Lumbar extension exercise (MedX) - Treatment for chronic low back pain - Review and meta-analysis

Aim: Low back pain ranks high among the reasons for physican office visits and is costly in terms of medical treatment. A number of studies have shown that low back pain patients have significantly lower trunk strength when c ompared with healthy controls. The working hypothesis at the beginning of t he 1990's was that low back pain patients could be treated effectively usin g lumbar extension exercise. Method: 21 papers and abstracts reporting on l umbar extension training are rated. Validation was performed for each paper according to the internationally accepted system of the American Associati on of Spine Surgery in types A-E. Results: 1100 cases from 21 publications and abstracts dealing with lumbar extension training were evaluated. We did not find a single type A study in our search. The clinical outcome of the studies was a reduction of pain, improvement of range of motion, improvemen t of spinal condition and of the lumbar extension strength. Conclusion: Pro spective, randomized, controlled studies with long-term results should help to delineate further the role of isolated lumbar extension exercise for th e treatment of low back pain and to test the efficancy compared to other me thods of care.