Goal of the Study?
The objective of this study [1. An Evaluation of an Innovative Exercise to Relieve Chronic Low Back Pain in Sedentary Workers] was to examine the effectiveness of a unique supported dynamic lumbar extension with the abdominal drawing-in maneuver (ADIM) technique on stature change, deep abdominal muscle activity, trunk muscle fatigue and pain intensity during prolonged sitting in chronic low back pain (CLBP) participants.
Why are they doing this study?
Low back pain (LBP) is a global issue among the working population. In Thailand, where this study is based, the prevalence of LBP across various occupations is approximately 83%, and 60% of workers in call centers have reported that their LBP is aggravated by sitting during the workday.
Previous research has demonstrated that continuous sitting results in trunk muscles’ contraction, causing muscle fatigue and reducing muscular support to the spine. This increases stress on ligaments and intervertebral discs, ultimately leading to LBP. Existing research, such as that by lead author Jerome Fryer (the CEO of Dynamic Disc Designs Corp.) et al. (2010), has demonstrated the value of the dynamic sitting exercise on restoring disc height. Moreover, the ADIM technique has been shown to be effective in reducing the spinal lumbar load in patients with chronic LBP.
What was done?
This is the first study investigating the combined use of a supported lumbar extension with the ADIM technique on stature recovery in CLBP patients.
They recruited 30 patients (15 males and 15 females) between the ages of 20-39 years old. All participants included had CLBP lasting more than 3 months, had low to moderate pain levels and reported sitting for at least 2 hours at work.
The participants were randomly assigned to one of two groups: 1) control – sitting without exercise; 2) sitting with supported dynamic lumbar extension with the ADIM technique. The control group sat for a 41-minute testing period. The intervention group sat in a neutral posture for 27 seconds; at the 28th second, they straightened their lower back and drew in their lower abdomen and extend their lumbar spine with their upper limbs supported to transfer the spinal load to the upper limbs, with their chest up slightly and chin in for 5 seconds. Participants were then repositioned to a neutral position and relaxed their lower abdomen for 3 seconds. This was completed 3 times over the 41-minute sitting period.
What did they find?
This study found that a dynamic lumbar extension with the ADIM technique protected from the detrimental effects on stature change and deep trunk muscle fatigue that can result from prolonged sitting. They found the intervention significantly reduced stature loss compared to the control group. Additionally, they found that this combined approach prevented an increase in pain intensity during prolonged sitting in people with CLBP.
This study has several limitations, including the use of young participants, setting the study in a laboratory rather than the workplace, self-reported data, lack of consensus on body positioning, and limiting the findings to immediate effects rather than long-term outcomes.
Why do these findings matter?
Clinicians can implement this intervention for patients who sit for long periods of time as a way to prevent LBP problems.