Article

Chronic low back pain (CLBP) is prevalent, costly, and acknowledged as
multifactorial in nature. However, deconditioning of the lumbar extensor
musculature may be a common factor. Thus specific resistance exercise is often
recommended. Many resistance exercises for the lumbar extensors exist, although
recent evidence suggests that isolated lumbar extension (ILEX) resistance
training may best for conditioning these muscles. Thus this review aimed to
examine the use of ILEX resistance training in participants with CLBP to provide
a best-evidence synthesis for practitioners and clinicians. LITERATURE SURVEY:
Reference lists from previous reviews were searched in addition to SPORTDiscus,
PubMed, and Google Scholar databases up to May 2014 using search terms including
combinations and synonyms of "isolation," "lumbar extension," "lumbar exercise,"
"lumbar strength," "lumbar endurance," "lumbar spine," "low back exercise,"
"CLBP," "pain," and "disability." METHODOLOGY: A "snowballing"-style literature
search was used that involved an emergent approach. Studies examining ILEX
resistance training as an intervention in symptomatic CLBP populations reporting
pain, disability, or global perceived outcomes (GPO) as outcomes were examined.
Pain and disability were outcomes and were compared to consensus guidelines for
minimal clinically important changes. Single case reports were excluded.
SYNTHESIS: Results suggest that ILEX resistance training produces significant and
meaningful improvements in perceived pain, disability, and GPOs, as part of a
multiple intervention or stand-alone approach. A low frequency (once per week)
yet high intensity of effort (to momentary muscular failure) approach using
either full or limited range-of-motion ILEX resistance training appears to be
sufficient and best for significant and meaningful outcomes. Limited comparative
studies between ILEX resistance training and other specific exercise approaches
exist; however, only limited evidence supports ILEX resistance training as being
more effective. CONCLUSIONS: These findings highlight ILEX resistance training as
effective for significant and meaningful improvements in perceived pain,
disability, and GPOs for CLBP participants. Further research should elucidate
comparisons between ILEX resistance training and other specific exercise
approaches and should clarify whether lumbar extensor conditioning is the
mechanism responsible for the improvements reported.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS