LOW-BACK EXERCISES - EVIDENCE FOR IMPROVING EXERCISE REGIMENS

Despite the wide variety of exercises that are prescribed for the low hack, the scientific foundation to justify their choice is not as comp lete as one may think, or expect. Thus, the clinician must often call upon ''clinical opinion'' when selecting exercise. Given that low back tissues may need stressing to enhance their health but too much loadi ng call be detrimental, choosing the optimal exercise requires judgmen t based on clinical experience and scientific evidence. To assist in d eveloping better exercise programs, this review documents some recent biomechanical evidence from my laboratory and from laboratories of oth er researchers that has been reported in various publications in an at tempt to update clinicians on issues of low back exercise. Among the i ssues examined ar-e mechanisms of injury; the relative importance of ' 'strength'' (ie, maximum force a muscle can produce during a single ex ertion to create joint torque), ''flexibility,'' and ''endurance''; an d training to enhance stability. Finally, some specific exercises are described that have been shown to challenge muscle and enhance perform ance but that are performed in such a way as to minimize loading of th e spine to reduce the risk of injury exacerbation. These exercises for m a basic program for rehabilitation and maintenance of low back healt h.