Article

OBJECTIVE: To compare the effects of 4 months of isolated lumbar resistance
exercise and total body resistance exercise on walking performance in obese,
older adults with chronic low back pain. A secondary analysis examined whether
responsiveness to training modulated walking improvement. DESIGN: Randomized,
controlled trial. SETTING: Research laboratory affiliated with tertiary care
facility. METHODS : Participants (N = 49; 60-85 years) were
randomized into a 4-month resistance exercise intervention (TOTRX), lumbar
extensor exercise intervention (LEXT), or a control group (CON). MAIN OUTCOME MEASUREMENTS: Walking performance, maximal low back strength and leg strength,
and average resting and low back pain severity score (from an 11-point numerical
pain rating scale; NRSpain) were collected at baseline and month 4. RESULTS: The
TOTRX and LEXT improved lumbar extensor strength relative to CON, and the TOTRX
(P < .05). NRSpain scores at month 4 were lowest in the TOTRX group compared with
the LEXT and CON groups, respectively (2.0 +/- 1.7 points vs 3.7 +/- 2.6 points
and 4.6 +/- 2.4 points; P < .006). A total of 53% and 67% of participants in the
TOTRX and LEXT groups were responders who made lumbar extensor strength gains
that achieved >/=20% greater than baseline values. Although the TOTRX
demonstrated the greatest improvement in walking endurance among the intervention
groups, this did not reach significance (10.1 +/- 12.2% improvement in TOTRX vs
7.4 +/- 30.0% LEXT and -1.7 +/- 17.4% CON; P = .11). Gait speed increased most in
the TOTRX (9.0 +/- 13.5%) compared with the LEXT and CON groups (P < .05). The
change in lumbar extensor strength explained 10.6% of the variance of the
regression model for the change in walking endurance (P = .024). CONCLUSIONS: The use of LEXT and TOTRX produced similar modest improvements in patients' walking
endurance. Lumbar extensor strength gain compared with leg strength gain is a
moderate but important contributor to walking endurance in obese older adults
with chronic low back pain. Responders to resistance exercise programs (event
those with only lumbar extension exercise) who make at least a 20% improvement in
strength can expect better improvement in walking endurance than those who do not
achieve this strength improvement.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS