar stability exercise with teeth clenching (LSETC) group. Patients in both groups performed respective exercises twice weekly for 12 weeks. The Numeric Pain Rating Scale (NPRS), Roland Morris Disability Questionnaire (RMDQ), and Pressure Biofeedback Unit (PBU) were used to assess pain, disability, and muscle endurance respectively. Data were collected at the baseline, after six weeks and 12 weeks of intervention. A p-value of <0.05 was considered statistically significant. Both groups showed statistically significant improvements in pain, disability, and muscle endurance. Upon further stratification, participants aged 20-30 years in the LSETC group showed significantly higher scores than the LSE group for NPRS, RMDQ, and PBU after 12 weeks. Overall, the LSETC group showed relatively higher improvement in mean scores for NPRS, RMDQ, and PBU than the LSE group. Lumbar stabilization exercises with and without jaw movement are effective for the treatment of chronic non-specific low back pain. The addition of teeth clenching enhanced the effectiveness of lumbar stability exercises, especially in young adults. Trial Registration: Clinicaltrials.gov (NCT04801212), Prospectively registered on March 16, 2021.

Comparison of trunk muscle activity during lumbar stabilization exercises on stable and unstable surfaces.

Lumbar stabilization exercises (LSE) provide dynamic trunk stability, promote muscle strength and endurance, and improve low back pain rehabilitation and performance. To clarify the differences in trunk muscle activity during LSEs on stable and different unstable surfaces. Fifteen healthy males performed three exercises (elbow-toe, hand-knee, and side bridge) on stable (floor) and unstable surfaces. Muscle activity of the bilateral rectus abdominis, internal oblique, external oblique, and erector spinae were recorded. Data were compared using the Friedman test. Pairwise comparisons were performed using Wilcoxon's signed rank test if significant differences were observed. In the elbow-toe exercise, muscle activity of the rectus abdominis and right internal oblique increased in the following order: floor, low-difficulty, and high-difficulty unstable surface. In the hand-knee exercise, muscle activity of the internal oblique on the lower-extremity elevated side, external oblique, and erector spinae on the upper-extremity elevated side were greater on unstable surface exercise performance. In the side bridge exercise, rectus abdominis muscle activity was highest on a high-difficulty unstable surface. Trunk muscle activity increased during exercise on unstable surfaces. Since the effects of unstable surfaces vary depending on muscle and exercise types, exercise difficulty and surface stability must be considered accordingly.

Effect Of Improving Lumbar Mobility, Spinal Stability ; With Core Stability Training To Achieve Per-sonal Best Runner

Running consists of simple basic movements, and to achieve these simple basic movements requires good mobility and stability, because the weakening of mobility and stability of the body causes misalignment or weakness of the legs so as to interfere with the absorption or propulsion phase in leg movement while running. Apply appropriate exercise methods to improve lumbar mobility and spinal stability. One training method that can be used is the core stability training method. Core stability is an exercise model to improve the ability to control the position of trunk movement through the pelvis and legs to allow optimal motion production. This study aims to ascertain whether core stability training can improve lumbar mobility and spinal stability in running athletes. The study used an experimental method with a research pattern using a group pretest-posttest design. 10 running athletes were sampled according to the criteria to be treated in the form of core stability training for 6 weeks. The athletes were assessed before and after training using the Functional Reach Test and Unilateral Hip Bridge Endurance. This study showed that there was a significant effect between core stability training and lumbar mobility (P = 0.000) and spinal stability (P = 0.000) in athletes. The results of this study show that the application of core stability exercises can increase the ability of lumbar mobility and spinal stability, so if the core stability exercises are done properly, they can increase stability in the spine and mobility in the lumbar, which causes dynamic limb movement to be more efficient. Key Words: athletics; Core Stability; Lumbar Mobility; spine stability.

Disability reduction following a lumbar stabilization exercise program for low back pain: large vs. small improvement subgroup analyses of physical and psychological variables

