Article

Effect of Roman Chair Exercise Training on the Development of Lumbar Extension Strength

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Abstract

The purpose of this study was to determine the effect of 45 degrees Roman chair exercise training on the development of lumbar extension strength. Fifteen healthy volunteers (9 women, 6 men) were recruited from a university setting and were randomly assigned to 1 of 2 groups. One group (n = 9) performed progressive resistance back extension exercise on a 45 degrees Roman chair once weekly for 12 weeks. Training consisted of one set of 8-20 dynamic repetitions to volitional exhaustion using hand-held metal plates for additional resistance. The other group did not train (control, n = 6). Peak isometric lumbar extension torque was measured on a lumbar extension dynamometer before and after the 12-week program. Following training, peak isometric lumbar extension torque did not increase for the Roman chair group (before: 224.0 +/- 134.1 N x m; after: 240.3 +/- 137.4 N x m; p > 0.05) compared with the control group (before: 175.6 +/- 68.9 N x m; after: 178.2 +/- 69.9 N x m; p > 0.05), despite an increase in dynamic exercise load.

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... 7 Different types of exercises (eg, machines, benches, and/or Roman chair) can provide enough stimuli to improve strength and/or endurance of lumbar-extensor muscles, which in return promote better stability and protect the lumbar spine. 8 However, the optimal training volume with regard to back strength and endurance gains remains unknown for the lumbar muscles. Strength/resistance training volume has historically been supported by the American College of Sports Medicine (ACSM) recommendations, 9 which also take into consideration the back muscles with regard to CLBP disorder prevention. ...
... There are some limitations of this study that need to be considered here. The duration of the training was only 10 weeks, while some studies have worked with 12 weeks of training for better results, 8,30 especially with regard to the effects on EMG estimates and strength variables. Moreover, EMG estimates were reported only for the isometric test, which limits the specificity of training in a dynamic context. ...
Article
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Context: Strength/resistance training volume has historically been supported in the American College of Sports Medicine recommendations. However, for the back muscles, exercise prescription related to the number of sets, such as single vs. multiple, is not well established in the literature. Objective: The purpose of this study was to compare the effects of two training volumes on strength and endurance of back extensor muscles in untrained young participants, with regard to a repeated measures design. Design: Randomized controlled trial. Setting: Laboratory of functional evaluation and human motor performance. Participants: Forty-four untrained young participants (mean age= 21 yrs) were randomized into three groups: single set (SSG, n= 14), multiple sets (MSG, n= 15), and untrained control (CG, n= 15). Intervention: The SSG and MSG underwent a 10-wk progressive resistance training program (2 days·week(-1)) using a 45° Roman chair. Main outcome measures: Back maximal strength (dynamometer) and isometric and dynamic endurance (time-limit, trunk extension-flexion cycles, and electromyography muscle fatigue estimates). Results: The results showed differences between the MSG and control group for isometric endurance time (mean 19.8 seconds, 95% CI 44.1 to 4.8), but without time intervention significance. Significant improvement after training (P <0.05) was found predominantly during dynamic endurance (number of repetitions) for both the MSG (+61%) and SSG (+26%) compared to pre-intervention, while the control group reported no benefit. There was no significant (P > 0.05) difference in either strength or electromyography estimates after training. Conclusions: Both multiple and single volume training were efficient in promoting better back endurance during dynamic performance based on mechanical variables (time and number of repetitions).
... However, to date these results have not been replicated using lower-tech training methods. Thus far, attempts to strengthen the lumbar musculature using roman chair exercises and Romanian deadlifts (RDLs) have been unsuccessful (14,27,43). This is supportive of the hypothesis that the rotation of the pelvis permitted during these exercises provides a greater training stimulus to the hip extensors and insufficient stimulus to the lumbar extensors (14,18,35). ...
... Kettlebell swings Fatigue Response Test 3 extensors (14,27,43). In addition, previous studies have considered the use of surface electromyography (sEMG) as a method of assessing lumbar extensor activation to hypothesise training efficacy. ...
Article
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The aim of the present study was to use a Fatigue Response Test (FRT) to measure the muscular fatigue (defined as a reduction in torque production) sustained by the lumbar extensors after a single set of kettlebell swings (KBS) in comparison to isolated lumbar extensions (ILEX), and a control condition (CON). The purpose of which is to measure the physiological response of KBS against an already established modality. Subsequent data provides insight of the efficacy of kettlebells swings in strengthening the lumbar muscles and lower back pain treatment. Eight physically active males participated in a repeated measures design where participants completed all conditions. There were statistically significant reductions in maximal torque, reported as strength index (SI), following both KBS and ILEX exercise. A statistically significant difference was found for reductions in maximal torque (POST-PRE) between CON and both KBS (p = 0.005) and ILEX (p = 0.001) and between KBS and ILEX (p = 0.039). Mean reduction and effect sizes were -1824 ± 1127.12(SI) and -1.62 for KBS and -4775.6 ± 1593.41(SI) and -3.00 for ILEX. In addition a statistically significant difference was found between KBS and ILEX for rate of perceived exertion (p = 0.012). Data suggests that both KBS and ILEX were able to fatigue the lumbar extensors. ILEX was able to generate a greater level of fatigue. However, contrary to previous research, the kettlebell swing was able to elicit a physiological response despite the lack of pelvic restraint supporting the potential to strengthen the lumbar extensors.
... Great success has been attained with the MedX lumbar extension machine (see method for validity and reliability data) in both measuring isometric force production and strengthening the lumbar muscles (Bruce-Low, Smith, Bissell, Burnet, Fisher & Webster, 2012;Carpenter et al., 1991;Graves et al., 1990;Pollock et al., 1989;Smith, Bruce-Low, & Bissell, 2008). However, more common 'lower-back' exercises, such as the roman chair, have been shown not to improve lumbar extension strength when tested on an isometric dynamometer, even where training resistance has increased throughout an intervention (Mayer, Udermann, Graves, & Ploutz-Snyder, 2003). Other research has considered alternative lumbar extension machines that do not fixate the pelvis and therefore do not isolate the lumbar extensors, once again reporting no significant increase in isometric torque production in the lumbar muscles from training on such machines (Graves et al., 1994). ...
... The data showed that progressive training of the Romanian deadlift, 1Â/ week for 10 weeks, significantly improved the 1RM performance of the Romanian deadlift, but did not significantly enhance lumbar extension torque at any of the joint angles tested on the MedX lumbar extension machine. These findings are supported by previous research, which has suggested that pelvic stabilization is necessary to optimally activate and strengthen the lumbar extensors (Da Silva et al., 2009;Graves et al., 1994;Mayer et al., 2003;San Juan et al., 2005). Indeed, other authors have suggested that where there is no pelvic stabilization it is the hamstring and gluteal muscles that are primarily acting to "de-rotate" the pelvis, rather than the lumbar muscles acting to provide lumbar extension (Graves et al., 1994). ...
Article
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To consider the efficacy of 10 weeks of Romanian deadlift (DL) training in increasing lumbar extension strength compared to isolated lumbar extension (LUMX) training. Comparison of pre- and post-test data for Romanian deadlift 1RM, and lumbar extension torque between and within groups. Male trained subjects (n = 36; (x¯±SD) 24.9 ± 6.5 years; 178.5 ± 5.2 cm; 81.6 ± 10.0 kg). Pre- and post-testing included a Romanian deadlift 1RM and isometric strength tests every 12° through full range of motion on the MedX lumbar extension machine (MedX, Ocala, FL). Repeated measures analysis of variance (ANOVA) with Bonferroni adjustments revealed that 1RM Romanian deadlift significantly increased from pre- to post-test in the DL group (p < 0.008; 143.3 ± 23.4 kg to 166.3 ± 21.9 kg) and the LUMX group (p < 0.008; 135.8 ± 23.1 kg to 146.0 ± 25.5 kg). In contrast, tested functional torque (TFT) significantly increased at 6 out of 7 joint angles (p < 0.008) for the LUMX group only. The control group showed no significant differences pre- to post-test. These data suggest that the Romanian deadlift does not enhance lumbar extension torque. However, performing specific isolated lumbar extension training appears to improve both lumbar extension torque and Romanian deadlift 1RM.
