The Clinical Effects of Intensive, Specific Exercise on Chronic Low Back Pain: A Controlled Study of 895 Consecutive Patients with 1-Year Follow Up


The purpose of this study was to test the efficacy of a specific, aggressive program in patients with low back pain. The authors of this study began a prospective study in 1990 to look at the objective results in a large number of patients treated with aggressive exercise. The working hypothesis was chronic low back pain could be treated effectively using intensive,  specific  exercise. Intensive was defined as muscular exercise against dynamic resistance to volitional failure. The exercise activity was continued for as many repetitions as possible, so long as the patient could maintain full range of motion. Specific was defined as exercise with the pelvis immobilized so as to isolate the lumbar extensor muscles. The authors set out 8 questions they intended to answer through the study.


895 consecutive chronic low back pain patients were evaluated, and 627 completed the program.  The average duration of symptoms prior to evaluation was 26 months, 47% of  patients  were  workers’  compensation patients. The primary treatment was intensive, specific exercise using firm pelvic stabilization to isolate and rehabilitate the lumbar spine musculature using the MedX Lumbar Extension Machine. Patients were encouraged to work hard to achieve specific goals. 76% of patients completing the program had excellent or good results. At 1-year follow up 94% of patients with good or excellent results reported maintaining their improvement. Results in the control group were significantly poorer in all areas surveyed except employment.

Key Findings

  • Static strength showed significant improvement throughout the range of motion in both males and females
  • There was significant increase in range of motion
  • There was significant increases in dynamic strength
  • 64% of patients reported a substantial decrease in the perception of pain in the low back

Keywords: MedX Lumbar Extension Machine, lumbar extensor muscles, chronic low back pain, dynamic exercise, range of motion, return to work

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