Steiger et al. 2011: relationships and specificity in CLBP rehabilitation through exercise

Steele, James; Bruce-Low, Stewart

doi:10.1007/s00586-012-2449-y

Cited by 7 publications

(4 citation statements)

References 5 publications

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“…The Cochrane reviews have been specifically criticized for this flaw and their wide-sweeping conclusions [213][214][215][216] . Indeed we have also raised this issue of specificity 60,200,217,218 . As noted, research has shown that the lumbar extensors are notoriously difficult to train unless the pelvis is appropriately restrained in order to provide ILEX 183,186,[205][206][207][208][209][210]219 .…”

Section: Discussionmentioning

confidence: 92%

A reappraisal of the deconditioning hypothesis in low back pain: review of evidence from a triumvirate of research methods on specific lumbar extensor deconditioning

Steele

Bruce-Low

Smith

2014

Current Medical Research and Opinion

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The hypothesis of specific lumbar extensor deconditioning as being a causal factor in LBP is presently well supported. It is by no means the only causative factor and further research should more rigorously test this hypothesis addressing the methodological issues highlighted regarding previous studies. However, its role suggests specific exercise may be a worthwhile preventative and rehabilitative approach.

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Section: Discussionmentioning

confidence: 92%

A reappraisal of the deconditioning hypothesis in low back pain: review of evidence from a triumvirate of research methods on specific lumbar extensor deconditioning

Steele

Bruce-Low

Smith

2014

Current Medical Research and Opinion

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“…However, there are controversial opinions concerning the relationship between improving trunk muscle performance (i.e., strength/endurance) and relief of painful symptoms and disability ( 54 ). We identify that this criticism is related to the lack of a specific exercise treatment to halt LBP and evidence for casual relationship between changes in strength or CSA and pain and disability level, respectively ( 55 ).…”

Section: Exercise-training Regimes In Nsclbp: the Story So Farmentioning

confidence: 99%

“…The conditioning of musculature by progressive resistance exercise improves muscle hypertrophy, strength/endurance performance, and cardiovascular capacity ( 56 ). In addition, therapeutic training that improves both of the former parameters was found to relieve symptoms of CLBP and disability ( 54 , 57 ) related to musculoskeletal disorders. There is also evidence for a combination of electrical stimulation or ultrasound therapy and exercises in increasing quality of life by improving pain, muscle strength/endurance and spine mobility ( 58 ).…”

Section: Exercise-training Regimes In Nsclbp: the Story So Farmentioning

confidence: 99%

Does a Better Perfusion of Deconditioned Muscle Tissue Release Chronic Low Back Pain?

et al. 2018

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Non-specific chronic low back pain (nsCLBP) is a multifactorial condition of unknown etiology and pathogenesis. Physical and genetic factors may influence the predisposition of individuals to CLBP, which in many instances share a musculoskeletal origin. A reduced pain level in low back pain patients that participate in exercise therapy highlights that disuse-related muscle deconditioning may predispose individuals to nsCLBP. In this context, musculoskeletal pain may be the consequence of capillary rarefaction in inactive muscle as this would lower local tissue drainage and washing out of toxic waste. Muscle activity is translated into an angio-adaptative process, which implicates angiogenic-gene expression and individual response differences due to heritable modifications of such genes (gene polymorphisms). The pathophysiologic mechanism underlying nsCLBP is still largely unaddressed. We hypothesize that capillary rarefaction due to a deconditioning of dorsal muscle groups exacerbates nsCLBP by increasing noxious sensation, reducing muscle strength and fatigue resistance by initiating a downward spiral of local deconditioning of back muscles which diminishes their load-bearing capacity. We address the idea that specific factors such as angiotensin-converting enzyme and Tenascin-C might play an important role in altering susceptibility to nsCLBP via their effects on microvascular perfusion and vascular remodeling of skeletal muscle, inflammation, and pain sensation. The genetic profile may help to explain the individual predisposition to nsCLBP, thus identifying subgroups of patients, which could benefit from ad hoc treatment types. Future therapeutic approaches aimed at relieving the pain associated with nsCLBP should be based on the verification of mechanistic processes of activity-induced angio-adaptation and muscle-perfusion.

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“…In a recent meta‐regression, the authors noted first that exercise type may be an important factor that explains the heterogeneity between “exercise” studies, yet because of the limitations of the methodology used, the authors were unable to analyze the trials included based on differences in this characteristic [36]. This issue of specificity of exercise type has also been discussed more recently and continues to be suggested as a potentially important factor to consider [37,38].…”

Section: Introductionmentioning

confidence: 99%

A Review of the Clinical Value of Isolated Lumbar Extension Resistance Training for Chronic Low Back Pain

Steele

Bruce-Low

Smith

2014

PM&R

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These findings highlight ILEX resistance training as effective for significant and meaningful improvements in perceived pain, disability, and GPOs for CLBP participants. Further research should elucidate comparisons between ILEX resistance training and other specific exercise approaches and should clarify whether lumbar extensor conditioning is the mechanism responsible for the improvements reported.

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Steiger et al. 2011: relationships and specificity in CLBP rehabilitation through exercise

Cited by 7 publications

References 5 publications

A reappraisal of the deconditioning hypothesis in low back pain: review of evidence from a triumvirate of research methods on specific lumbar extensor deconditioning

A reappraisal of the deconditioning hypothesis in low back pain: review of evidence from a triumvirate of research methods on specific lumbar extensor deconditioning

Does a Better Perfusion of Deconditioned Muscle Tissue Release Chronic Low Back Pain?

A Review of the Clinical Value of Isolated Lumbar Extension Resistance Training for Chronic Low Back Pain

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