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Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_2 | Pages 13 - 13
1 Feb 2018
LUMBAR STRENGTH AND ACTIVATION PATTERNS IN FOOTBALL PLAYERS WITH AND WITHOUT A HISTORY OF HAMSTRING INJURIES
Perrin C Bruce-Low S Arnold J Burnet S Holloway S Steele J
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Background & Purpose

The co-ordinated contraction of the kinetic chain is responsible for the dissipation of force. Weakness in the kinetic chain, such as the posterior oblique sling (POS), may increase the demand on additional muscles, such as the hamstrings, to compensate. The lumbar extensors may be particularly vulnerable in the kinetic chain, as they appear difficult to strengthen due to the dominant hip extensors. Therefore, this study aimed to investigate whether participants with a history of hamstring injuries presented with low back pain because of greater deficits in lumbar extensor strength, and impaired co-ordination of the POS.

Methods

Twenty male footballers were recruited (n: Injured- 9, Controls- 11). Isolated lumbar extension strength, low back pain, and the contraction time of muscles within the POS during a hip extension test were recorded. Participants were then grouped in either the injury or control group.

Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_2 | Pages 15 - 15
1 Feb 2018
VARIABILITY IN STRENGTH, PAIN AND DISABILITY CHANGES IN RESPONSE TO AN ISOLATED LUMBAR EXTENSION RESISTANCE TRAINING INTERVENTION IN PARTICIPANTS WITH CHRONIC LOW BACK PAIN
Steele J Fisher J Bruce-Low S Smith D Osborne N Newell D
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Purpose and Background

Strengthening the lumbar extensor musculature is a common recommendation for CLBP. Although reported as effective, variability in response in CLBP populations is not well investigated. This study investigated variability in responsiveness to isolated lumbar extension (ILEX) resistance training in CLBP participants by retrospective analysis of 3 RCTS.

Methods and Results

Data from 77 intervention participants was available (males = 43, females = 34) 37 control participants (males = 20, females = 17). Intervention participants all underwent 12wks of ILEX resistance training and changes in ILEX strength, pain (VAS) and disability (ODI) measured. True inter-individual response variability was examined through calculation of difference in the standard deviation of change scores for both control and intervention. Intervention participants were classified into using k-means cluster analysis for strength changes and using MCIC cut-offs for VAS and ODI. Analysis suggested true inter-individual responses to the intervention existed. Participants were classified for strength changes as low (n = 31), medium (n = 36), and high responders (n = 10). Participants were classified for VAS changes as negative (n = 3), non-responders (n = 34), responders (n = 15), and high responders (n = 19). Participants were classified for ODI changes as negative (n = 2), non-responders (n = 21), responders (n = 29), and high responders (n = 25).

Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_I | Pages 235 - 235
1 Mar 2010
THE EFFECT OF LUMBAR EXTENSION TRAINING WITH AND WITHOUT PELVIC STABILISATION ON LOW BACK PAIN AND LUMBAR EXTENSION STRENGTH
Smith D Bissell G Bruce-Low S Wright C
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Purposes and background of study: We compared the effects of lumbar muscle-strengthening programmes with and without pelvic stabilisation on low back pain (LBP). A dynamometer employing a stabilisation procedure (lumbar extension machine, MedX, Ocala, FL) is effective in improving strength and reducing LBP symptoms (Nelson et al., Orthopedics, 1995, 18,971–981), and researchers have hypothesised that this effectiveness is due to the pelvic stabilisation (Graves et al., Arch Phys Med Rehabil, 1994, 75,210–215). However, effects of the dynamometer with and without pelvic stabilisation on LBP have not been compared, so we examined this issue.

Methods and Results: Fifty-seven chronic LBP patients were randomly assigned to a lumbar extension training with pelvic stabilisation group (STAB; n=20), a lumbar extension without pelvic stabilisation group (NO-STAB; n=17) and a control group (n=20). STAB and NO-STAB participants completed one weekly session of dynamic variable resistance exercise (one set of 8–12 repetitions to fatigue) on the lumbar extension machine (with or without pelvic stabilisation) for 12 weeks. Pre- and post-test measures of self-reported LBP (101-point visual analogue scale; pre-test mean of 25), related disability (Oswestry disability index; pre-test mean of 34) and lumbar strength were taken. After the exercise programme, the STAB group increased significantly in lumbar strength at all joint angles, and decreased significantly in visual analogue and Oswestry scores. However, there were no significant changes in these variables in the NO-STAB and control groups.

Conclusion: Isolated lumbar extension exercise is very effective in reducing LBP in chronic patients. However, when the pelvis is not stabilised, otherwise identical exercises appear ineffective in reducing LBP.