A Randomized controlled trial of limited range of motion lumbar extension exercise in chronic low back pain

Steele, James, Bruce-Low, Stewart, Smith, Dave, Jessop, David and Osborne, Neil (2015) A Randomized controlled trial of limited range of motion lumbar extension exercise in chronic low back pain. Spine, 38 (15). pp. 1245-1252. ISSN 0362-2436

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Abstract

Study Design. Randomized controlled trial. Objective. To compare the effects of full range of motion (ROM) and limited ROM isolated lumbar extension exercise upon full ROM lumbar extension strength, ROM, perceived pain, and disability. Summary of Background Data. Limited ROM is common in chronic low back pain as is lumbar extensor deconditioning. Limited ROM exercise is a common prescription but is yet to be empirically tested. Methods. Males (n = 21) and females (n = 17) with nonspecific chronic low back pain were initially recruited. Participants were randomized to either a full ROM (FullROM) or limited ROM (LimROM) training group or a control group. A total of 24 participants (males: n = 14, females: n = 10) completed the study and were included in analysis. The intervention lasted 12 weeks. FullROM and LimROM groups completed isolated lumbar extension resistance training once per week, performing one set of exercise at 80% of their maximal tested functional torque to failure. FullROM group trained through a full ROM. LimROM group trained through the mid 50% of their full ROM. Full ROM isolated lumbar extension strength, lumbar and standing ROM (Schobers test), perceived pain (visual analogue scale), and disability (Revised Oswestry Disability Index) were measured pre- and postintervention. Results. FullROM and LimROM significantly improved in full ROM lumbar extension strength, perceived pain, and disability compared with the control group. No changes occurred in lumbar or standing ROM. No significant differences were found between either FullROM or LimROM for any outcome measure. Changes in perceived pain and disability met minimal clinically important change values for FullROM (visual analogue scale, −30.3 + 25.76 mm and Oswestry Disability Index, −18.2 + 6.63 patients) and LimROM (visual analogue scale, −16.29 + 10.97 mm and Oswestry Disability Index, −12 + 5.16 patients). Conclusion. The results suggest that both FullROM and LimROM are equally effective in increasing full ROM lumbar extension strength and producing clinically meaningful improvement in perceived pain and disability. Level of Evidence: 2