Immediate effects of isometric trunk stabilization exercises with suspension device on flexion extension ratio and strength in chronic low back pain patientss

BACKGROUND Recent clinical research has supported the use of suspension devices in rehabilitation procedures both in practice and in theory. Although a longitudinal study has reported on the use of suspension devices among asymptomatic subjects, it is necessary to investigate the immediate effects of suspension exercises in patients with CLBP. OBJECTIVE The present study aims to investigate changes in neuromuscular activation after the prescription of suspension exercises in patients with CLBP. A secondary aim was to determine whether practical flexion and extension strength can be effectively enhanced. METHODS Before and after suspension exercise, flexion extension (FE) ratio and trunk strength of flexion and extension were measured. Patients performed two types of suspension exercises: supine bridge and forward leaning exercises. The paired t-test was used to compare the FE ratio and strength data. Pearson correlation coefficient was performed to study the correlation between measured variables. RESULTS Compared to the pre-exercise measurements, the flexion-extension ratio and trunk extension strength was significantly increased at the post-exercise measurement (p< 0.05). The FE ratio in the right lumbar erector spine muscle was significantly correlated with post-exercise trunk extension strength (p< 0.05). CONCLUSIONS For patients with chronic lower back pain, stimulation of the lumbar extensor muscle and of proprioception is effective both for strengthening lumbar extensors and for improving the flexion-extension ratio. Consequently, forward leaning and supine bridge exercises with a suspension device are beneficial for normalising neuromuscular control of the erector spinae muscles.