[Strengthening lumbar extensors--therapy of chronic back pain--an overview and meta-analysis].
OBJECTIVE
Low back pain ranks high among the reasons for physician office visits and is costly in terms of medical treatment. A number of studies have shown that low back pain patients have significantly lower trunk strength when compared with healthy controls. The working hypothesis at the beginning of the 1990's was that low back pain patients could be treated effectively using lumbar extension exercise.


METHODS
21 papers and abstracts reporting on lumbar extension training are rated. Validation was performed for each paper according to the internationally accepted system of the American Association of Spine Surgery in types A-E.


RESULTS
1100 cases from 21 publications and abstracts dealing with lumbar extension training were evaluated. We did not find a single type A study in our search. The clinical outcome of the studies was a reduction of pain, improvement of range of motion, improvement of spinal condition and of the lumbar extension strength.


CONCLUSIONS
Prospective, randomized, controlled studies with long-term results should help to delineate further the role of isolated lumbar extension exercise for the treatment of low back pain and to test the efficacy compared to other methods of care.
Miltner
O
O
Orthopädische Universitätsklinik, RWTH Aachen. Miltner.Heuter@t-online.de
Wirtz
D C
DC
Siebert
C H
CH
D005081:Exercise Therapy; D006801:Humans; D007537:Isometric Contraction; D017116:Low Back Pain / Q000534:rehabilitation*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome