Journal of Manipulative and Physiological Therapeutics
Review of the LiteratureIsometric Back Extension Endurance Tests: A Review of the Literature*,**,★,★★,♢
Introduction
During the past 4 decades, many methods of back muscle testing have been studied in an attempt to predict, prevent, and rehabilitate low back pain (LBP).1 Methods have included spinal muscle strength assessment, flexibility, coordination, correlation of demographic factors with LBP, range of motion, and spinal muscle endurance. A recent focus has been placed on back muscle endurance and its relationship to LBP. Knowledge of the relationship between LBP and isometric back endurance is sparse and somewhat conflicting.2, 3
Several types of methods of testing spinal muscle endurance have been studied. Most commonly, these are (1) measures of isometric, or static, endurance, (2) active measures of endurance within a nonfixed range of motion (isotonic), and (3) isokinetic testing that places subjects in a fixed range of motion as well as a fixed rate of joint motion acceleration.
Of the assessment strategies available, isometric endurance testing seems to be cost-effective and requires little equipment for testing. Because of these features, we chose to focus on isometric endurance assessment; we felt that if there was evidence to support it as a clinically useful and valid procedure, it would be the type of testing that clinicians would choose to use to measure spinal muscle endurance. We also explored the literature for evidence regarding the endurance of the lumbar spine extensors specifically, because many methods are purported to test the lumbar spine extensors.4, 5, 6, 7
The purpose of this study was to review the literature that investigates the use of isometric back extension endurance testing. Different testing methods and evidence regarding their utilization are presented in this review.
Section snippets
Discussion
Articles were retrieved through a search of MEDLINE (January 1966 through February 1999) and the Index to Chiropractic Literature (ICL;1985-1997). Key search terms used were as follows: back muscle endurance, isometric back endurance, trunk extensors, back muscle performance, and Sorensen test. References in retrieved articles were searched for additional sources. The criteria for inclusion were as follows: any study that discussed or tested an isometric back endurance extension test was
Conclusion
Six different types of back extension endurance tests were found in the literature. A major finding of this review is that when the Sorensen test, the pulling test, or the prone isometric chest raise was used to test isometric extension endurance of the low back, subjects with LBP demonstrated lower endurance times. Some data support the assertion that this might provide a mechanism for identifying subjects who are at risk of having LBP in the future. On the basis of the literature reviewed, we
Acknowledgements
We thank Cheryl Hawk, DC, PhD, and Robert Jansen, PhD, for their assistance with this project. Todd Andrew, DC, Cindy Chapman, DC, Patricia Henkhaus, Phil Schember, and Stacy Schulenberger also deserve thanks for critiquing early versions of the manuscript.
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2022, Physical Therapy in SportCitation Excerpt :An increase in endurance strength is expected with rapid growth during puberty and in our cohort, strength increased with age but was not correlated to body mass. Psychological outcome measures for motivation and perceived effort during isometric low back testing should also be evaluated further (Moreau et al., 2001). Extensor muscle endurance of the back seems to play an important role in prevention, rehabilitation and the risk of future back pain, and the Biering-Sörensen test might be of value as a screening tool for preventive measures (Moreau et al., 2001).
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bAssociate Professor, Palmer Center for Chiropractic Research, San Jose, Calif.
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cAssociate Clinical Professor, Palmer Center for Chiropractic Research, San Jose, Calif.
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dResident in Diagnostic Imaging, Los Angeles College of Chiropractic, Los Angeles, Calif.
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Submit reprint requests to: Chad E. Moreau, DC, Horrigan Sports Chiropractic Soft Tissue and Athletic Injuries, 2080 Century Park East, Suite 605, Los Angeles, CA 90067; [email protected].
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Supported by the Palmer Center for Chiropractic Research and the Los Angeles College of Chiropractic.