Immediate effects of isometric trunk stabilization exercises with suspension device on flexion extension ratio and strength in chronic low back pain patientss

J Back Musculoskelet Rehabil. 2019;32(3):431-436. doi: 10.3233/BMR-181298.

Abstract

Background: Recent clinical research has supported the use of suspension devices in rehabilitation procedures both in practice and in theory. Although a longitudinal study has reported on the use of suspension devices among asymptomatic subjects, it is necessary to investigate the immediate effects of suspension exercises in patients with CLBP.

Objective: The present study aims to investigate changes in neuromuscular activation after the prescription of suspension exercises in patients with CLBP. A secondary aim was to determine whether practical flexion and extension strength can be effectively enhanced.

Methods: Before and after suspension exercise, flexion extension (FE) ratio and trunk strength of flexion and extension were measured. Patients performed two types of suspension exercises: supine bridge and forward leaning exercises. The paired t-test was used to compare the FE ratio and strength data. Pearson correlation coefficient was performed to study the correlation between measured variables.

Results: Compared to the pre-exercise measurements, the flexion-extension ratio and trunk extension strength was significantly increased at the post-exercise measurement (p< 0.05). The FE ratio in the right lumbar erector spine muscle was significantly correlated with post-exercise trunk extension strength (p< 0.05).

Conclusions: For patients with chronic lower back pain, stimulation of the lumbar extensor muscle and of proprioception is effective both for strengthening lumbar extensors and for improving the flexion-extension ratio. Consequently, forward leaning and supine bridge exercises with a suspension device are beneficial for normalising neuromuscular control of the erector spinae muscles.

Keywords: Electromyography; extensor strengthening; forward leaning; sling.

MeSH terms

  • Adult
  • Chronic Pain / rehabilitation*
  • Electromyography
  • Exercise / physiology
  • Exercise Therapy / instrumentation*
  • Female
  • Humans
  • Low Back Pain / rehabilitation*
  • Lumbosacral Region
  • Male
  • Middle Aged
  • Muscle Strength*
  • Muscle, Skeletal / physiology*
  • Torso / physiology