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Long-term effects of lumbar flexion versus extension exercises for chronic axial low back pain: a randomized controlled trial.

ABSTRACT: This study aimed to compare the long-term effects of flexion- and extension-based lumbar exercises on chronic axial low back pain (LBP). This was a 1-year follow-up of a prospective, assessor-blind, randomized controlled trial. Patients with axial LBP (intensity ≥ 5/10) for > 6 months allocated to the flexion or extension exercise group. Patients underwent four sessions of a supervised treatment program and were required to perform their assigned exercises daily at home. Clinical outcomes were obtained at baseline, 1, 3, 6 months, and 1-year. A total of 56 patients (age, 54.3 years) were included, with 27 and 29 in the flexion and extension groups, respectively. Baseline pain and functional scales were similar between both groups. The mean (± standard deviation) baseline average back pain was 6.00 ± 1.00 and 5.83 ± 1.20 in the flexion and extension groups, respectively. At 1-year, the average pain was 3.78 ± 1.40 and 2.26 ± 2.62 (mean between-group difference, 1.52; 95% confidence interval 0.56-2.47; p = 0.002), favoring extension exercise. The extension group tended to have more improvements in current pain, least pain, and pain interference than the flexion group at 1-year. However, there was no group difference in worst pain and functional scales. In this controlled trial involving patients with chronic axial LBP, extension-based lumbar exercise was more effective in reducing pain than flexion-based exercises at 1-year, advocating lumbar extension movement pattern as a component for therapeutic exercise for chronic LBP.Clinical Trial Registration No.: NCT02938689 (Registered on www.clinicaltrial.gov ; first registration date was 19/10/2016).

SUBMITTER: Park CH

PROVIDER: S-EPMC10834418 | biostudies-literature | 2024 Feb

REPOSITORIES: biostudies-literature

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Long-term effects of lumbar flexion versus extension exercises for chronic axial low back pain: a randomized controlled trial.

Park Chul-Hyun CH Beom Jaewon J Chung Chun Kee CK Kim Chi Heon CH Lee Mi Yeon MY Park Myung Woo MW Kim Keewon K Chung Sun Gun SG

Scientific reports 20240201 1

This study aimed to compare the long-term effects of flexion- and extension-based lumbar exercises on chronic axial low back pain (LBP). This was a 1-year follow-up of a prospective, assessor-blind, randomized controlled trial. Patients with axial LBP (intensity ≥ 5/10) for > 6 months allocated to the flexion or extension exercise group. Patients underwent four sessions of a supervised treatment program and were required to perform their assigned exercises daily at home. Clinical outcomes were o ...[more]

PMID: 38302483

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Project description:Nonspecific low back pain (LBP), a prevalent condition with a lifetime prevalence of up to 84%, presents a considerable burden on individuals and healthcare systems. Isolated lumbar extension (ILEX) has been studied for its ability to exercise the lumbar region with more controlled activation of the erector spinae and other paravertebral muscles. It aims to serve as a specific resistance training method to improve outcomes related to pain, disability, and physical functionality in adults with nonspecific low back pain (LBP). This systematic review and meta-analysis aimed to evaluate and summarize the effects of ILEX in alleviating pain, reducing disability, and improving physical functionality in adults with chronic LBP. Searches were conducted on October 14, 2024, across key databases, including PubMed, Scopus, and Web of Science. Eligibility criteria included adults (> 18 years old) with chronic LBP participating in resistance training focused on ILEX, with comparators comprising true control or active control groups, all from randomized clinical trials. The RoB2 was used to assess the risk of bias in the studies, while the GRADE scale was employed to evaluate the certainty of the evidence. The meta-analysis calculated Hedges' g effect sizes (ES) with 95% CIs and PIs for main outcomes, using the DerSimonian and Laird random-effects model to address inter-study variability, I² for heterogeneity, and the extended Egger's test for publication bias, all performed with SPSS Software. After screening, a total of 8 randomized studies were included, with 381 participants overall. The results indicated a significant favorable effect of ILEX compared to the true control group in pain-related outcomes (ES = - 0.633, p = 0.004). However, there was a non-significant effect of ILEX compared to the true control group in disability-related outcomes (ES = - 0.292, p = 0.190) and isometric strength outcomes (ES = 0.967, p = 0.150). The GRADE scale indicated that the certainty of the evidence is very low.ILEX significantly reduces pain intensity in individuals with low back pain, indicating its potential as an effective intervention, but its impact on disability and physical functionality is less consistent, warranting cautious use alongside pelvic stabilization to optimize rehabilitation outcomes.

Dataset Information

Long-term effects of lumbar flexion versus extension exercises for chronic axial low back pain: a randomized controlled trial.

Publications

Long-term effects of lumbar flexion versus extension exercises for chronic axial low back pain: a randomized controlled trial.

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