... • la position des bras : selon les auteurs, l'épreuve se réalise avec les coudes écartés et les mains positionnées au niveau des oreilles [17], du front [18] ou derrière la nuque [19,20] et parfois les bras le long du corps [13,21,22]. Compte tenu de leur impact sur la position du centre de gravité, ces différentes modalités de réalisation influencent le moment de pesanteur de la partie supérieure du corps et donc la performance [23] ; • le repère anatomique positionné à la limite du débord de table : le bord supérieur des crêtes iliaques est pris comme repère dans le test original de Sorensen alors que d'autres études retiennent les épines iliaques antérosupérieures [24,25] ; • le nombre de sangles : deux [19,[26][27][28] à cinq sangles [14] sont placées, et parfois aucune dans le cas de l'utilisation d'une chaise romaine (Fig. 2) qui permet une fixation unique des membres inférieurs au niveau des pieds [29][30][31][32][33][34] ; • la position de départ du test : dans certaines études [31,34] le sujet débute l'épreuve avec le tronc incliné vers le sol, et doit réaliser une contraction concentrique préalable des extenseurs du tronc afin d'atteindre la position horizontale ; • la flexion de hanche : sensée être nulle, elle atteint respectivement 6°et 40°dans les travaux de Holmstrom et al. • le moyen de vérifier l'horizontalité du tronc : de nombreux auteurs (dont Biering-Sorensen) se limitent à une observation visuelle [10,19,21,27,31,[34][35][36]. Certains utilisent des inclinomètres [24,37,38], un goniomètre [18], ou une cellule photoélectrique [10,39] alors que d'autres invitent simplement le sujet à maintenir un contact postérieur avec une toise ou un poids suspendu au plafond [18,40,41] ; ...
... Plusieurs auteurs rapportent, chez le lombalgique, une augmentation significative du temps de maintien suite à un programme actif de réadaptation [38,75]. Á la suite d'un entraînement de plusieurs semaines composé d'exercices dynamiques sur une chaise romaine, le temps de maintien apparaît significativement augmenté [71] malgré l'absence d'une amélioration spécifique de la force des muscles extenseurs du rachis mesurée à l'aide d'un dynamomètre spécifique [32,71]. ...
Article
The first test for evaluating the isometric endurance of trunk extensor muscles was described by Hansen in 1964. In 1984, following a study by Biering-Sorensen, this test became known as the “Sorensen test” and gained considerable popularity as a tool reported to predict low back pain within the next year in males. The test consists in measuring the amount of time a person can hold the unsupported upper body in a horizontal prone position with the lower body fixed to the examining table. This test has been used in many studies, either in its original version or as variants. Although its discriminative validity, reproducibility, and safety seem good, debate continues to surround its ability to predict low back pain; in addition, the gender-related difference in position-holding time remains unexplained and the influence of body weight unclear. A contribution of the hip extensor muscles to position–holding has been established, but its magnitude remains unknown. The influence of personal factors such as motivation complicates the interpretation of the results. Despite these drawbacks, the Sorensen test has become the tool of reference for evaluating muscle performance in patients with low back pain, most notably before and after rehabilitation programs.
... @BULLET Location of the edge of the table: in several studies, the anterior–superior iliac spines were placed at the edge of the table, instead of the upper edge of the iliac crests [24,25]. @BULLET Number of straps: two [19,262728 to five straps [14] have been used to hold the lower body to the table; in the Roman chair variant (Fig. 2), the feet are fixed to the device and no straps are needed293031323334. @BULLET Starting position: in several studies [31,34], the test was started with the upper body sloping downward toward the floor so that a concentric contraction of the trunk extensor muscles was needed initially to reach the horizontal posi- tion. ...
... The position-holding time has been reported to increase significantly after active rehabilitation therapy [38,75]. A training program involving dynamic exercises performed on a Roman chair regularly over several weeks was followed by a significant increase in the position-holding time [71], although measurements obtained using a dedicated dynamometer showed no increase in back extensor muscle strength [32,71]. ...
Article
The first test for evaluating the isometric endurance of trunk extensor muscles was described by Hansen in 1964. In 1984, following a study by Biering-Sorensen, this test became known as the "Sorensen test" and gained considerable popularity as a tool reported to predict low back pain within the next year in males. The test consists in measuring the amount of time a person can hold the unsupported upper body in a horizontal prone position with the lower body fixed to the examining table. This test has been used in many studies, either in its original version or as variants. Although its discriminative validity, reproducibility, and safety seem good, debate continues to surround its ability to predict low back pain; in addition, the gender-related difference in position-holding time remains unexplained and the influence of body weight unclear. A contribution of the hip extensor muscles to position holding has been established, but its magnitude remains unknown. The influence of personal factors such as motivation complicates the interpretation of the results. Despite these drawbacks, the Sorensen test has become the tool of reference for evaluating muscle performance in patients with low back pain, most notably before and after rehabilitation programs.
