Purpose: Low back pain (LBP) has becoming one of the most prevailing modern epidemics. This article addresses use of exercises with a rehabilitative device as a potent LBP therapy. Method: An experimental case series study centered on effectiveness of lumbar extension exercise on low back pain using the variable angle Roman chair (VARC) for individualized strength and resistance adjustment. Summary: The study has found that use of lumbar extension exercise with VARC for 8 weeks markedly improved conditions in low back pain patients, in not only pain, but also health status, physical function, and social function that had been impaired by their LBP. The clinical effectiveness warrants further study and suggests a potential for broad use of VARC for efficient LBP rehabilitation. Key words: exercise therapy, low back pain, rehabilitation
LOW BACK PAIN (LBP) is steadily becoming a momentous health care problem in the United States. LBP is not only the most common cause of disability, but also the most expensive health care problem in the United States. (1,2) Chronic LBP is the second most frequently offered reason for doctor visitation and third most common reason for hospitalization. In terms of costs, medical treatment and compensation results in approximately $16 billion to $50 billion spent per annum in the United States. (2) One third of all disability costs in the United States are related to LBP. (1) The prevalence of back pain is estimated to be somewhere between 14% and 40% in America, where 60% to 70% will experience some form of back pain in their lives at some point. (3) At any given time, 1% of the population will be temporarily disabled and not be able to perform their work responsibilities. (3) Peak prevalence is in the age group between 45 to 60 years of age. (3) Although the primarily affected group is the aforementioned, adolescents and adults of all ages report back pain.
Considering the prevalence of low back pain and the significant economic cost involved, the condition has broad implications. Effective diagnosis and treatment can relieve the suffering for a multitude of patients and at the same time save valuable health care resources. The traditional approaches to acute, subacute, or chronic low back pain have largely been passive modalities, medication, and rest. Active exercise has becoming an increasing choice by many health care practitioners since the mid-1980s after evidence that active "sports medicine" better serves the purpose of rehabilitation. (4-7) Evidence suggests that compromised trunk muscle, especially strength of the trunk extensor muscles, is a leading risk for low back injury. (8-11) There is an inverse relationship between trunk extension endurance and the likelihood for future low back pain, allowing the use of extensor muscle strength as a reliable predictor for back pain. (8,12,13) Consistently, back muscle strength training, especially progressive low back conditioning extensor exercises, has been shown to improve rehabilitation from low back pain. (10,12,14-18) Recent studies of acute LBP patients using magnetic resonance imaging have lent further support to the notion by demonstrating the...