Isolated Lumbar Extensor Strengthening Versus Regular Physical Therapy in an Army Working Population With Nonacute Low Back Pain: A Randomized Controlled Trial

Abstract

Consistent with prior evidence, specific back strengthening does not seem to offer incremental benefits in LBP management compared with regular PT care that mainly consists of general exercise therapy. (ISRCTN identifier ISRCTN19334317.)

Resistance training in musculoskeletal rehabilitation: a systematic review

“…Long-term benefits after RT intervention can be observed in patients with CLBP20 but also appear to be further influenced by extrinsic factors such as physical activity, smoking and treatment outcome expectations 21. Isolated data have suggested that RT offers no benefits over normal physical therapy in the treatment of CLBP;22 however, such conclusions are not supported by the majority of the current literature.…”

A literature review reveals that trials evaluating treatment of non-specific low back pain use inconsistent criteria to identify serious pathologies and nerve root involvement

“…13 Ambiguous phrases which may or may not have been referring to serious pathologies were used in a further nine (18%) papers (see Table 2). Several of the studies we rated as ambiguous, referred to 'specific' [14][15][16][17][18][19] or exact diagnoses of LBP (Table 2). Six studies (12%) did not report any exclusion criteria for identifying patients with potential serious pathology.…”

“…14 Hernandez et al 15 Yakhno et al 16 Helmhout et al 17 Helmhout et al 19 Smeets et al 20 Inoue et al 21 Yelland et al 49 Yip et al 50 Chrubasik et al 51 Steenstra et al 52 Rasmussen et al 53 Preyde et al 54 Seferlis et al 55 Storheim et al 56 Lierz et al…”

“…In half of the included studies, the criteria used, while alluding to nerve root involvement, were not explained adequately for us to determine the types of patients included or excluded (Table 1, category 5). Examples of terms used that we considered ambiguous were sciatic nerve involvement, 15 current nerve root pathology, 20 other relevant neurologic diseases, 19 and leg symptoms. 21 Table 1 presents the types of patients included in each study, based on the reported exclusion criteria for nerve root involvement.…”

Prevalence of Modic Changes in Active Duty Military Men With Lumbar Disk Herniation Who Were Scheduled for Surgery

“…It is obvious that the enlisted category is associated with a higher-than-average risk of disability related to the lumbar spine due to military tasks as repetitive lifting, frequent bending and twisting, pushing and pulling, and awkward body postures. 20 Nevertheless, an indisputable correlation between rank and physical workload has not been established yet.…”