Isolated Lumbar Stabilization Exercises Versus Dynamic Lumbar Strengthening Exercises in Patients with Spondylolisthesis

Background: Spondylolisthesis is one of back disorders that may cause pain and can produce lumbar curvature changes due to decreased extensor muscles strength. In later stages, it may result in straighten lumbar curvature (flattening), complaining from low back pain, hamstring muscle tightness, pain, numbness, or tingling in the thighs and buttock and lower limb muscles weakness. Purpose: To compare between the effects of lumbar stabilization exercises and lumbar dynamic strengthening exercises on the maximal isometric strength of the lumbar extensors and pain severity level in patients with spondylolisthesis. Subjects and Methods: Forty patients suffering from spondylolisthesis; their age (45-57) years for more than 3 months were included in this study. They were randomly assigned into 2 groups; the first group received lumbar isolated stabilization exercises by using medx machine (n=29) and the second group received lumbar dynamic strengthening exercises (n=11). The treatment session was 30 minutes twice a week for 3 weeks in both groups. The strength of the lumbar extensors was measured by isometric torque, at various angles; (12º, 24º, 36º, 48º and 60º) flexion to extension at intervals using the medx machine. The severity of low back pain was measured by visual analog scale (VAS) before and after the two different exercises methods. Results: Compared with the baseline, lumbar extensors strength at all angles were improved significantly in both groups. The improvements were significantly greater in the isolated lumbar stabilization exercise group at angles (12º, 36º, 48º and 60º) but not significantly greater at angle (24º). Pain severity level as determined by VAS was significantly decreased after treatment in the isolated muscles lumbar stabilization exercise group than the second group. Initial and final VAS “back pain” results were 76.20±18.05mm and 34.5 ±22.09 (p=0.007) respectively. Conclusion: Both isolated lumbar stabilization and dynamic strengthening exercises programs can strengthen the lumbar extensors and help in relieving LBP in patients with spondylolisthesis.