tESting AnD tRAining LUMBAR SPinE
Testing and training the
muscles that extend the
lumbar spine:
a review of lumbar extension research
By Dave Smith PhD, Stewart Bruce-Low PhD and Gary Bissell MCSP
Sources of funding:
Current study using the MedX mchine
funded by grant from BackCare, ●
In this article, the three authors summarise research to date

examining the usefulness of a machine designed to measure the
strength of the lumbar extensor muscles, and to train these muscles.
purchase of the MedX machine at They examine its validity and reliability, its effect on lumbar strength and
Chester funded by a grant from the on prevention and rehabilitation of low back pain (LBP). They also give a
Science Research Investment Fund. brief overview of their own work with this machine and conclude by offering
suggestions for future research.
Conflicts of interest: None.
Introduction of our own recent work and future
Addresses for correspondence: During the past several years we have research directions.
Dave Smith, Ph.D. been involved in a research project
Senior Lecturer, Department of Exercise examining the effects of isolated lumbar Lumbar extension machine
and Sport Science extension exercise on lumbar strength The machine was developed to enable
MMU Cheshire and LBP. specific exercise and testing of the
Hassall Road muscles that extend the lumbar spine.
Alsager The lumbar extension machine (MedX, To achieve these aims, it is essential to
Stoke-on-Trent ST7 2NG Orlando, FL) was developed specifically stabilise the pelvis so that the muscles
0161 247 5338 to exercise and test the muscles that that cause backward rotation of the pelvis
d.d.smith@mmu.ac.uk extend the lumbar spine, and since its (i.e. the gluteal and hamstring muscles)
development in 1986, much research cannot contribute.
Stewart Bruce-Low, Ph.D. using this equipment has been published
Laboratory Director & Senior Lecturer, in various scientific journals. The gluteal and hamstring muscles are
Southampton Solent University much larger than the lumbar extensors
East Park Terrace However, in our discussions with and have a longer moment arm,
2
and
Southampton SO14 0YN physiotherapists and others involved in therefore will contribute much greater
0238 031927 back care, it has been made clear that force to trunk extension movements.
stewart.bruce-low@solent.ac.uk many involved in this field are unaware Therefore, in the machine a pelvic
of this programme of research. Given restraint system prevents movement of
Gary Bissell MCSP that the findings to date have important the pelvis using the femurs.
Physiotherapist implications for evaluation of lumbar
ProPhysio Spinal and Sports Injury Centre strength, strength training of the lumbar To neutralize the effects of gravity acting
Greengates extensors and rehabilitation of chronic upon the head and torso, the centre-
Greenfield Lane LBP, we present a brief overview of line of the torso mass of the patient is
Hoole the key literature on this topic (we refer established, and a counterweight is
Chester CH2 2PA interested readers to Smith, Bruce-Low connected to the resistance arm of the
01244 350550 and Bissell
1
for a much more detailed machine so that it is 180° out of phase
gary@prophysiohealthfs.net analysis), concluding with an explanation with the patient’s centre-line. This is
24 The Backcare Journal
backcare Winter 2009/10.indd 24 8/1/10 11:19:52
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