THE EFFECTS OF SPINAL FLEXION AND EXTENSION EXERCISES AND THEIR ASSOCIATED POSTURES IN PATIENTS WITH ACUTE LOW-BACK-PAIN

Study Design. A prospective randomized clinical trial compared the eff ects of flexion and extension back exercises and postures among soldie rs with acute low back pain. Objective. To compare the immediate effec ts of back exercise on functional status, spinal mobility, straight le g raising, pain severity, and treatment satisfaction, and to determine whether spinal exercise during the acute stage of low back pain reduc es recurrent episodes of low back pain. Summary of Background Data. Co nflicting reports exist-concerning the efficacy of spinal flexion and extension exercises in patients with low back pain of varying duration . Poor study design and lack of functional outcomes characterize many of these studies. Methods. One-hundred-forty-nine subjects with acute low back pain received flexion exercise and pos: ture (n = 57), extens ion exercise and posture (n = 62), or no exercise or posture (n = 30) for 8 weeks. Outcomes were assessed 1, 2, 4 and 8 weeks after treatmen t onset. A questionnaire assessed the recurrence of lowback pain 6-12 months after study entry. Results. Flexion and extension exercise grou ps did not differ in any outcome over 8 weeks. After 1 week, both exer cise groups had reduced disability scores, a higher proportion returni ng to work, and fewer subjects with positive straight-leg raise compar ed with the control group. There was no difference among groups regard ing recurrence of low back pain after 6-12 months. Conclusions. There was no difference for any outcomes between the flexion or extension ex ercise groups. However, either exercise was slightly more effective th an no exercise when patients with acute low back pain were treated.