What is the role of dynamic lumbar stabilization exercises (LSEs) in the treatment of low back pain (LBP)?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Dynamic lumbar stabilization exercises (LSEs) are widely accepted as being effective. This technique begins with the spine placed in a neutral position, which is defined as the posture of least pain, biomechanical stress, and potential risk for injury. The patient is taught to maintain this position while the surrounding muscles isometrically brace the spine. The extremities can then be moved in patient positions ranging from supine to standing by using no resistance other than the weight of the arms and legs or by adding free weights, weight machines, or functional activities.

A 2008 evidence-informed evaluation of the available evidence suggests that LSEs are effective at improving pain and function in a heterogeneous group of patients with cLBP. However, strong evidence coexists that this treatment is no more effective for back pain than less specific exercises. There is moderate evidence that LSEs are no more effective than manual therapy in the same population.

Only 3 studies were deemed eligible for this review, and only 2 of those were high-quality. Although the theoretical and experimental bases for considering this type of exercise training seem relatively sound, study participants were heterogeneous. Therefore, no specific subgroup of patients could be identified that may be more responsive to this type of exercise. Until further data become available, LSE training should be considered a useful tool for the management of cLBP, but must be prescribed on a case-by-case basis. [280]

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