... Strength training has been recommended by the American College of Sports Medicine (ACSM) for various health and performance benefits (American College of Sports Medicine, 2009). Different types of strengthening exercises were used as part of a strategy for restoring muscle functions while improving stability of the lumbar spine (Mayer et al., 2003). In previous literature, stabilisation exercises (Dreisinger, 2014;Inani and Selkar, 2013;Šarabon, 2011) were more widely used than the free-weight exercises (Jackson et al., 2011;Welch et al., 2015), although freeweight exercises are safe and yielded positive results (Jackson et al., 2011;Welch et al., 2015). ...
Article
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Low back pain (LBP) is a common disabling health problem that can cause decreased spine proprioception. Stochastic resonance (SR) can influence detection performance, besides improving patients with significant sensory deficits, but have not been thoroughly tested for LBP. This study aimed to examine the application of SR therapy (SRT) and strength training for LBP treatment. The subject was a resistance-trained male in his early thirties. His back pain was unbearable after a strength training session. Standard pain relief alleviated the pain but the LBP developed at a similar intensity after 4 weeks. SRT (4–5 sets × 90 sec, 30-sec rest interval, supine position) was prescribed along with other exercises for 3 weeks (phase 1), and followed by tailor-made strength training for 16 weeks (phase 2). The Oswestry Disability Index was 66.7% (interpreted as “crippled”) prior to first SRT, and reduced to minimal levels of 15.6% and 6.7% after four and seven SRT sessions, respectively. Similarly, pain intensity was ranging from 5 to 9 (distracting-severe) of the Numeric Rating Scale (NRS-11) prior to the first session but this was reduced considerably after four sessions (NRS-11: 0–1). During phase 2, the patient performed without complaining of LBP, two repetitions of bench press exercise at a load intensity of 1.2 his body weight and attained 4 min of plank stabilisation. This LBP management strategy has a clinically meaningful effect on pain intensity, disability, and functional mobility, by receding the recurrent distracting to severe LBP. Keywords: Back pain | Muscular strength | Sensory neuron | Stabilisation
... Strength training has been recommended by the American College of Sports Medicine (ACSM) for various health and performance benefits (American College of Sports Medicine, 2009). Different types of strengthening exercises were used as part of a strategy for restoring muscle functions while improving stability of the lumbar spine (Mayer et al., 2003). In previous literature, stabilisation exercises (Dreisinger, 2014;Inani and Selkar, 2013;Šarabon, 2011) were more widely used than the free-weight exercises (Jackson et al., 2011;Welch et al., 2015), although freeweight exercises are safe and yielded positive results (Jackson et al., 2011;Welch et al., 2015). ...
Article
Full-text available
Low back pain (LBP) is a common disabling health problem that can cause decreased spine proprioception. Stochastic resonance (SR) can influence detection performance, besides improving patients with significant sensory deficits, but have not been thoroughly tested for LBP. This study aimed to examine the application of SR therapy (SRT) and strength training for LBP treatment. The subject was a resistance-trained male in his early thirties. His back pain was unbearable after a strength training session. Standard pain relief alleviated the pain but the LBP developed at a similar intensity after 4 weeks. SRT (4–5 sets × 90 sec, 30-sec rest interval, supine position) was prescribed along with other exercises for 3 weeks (phase 1), and followed by tailor-made strength training for 16 weeks (phase 2). The Oswestry Disability Index was 66.7% (interpreted as “crippled”) prior to first SRT, and reduced to minimal levels of 15.6% and 6.7% after four and seven SRT sessions, respectively. Similarly, pain intensity was ranging from 5 to 9 (distracting-severe) of the Numeric Rating Scale (NRS-11) prior to the first session but this was reduced considerably after four sessions (NRS-11: 0–1). During phase 2, the patient performed without complaining of LBP, two repetitions of bench press exercise at a load intensity of 1.2 his body weight and attained 4 min of plank stabilisation. This LBP management strategy has a clinically meaningful effect on pain intensity, disability, and functional mobility, by receding the recurrent distracting to severe LBP.
... Despite the fact that only some of these muscles directly attach on to the lumbar vertebrae, a contraction of one of the muscles will influence the lumbar region, even if this is not the muscle its primary function. Although many different modalities of lumbar extension exercises exist (Mayer et al., 1999;Mayer, Mooney, & Dagenais, 2008;Mayer, Verna, Manini, Mooney, & Graves, 2002;Plamondon, Serresse, Boyd, Ladouceur, & Desjardins, 2002) trainers often implement modalities performed from prone position into training programs (Mayer, Udermann, Graves, & Ploutz-Snyder, 2003;Verna et al., 2002). By extending either the trunk or the legs, lumbar extension and activation of the muscles generating this movement is induced. ...
