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A Randomized Controlled Trial of the Effects of Isolated Lumbar Extension Exercise on Lumbar Kinematic Pattern Variability During Gait in Chronic Low Back Pain
Author(s) -
Steele James,
BruceLow Stewart,
Smith Dave,
Jessop David,
Osborne Neil
Publication year - 2016
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2015.06.012
Subject(s) - lumbar , physical medicine and rehabilitation , medicine , sagittal plane , low back pain , gait , physical therapy , kinematics , randomized controlled trial , biomechanics , surgery , anatomy , pathology , physics , alternative medicine , classical mechanics
Background Chronic low back pain (CLBP) is a multifactorial condition with a variety of symptoms, one of which is abnormal gait. The lumbar spine and its musculature are important in controlling gait, and in CLBP the lumbar extensors are often deconditioned. Because of this specific isolated lumbar extension, exercise often is recommended. It was therefore of interest to examine its effects of upon gait variability. Objective To examine the effects of isolated lumbar extension resistance training on lumbar kinematic variability during gait in participants with CLBP. Design Randomized controlled trial. Setting University Health, Exercise and Sport Science Laboratory. Participants Twenty‐four participants with nonspecific CLBP. Interventions Participants were randomly allocated to a 12‐week isolated lumbar extension exercise intervention (1×/week performing a single set to momentary muscular failure using a load equal to 80% max tested torque) or nontraining control period. Main Outcome Measurements Lumbar kinematics during gait, including angular displacement, kinematic waveform pattern (CV p ), and offset (CV o ) variability, were examined via 3‐dimensional analyses. Results No significant changes in displacement or CV o were found as a result of the intervention; however, a small but significant reduction in sagittal plane CV p (−20.90 ± 3.53%, effect size = 0.48, P = .044) occurred, indicating improved motor pattern replication through this movement plane. Conclusions Considering the role of the lumbar extensors in gait, and their common deconditioning in CLBP, an isolated lumbar extension resistance exercise intervention may reduce gait variability. These results suggest isolated lumbar extension exercise may specifically reduce sagittal plane variability, indicating improved motor pattern replication through this movement plane, perhaps attributable to the plane of movement used during the exercise.