Dynamic Sitting Exercise vs. McKenzie Prone Press-Up (Low back pain and quality of life)
Indian Journal of Physiotherapy and Occupational Therapy, January-March 2020, Vol. 14, No. 1The Dynamic Sitting Exercise (DSE)
Life can be busy. And with this busyness, people often do not have the time for lower back pain exercises. In 2010, Jerome Fryer (the owner and developer of Dynamic Disc Designs Corp.) set out to measure a simple seated decompression strategy for the lumbar spine. A pilot study used an upright MRI to investigate changes in the lumbar spine before and after this Dynamic Sitting Exercise (DSE) 1
It was originally coined “chair-care decompression exercise” to make it memorable. In a recent article written in the Indian Journal of Physiotherapy and Occupational Therapy, the researchers renamed it DSE and compared it to the popular McKenzie prone press-up. 2
Dynamic Sitting Exercise (DSE)
McKenzie Prone Press-up
These researchers recruited thirty adults in the age range of 20-30 years with mechanical low back pain. To read the full inclusion and exclusion criteria, you can visit the full-text link in the references below. They randomly assigned the participants to two groups: the DSE group or the McKenzie prone press-up group. Each subject conducted 6 repetitions within the 5-minute interval with the exercises being conducted at the beginning of the 5 minutes, followed by 4 minutes of rest. Over the course of 30 minutes, each participant would have performed 6 repetitions multiplied by 5 sets for a total of 30 repetitions over the course of 30 minutes. This was equivalent to 2.5 minutes of active exercise over the course of 30 minutes.
Exercise Protocol
The DSE instructions included:
- sit upright
- place hands-on seat pan
- push down on the seat pan to offload the lower spine
- participants should feel a slight stretching in the lower back
- hold for 5 seconds
- return to neutral for 5 seconds
- while returning to neutral, draw-in-abdomen.
The McKenzie Prone Press-Up instructions included:
- lie down on the abdomen
- extend back while on elbows and palms down (neutral position)
- perform press-up maneuver with straight arms for 5 seconds
- return to neutral for 5 seconds
Over 6 weeks, outcome measures included the Visual Analog Scale for pain and the Short Form-36 Health Survey Questionaire for quality of life.
What did they conclude?
Both forms of exercise demonstrated improvement of pain and quality of life. However, the DSE outperformed the McKenzie Prone Press-up in this group of mechanical low back pain adults.
Overall, this paper could have been written a little better. Their conclusions were bold and overly confident. It is still an important paper to share as the practicality of investing a few seconds of offloading to your work-day while sitting looks to be promising in those with lower back pain in this age range.
Flight related low back pain (LBP) among helicopter pilots is frequent and may influence flight performance. Prolonged confined sitting during flights seems to weaken lumbar trunk (LT) muscles with associated secondary transient pain. Aim of the study was to investigate if structured training could improve muscular function and thus improve LBP related to flying. 39 helicopter pilots (35 men and 4 women), who reported flying related LBP on at least 1 of 3 missions last month, were allocated to two training programs over a 3-month period. Program A consisted of 10 exercises recommended for general LBP. Program B consisted of 4 exercises designed specifically to improve LT muscular endurance. The pilots were examined before and after the training using questionnaires for pain, function, quality of health and tests of LT muscular endurance as well as ultrasound measurements of the contractility of the lumbar multifidus muscle (LMM). Approximately half of the participants performed the training per-protocol. Participants in this subset group had comparable baseline characteristics as the total study sample. Pre and post analysis of all pilots included, showed participants had marked improvement in endurance and contractility of the LMM following training. Similarly, participants had improvement in function and quality of health. Participants in program B had significant improvement in pain, function c9 and quality of health. This study indicates that participants who performed a three months exercise program had improved muscle endurance at the end of the program. The helicopter pilots also experienced improved function and quality of health. Identifier: NCT01788111 Registration date; February h, 2013, verified April 2016.