Spinal height change in response to sustained and repetitive prone lumbar extension after a period of spinal unloading

Sustained versus repetitive standing trunk extension results in greater spinal growth and pain improvement in back pain:A randomized clinical trial

BACKGROUND

McKenzie standing trunk extension exercises have been used for the management of low back pain (LBP). However, no study to date has investigated the effect of standing trunk extension postures on spinal height and clinical outcomes.

OBJECTIVE

To evaluate in subjects with LBP following a period of trunk loading how spinal height, pain, symptoms' centralization and function outcome measures respond to two standing postures interventions: (1) repetitive trunk extension (RTE) and (2) sustained trunk extension (STE).

METHODS

A consecutive sample of convenience of people with LBP were recruited to participate in 2-session physical therapy using either RTE or STE in standing.

RESULTS

Thirty participants (18 women) with a mean age of 53 ± 17.5 years completed the study. The first session resulted in spinal height increase (spinal growth) of 2.07 ± 1.32 mm for the RTE intervention and 4.54 ± 1.61 mm for the STE group (p< 0.001; ES = 1.67), while the second session (2-week following the first session) resulted in spinal growth of 2.39 ± 1.46 mm for the RTE group and 3.91 ± 2.06 mm for the STE group (p= 0.027; ES = 0.85). The STE group presented with the larger reduction in most pain from 6 to 2 as compared to the RTE group from 6 to 4 between Session 1 and Session 2 (p< 0.001). There was no difference between the groups in Modified Oswestry score and symptoms centralization (p= 0.88 and p= 0.77, respectively).

CONCLUSION

People with LBP experienced greater spine growth and improvements of pain during standing STE as compared to RTE. People with LBP could use such postures and movements to alleviate their LBP and improve spine height while in a weight bearing position.

Innovative seated vertical lumbar traction allows simultaneous computer work while inducing spinal height changes similar to supine lying

BACKGROUND

Lumbar intervertebral disc height loss has been associated with spinal height change (SHC) and low back pain (LBP), including stenosis. Non-invasive methods to improve disc height loss require forms of lying down, which are unconducive to computer work.

OBJECTIVE

Intermittent vertical traction (VT) integrated with seated computer work may provide ergonomic alternatives for increasing SHC to promote LBP relief. The primary aim was to develop and introduce a safe VT prototype and dosage to induce and measure SHC. Prototype comfort and LBP ratings were exploratory secondary aims.

METHODS

Forty-one participants were stadiometry-measured for pre- and post-intervention SHC from seated VT at 35% body weight removed, supine lying (SL), and sitting at a computer (SIT) without VT. Pain ratings were recorded for those self-reporting LBP. VT prototype evaluations were compiled from a 3-question, 7-point Likert-style survey.

RESULTS

SHC increased by 3.9 ± 3.4 mm in VT, 1.7 ± 3.4 mm in SIT, and 4.3 ± 3.1 mm in SL (P< 0.000). Post hoc findings were significant between VT and SIT (P< 0.000), and SL and SIT (P< 0.000). VT and SL LBP ratings both decreased, but not SIT.

CONCLUSION

Intermittent seated VT is a promising alternative for postural relief during seated computer work, producing SHC similar to lying down without compromising workflow.

Assessment of Lumbar Spine Height Following Sustained Lumbar Extension Posture: Comparison Between Musculoskeletal Ultrasonography and Stadiometry

OBJECTIVES

The purpose of this study was to correlate sitting height measured by stadiometry with lumbar spine height (LSH) modifications measured by musculoskeletal ultrasonography (MSU).

METHODS

Eighteen healthy young adults were recruited for this study (mean age: 21.5 ± 1.5 years). All subjects were tested in the following sequence: (1) lying supine for 10 minutes, (2) sitting under loaded (9.5 kg) and unloaded conditions for 5 minutes each, (3) lying supine for 15 minutes with passive lumbar extension, and (4) sitting unloaded for 5 minutes. Both stadiometry and MSU measurements were taken after each step of the testing sequence.

RESULTS

Following the loaded sitting step, sitting height (measured by stadiometry) decreased by 3.4 ± 1.6 mm, whereas following sustained lumbar extension, sitting height increased by 5.4 ± 3.5 mm (P < .05). Following loaded sitting and sustained lumbar extension, LSH decreased by 3.8 ± 1.7 mm and increased by 6.2 ± 4.1 mm, respectively (P < .05). On the basis of the mean differences (between the different steps of the testing sequence), the mean correlation coefficient and the mean coefficient of determination between stadiometry and MSU measurements were calculated at 0.93 ± 0.07 and 0.88 ± 0.13, respectively, and no statistical differences were observed (P > .05).

CONCLUSIONS

In vivo measurements of sitting height changes, measured using stadiometry, were strongly correlated with LSH changes, measured using ultrasonography.

Evidence on the Ability of a Pneumatic Decompression Belt to Restore Spinal Height Following an Acute Bout of Exercise

OBJECTIVE

The purpose of this study was to evaluate the ability of a pneumatic decompression belt to restore spinal height lost following an acute bout of exercise that induced compression.

METHODS

This study implemented a test-retest repeated measures design in which twelve participants (male = 10, female = 2) age, 21.5 ± 1.0 years; height, 179.0 ± 7.70 cm; weight, 84.0 ±11.5 kg; were recruited from a university population and acted as their own control. All participants were healthy with no previous history of disabling back pain, and were frequent weight trainers. A stadiometer was used to measure spinal height at baseline, then following an acute bout of exercise and then again following the intervention (use of a pneumatic decompression belt for 20 minutes) or control (lying supine for 20 minutes). A 2-way repeated measures ANOVA was performed on the change in spinal height in order to evaluate differences between measurement phases and intervention conditions.

RESULTS

The use of the decompression belt increased spinal height gain (4.3 ± 3.0 mm) significantly more than the control condition (1.8 ± 1.2 mm) following an acute bout of weightlifting exercises known to elicit high compressive loads on the lumbar spine.

CONCLUSION

The pneumatic decompression belt restored spinal height faster than a non-belt wearing condition in young healthy asymptomatic participants.