%0 Journal Article
%T Rehabilitation of Back Extensor Muscles' Inhibition in Patients with Long-Term Mechanical Low-Back Pain
%A Chidozie Emmanuel Mbada
%A Olusola Ayanniyi
%A Samuel Olusegun Ogunlade
%A Elkanah Ayodele Orimolade
%A Ajibola Babatunde Oladiran
%A Abiola Oladele Ogundele
%J ISRN Rehabilitation
%D 2013
%R 10.1155/2013/928956
%X This study investigated the effect of static or dynamic back extensors endurance exercise in combination with McKenzie Protocol (MP) in patients with Long-term Mechanical Low-Back Pain (LMLBP). This randomized controlled trial involved 84 patients, who were assigned into MP Group (MPG), MP plus Static Back Extensors Endurance (SBEE) Exercise Group (MPSBEEG), or MP plus Dynamic Back Extensors＊ Endurance (DBEE) Exercise Group (MPDBEEG). Twenty-five, 22, and 20 participants in MPG, MPSBEEG, and MPDBEEG, respectively, completed the thrice weekly eight-week study (drop-out rate = 20.2%) and outcomes were measured in terms of SBEE, DBEE, and Back Muscles Fatigue (BMF) at the 4th and 8th week, respectively. There were significant differences in groups mean change scores on SBEE ( , and ˋsec), DBEE ( , , and rep), and BMF ( , , and ) at week 4, and SBEE ( , , and ˋsec), DBEE ( , , and reps), BMF ( , , and ) at week 8, respectively ( ). It was concluded that MP alone, or in combination with SBEE or DBEE, exercise was effective in the rehabilitation of back extensors＊ endurance and fatigability in patients with LMLBP. However, the addition of SBEE to MP led to significantly higher positive effects. 1. Introduction Long-term mechanical low-back pain (LBP) results in inhibition and atrophy of the deep segmental muscles such as multifidus and overactivity of the longer superficial muscles of the trunk with resultant decreased dynamic activity and increased fatiguibility [1每4]. Long-term mechanical LBP is more difficult to treat [5每7] and treatment outcomes give variable results [8每10] and it consequently results in both physical and psychological deconditionings that trap the patient in a vicious circle characterized with decreased physical performance, exacerbated nociceptive sensations, depression, impaired social functioning, and work disability [11]. One of the more commonly used physical therapy approaches in the management of long-term mechanical LBP with documented effectiveness is the McKenzie Protocol (MP) [12每15]; However, there seems to be inconclusive evidence whether the MP addresses the accompanying back muscles inhibition in patients with long-term mechanical LBP. Some studies considered the McKenzie＊s extension exercises as passive and presumably opined that it may not counter the back muscles＊ inhibition and atrophy resulting from long-term LBP [16每18], however, a study by Fiebert and Keller [19] among apparently healthy individuals demonstrated that the McKenzie＊s extension exercises were not truly passive for lumbar back extensor muscles. On the
%U http://www.hindawi.com/journals/isrn.rehabilitation/2013/928956/