BackgroundLittle is known about why patients with low back pain (LBP) respond differently to treatment, and more specifically, to a lumbar stabilization exercise program. As a first step toward answering this question, the present study evaluates how subgroups of patients who demonstrate large and small clinical improvements differ in terms of physical and psychological changes during treatment.MethodsParticipants (n = 110) performed the exercise program (clinical sessions and home exercises) over eight weeks, with 100 retained at six-month follow-up. Physical measures (lumbar segmental instability, motor control impairments, range of motion, trunk muscle endurance and physical performance tests) were collected twice (baseline, end of treatment), while psychological measures (fear-avoidance beliefs, pain catastrophizing, psychological distress, illness perceptions, outcome expectations) were collected at four time points (baseline, mid-treatment, end of treatment, follow-up). The participants were divided into three subgroups (large, moderate and small clinical improvements) based on the change of perceived disability scores. ANOVA for repeated measure compared well-contrasted subgroups (large vs. small improvement) at different times to test for SUBGROUP × TIME interactions.ResultsStatistically significant interactions were observed for several physical and psychological measures. In all these interactions, the large- and small-improvement subgroups were equivalent at baseline, but the large-improvement subgroup showed more improvements over time compared to the small-improvement subgroup. For psychological measures only (fear-avoidance beliefs, pain catastrophizing, illness perceptions), between-group differences reached moderate to strong effect sizes, at the end of treatment and follow-up.ConclusionsThe large-improvement subgroup showed more improvement than the small-improvement subgroup with regard to physical factors typically targeted by this specific exercise program as well as for psychological factors that are known to influence clinical outcomes.

Short-term lumbar disc and lumbar stability changes of one-hole split endoscope technique treatment of spinal stenosis

ObjectiveInvestigating the early biomechanical effects of the one-hole split endoscope (OSE) technique on lumbar spine after decompression surgery.MethodsA retrospective analysis was conducted on 66 patients with lumbar spinal stenosis (LSS) who underwent OSE technique surgery at the affiliated hospital of Binzhou Medical University from September 2021 to September 2022. The patients had complete postoperative follow-up records. The mean age was (51.73 ± 12.42) years, including 33 males and 33 females. The preoperative and postoperative imaging data were analyzed, including disc height (DH), foraminal height (FH), lumbar lordosis angle (LLA), changes in disc angle, anterior-posterior translation distance, and lumbar intervertebral disc Pfirrmann grading. The visual analogue scale (VAS) was applied to evaluate the severity of preoperative, postoperative day 1, postoperative 3 months, and final follow-up for back and leg pain. The Oswestry Disability Index (ODI) was applied to assess the functionality at all the listed time points. The modified MacNab criteria were applied to evaluate the clinical efficacy at the final follow-up.ResultsIn 66 patients, there were statistically significant differences (p < 0.05) in DH and FH at the affected segments compared to preoperative values, whereas no significant differences (p > 0.05) were found in DH and FH at the adjacent upper segments compared to preoperative values. There was no statistically significant difference in the LLA compared to preoperative values (p > 0.05). Both the affected segments and adjacent upper segments showed statistically significant differences in Pfirrmann grading compared to preoperative values (p < 0.05). There were no statistically significant differences in the changes in disc angle or anterior-posterior translation distance in the affected or adjacent segments compared to preoperative values (p > 0.05). The VAS scores for back and leg pain, as well as the ODI, significantly improved at all postoperative time points compared to preoperative values. Among the comparisons at different time points, the differences were statistically significant (p < 0.05). The clinical efficacy was evaluated at the final follow-up using the modified MacNab criteria, with 51 cases rated as excellent, 8 cases as good, and 7 cases as fair, resulting in an excellent-good rate of 89.39%.ConclusionsThe OSE technique, as a surgical option for decompression in the treatment of LSS, has no significant impact on lumbar spine stability in the early postoperative period. However, it does have some effects on the lumbar intervertebral discs, which may lead to a certain degree of degeneration.

Selective load control of lumbar muscles in robot-assisted isometric lumbar stabilization exercise

Lumbar stabilization exercises are commonly employed in the rehabilitation of patients with low back pain. However, many patients discontinue these exercises, generally calisthenics using various postures or tools, due to the difficulty of providing an appropriate exercise load intensity. This challenge results in an inability to apply the desired strength to the target lumbar muscles and sometimes leads to an excessive load on unintended areas during calisthenics. Consequently, a method that enables patients to exercise continuously and progressively recover is required, specifically one that can target the lumbar muscles with a desired load. To address this issue, we propose a rehabilitation assistive device that quantitatively controls the lumbar spine load. In isometric lumbar stabilization exercises, our method involves precise compensation for gravity. The device, equipped with a series elastic actuator, is positioned beneath the patient in a lying posture. It applies an assistive force in the direction opposite to gravity, enabling precise control of the load on the lumbar region and reducing the vertical load on the spine. To validate the effectiveness of our proposed method, we conducted experiments with 20 healthy subjects across three exercises and analyzed the electromyography signal using nonparametric statistical methods. Our objective was to determine whether the load on the target lumbar muscles could be precisely and gradually controlled. The statistical results indicate that exercises performed using the proposed device produce statistically significant load changes in the target lumbar muscles.