Answer to the Letter to the Editor of J. Steele et al. concerning manuscript 'is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in targeted aspects(s) of performance? A systematic review'. Eur Spine J 21(4):575-598, by F. Steiger, B. Wirth, E.D. de Bruin, A.F. Mannion (2012)

摘要

We thank the authors for their interest in our work and their letter to the editor. However, we must correct them in their assertion that we did not consider any of the research using isolated lumbar extension resistance exercise. Whilst the included articles may not have used the specific makes of device mentioned in their letter ("MedX Lumbar Extension" and "Backup Dynamometer"), a number of studies [1-4] had used the David Back Clinic DBC110 back extension device, which also purports to isolate the extension movements to the lumbar region using appropriate restraint mechanisms for the pelvis (for details see Fig. 2 and "Discussion" in [3]). These studies were among those that did examine the association between the changes in performance and the changes in pain/disability, finding no significant correlations. Hence, whilst it may well turn out to be true that without the use of appropriate restraint mechanisms for the pelvis to isolate the lumbar extensors neither lumbar extension strength nor pain/disability shows improvement as a result of training, it also seems to be the case that even after a programme of training with the use of appropriate restraint mechanisms, lumbar extension strength/endurance and clinical outcomes show improvements but the two do not necessarily correlate.