TY - JOUR A1 - Golonka, Witold A1 - Raschka, Christoph A1 - Harandi, Vahid M. A1 - Domokos, Bruno A1 - Alfredson, Håkan A1 - Alfen, Florian Maria A1 - Spang, Christoph T1 - Isolated lumbar extension resistance exercise in limited range of motion for patients with lumbar radiculopathy and disk herniation — clinical outcome and influencing factors JF - Journal of Clinical Medicine N2 - (1) Background: Reconditioning of the paraspinal lumbar extensor muscles by isolated lumbar extension resistance exercises (ILEX) has shown good clinical results for patients with chronic unspecific low back pain. However, the clinical value and safety for patients with specific spine pathologies is unclear. In this study, clinical outcome and influencing factors were retrospectively analyzed for patients with lumbar disk herniation (LDH) and radiculopathy. (2) Methods: 189 consecutive patients (123 men and 66 women; mean age, 36 years) with clinically diagnosed LDH and relative indications for surgery started a 9-week rehabilitation program (2x/week) including ILEX in limited range of motion (ROM) adjusted to patients’ symptoms. Patients diagnosed with advanced levels of spine degeneration were excluded. Pain/radiculopathy (PR), influence on mental health (IOMH), satisfaction rates were measured via Numeric Rating Scales (NRS, 0–10), and overall clinical outcome was stated in % (100% = full recovery). Isometric extension strength was tested before and after the program. (3) Results: 168 patients (88.9%) completed the program. For 162 out of 168 patients (96.4%) there was a significant reduction of clinical symptoms, whereas 6 patients reported no changes in symptoms. Scores (mean) for symptom intensity decreased from 4.2 (±1.5) to 1.9 (±1.5) (p < 0.001), the impact on mental health decreased from 5.9 (±2.3) to 2.4 (±2.0) (p < 0.001). There was a (weak) correlation between lower scores for PR and IOMH before the study and better clinical outcomes; PR also weakly correlated with satisfaction. Other factors such as age, strength increase, level/location and number of LDH did not have a significant impact on the clinical results. (4) Conclusion: The results indicate that ILEX in limited ROM can be an effective treatment for the majority of patients with LDH. For patients with high pain levels, the results are less consistent, and surgery may be considered. KW - disk herniation KW - radiculopathy KW - low back pain KW - ILEX KW - exercise KW - conservative treatment Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-239723 SN - 2077-0383 VL - 10 IS - 11 ER - TY - JOUR A1 - Kaiser, Moritz A1 - Brambrink, Sara A1 - Benditz, Achim A1 - Achenbach, Leonard A1 - Gehentges, Matthias A1 - König, Matthias Alexander T1 - Increase in lower limb strength after multimodal pain management in patients with low back pain JF - Medicina N2 - Background and Objectives: The aim of the present study was to evaluate the efficacy of a multimodal pain therapy (MPM) regarding the objective parameter muscle strength of segment-dependent lower limb muscle groups before and after such a treatment. Materials and Methods: 52 patients with a history of low back pain and/or leg pain received standardized multimodal pain management. Strength of segment indicating lower limb muscles were assessed for each patient before and after ten days of treatment by handheld dynamometry. Results: Overall strength increased significantly from 23.6 kg ± 6.6 prior to treatment to 25.4 ± 7.3 after treatment, p ≤ 0.001. All muscle groups significantly increased in strength with exception of great toe extensors. Conclusions: Despite lower basic strength values at the beginning of treatment, all investigated muscle groups, except for the great toe extensors, showed a significant increase of overall strength after completion of the multimodal pain management concept. Increased overall strength could help with avoiding further need of medical care by supporting patients’ autonomy in daily life activities, as well as maintaining working abilities. Thus, our study is the first to show a significant positive influence on lower limb strength in patients with low back pain after a conservative MPM program. KW - multimodal pain management KW - low back pain KW - muscle strength KW - dynamometer Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-284264 SN - 1648-9144 VL - 58 IS - 7 ER - TY - JOUR A1 - Domokos, Bruno A1 - Beer, Lisa A1 - Reuther, Stefanie A1 - Raschka, Christoph A1 - Spang, Christoph T1 - Immediate effects of isolated lumbar extension resistance exercise (ILEX) on spine posture and mobility measured with the IDIAG Spinal Mouse System JF - Journal of Functional Morphology and Kinesiology N2 - Posture and mobility are important aspects for spinal health. In the context of low back pain, strategies to alter postural anomalies (e.g., hyper/hypolordosis, hyper/hypokyphosis) and mobility deficits (e.g., bending restrictions) have been of interest to researchers and clinicians. Machine-based isolated lumbar extension resistance exercise (ILEX) has been used successfully for rehabilitation of patients suffering from low back pain. The aim of this study was to analyse the immediate effects of ILEX on spinal posture and mobility. In this interventional cohort study, the posture and mobility measures of 33 healthy individuals (m = 17, f = 16; mean age 30.0 years) were taken using the surface-based Spinal Mouse system (IDIAG M360©, Fehraltdorf, Switzerland). Individuals performed one exercise set to full exhaustion with an ILEX-device (Powerspine, Wuerzburg, Germany) in a standardized setup, including uniform range of motion and time under tension. Scans were made immediately before and after the exercise. There was an immediate significant decrease in standing lumbar lordosis and thoracic kyphosis. No change could be observed in standing pelvic tilt. Mobility measures showed a significant decrease in the lumbar spine and an increase in the sacrum. The results show that ILEX alters spine posture and mobility in the short-term, which may benefit certain patient groups. KW - low back pain KW - spine KW - posture KW - mobility KW - exercise KW - ILEX KW - surface scanner Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-319334 SN - 2411-5142 VL - 8 IS - 2 ER -