Article
Objective: Examine whether implementing an active lumbopelvic control strategy during high load prone lumbar extension exercises affects posterior extensor chain recruitment and lumbopelvic kinematics. Methods: Thirteen healthy adults acquired an optimal active lumbopelvic control strategy during guided/home-based training sessions. During the experimental session electromyography was used to evaluate the activity of the posterior extensor chain muscles during high load trunk/bilateral leg extension exercises with/without application of the strategy. Video-analysis was used to evaluate thoracic/lumbar/hip angles. Results: Implementing the active lumbopelvic control strategy decreased the lordotic angle during trunk (p=0.045; -3.2?) and leg extension exercises (p=0.019; -10?). The hip angle was solely affected during trunk extension (p<0.001;+9.2?). The posterior extensor chain (i.e. mean of the relative activity of all muscles (%MVIC) was recruited to a higher extent (p=0.026;+9%) during trunk extension exercises performed with active lumbopelvic control. Applying the strategy during leg extension exercises lead to less activity of longissimus thoracic (p=0.015; -10.2%) and latissimus dorsi (p=0.010; -4.4%), and increased gluteus maximus activity (p?0.001;+16.8%). Conclusions: When healthy people are taught/instructed to apply an active lumbopelvic control strategy, this will decrease the degree of lumbar (hyper)lordosis and this influences the recruitment patterns of trunk and hip extensors. Hence, the possible impact on predetermined training goals should be taken into account by trainers.
... The relative strength improvement of 33% in the manual resistance group and 27% in the free-weight group are greater than those of previously published investigations applying isolated lumbar extension exercises on healthy male adults (Fisher, Bruce-Low, & Smith, 2013) and participants with lower back pain (Smith, Bissell, Bruce-Low, & Wakefield, 2011). Others failed to improve strength of back extensors, e.g. by using Roman-chair exercises (Mayer, Udermann, Graves, & Ploutz-Snyder, 2003;Verna et al., 2002) or Romanian deadlifts (Fisher et al., 2013), even though the intervention periods of those studies were longer (8-12 weeks) than that of the present study. The effect size of 1.22 for the manual resistance group and 1.27 for the freeweight group in the present study is rated moderate according to the scale used to determine the magnitude of treatment effects in strength training research published by Rhea (2004). ...
Article
We tested a simple and compact device designed for manual resistance training in conditions of microgravity (Self-Powered Rope Trainer Duo (SPoRT Duo)) to increase muscle performance. Twenty-four participants (20.8 ± 2.1 years) were randomly assigned to a manual resistance group (n = 12) and a free-weight group (n = 12). Participants performed eight exercises (three sets; 8-12 efforts) either with free weights or the SPoRT Duo twice a week for 6 weeks. Maximal isometric force of trunk flexion, back extension and chest press increased (P at least 0.01, d at least 0.52) both in the manual resistance group (18.4% ± 15.0%; 32.7% ± 22.7%; 15.3% ± 9.7%) and free-weight group (18.0% ± 13.9%; 26.6% ± 28.9%; 13.3% ± 7.6%). The change in maximal isometric force of wide grip row in both groups (d at best 0.38) did not reach statistical significance (P at best 0.08). The squat one-repetition-maximum increased in the manual resistance group (29.8% ± 22.1%) and the free-weight group (32.4% ± 26.6%). Jump height, determined by a jump-and-reach test, increased in the free-weight group (9.8% ± 13.2%) but not in the manual resistance group (2.0% ± 8.5%). Manual resistance training was equally effective in increasing strength as traditional resistance training with free weights. This apparatus is a useful addition to current in-flight exercise systems.
... There is considerable evidence that resistance training of the trunk extensors is beneficial in the prevention and rehabilitation of low back pain (LBP) (Browder et al., 2007;Franca et al., 2010;Henchoz and So, 2008). To train endurance and strength of these muscles, trunk extension exercises in different starting positions (standing, semi-seated, seated, prone lying) are frequently prescribed and have been described in scientific literature (da Silva et al., 2009a,b;Lariviere, 2011;Mannion et al., 2001a,b;Mayer et al., 2003;Rissanen et al., 1995;Steele et al., 2013). Achievement of the desired training effects is dependent of appropriate exercise dosage. ...
... Although the wide LoAs observed in our study probably induce high relative reliability values, the precision of the dAVId ® test devices is sensitive enough to detect changes that may be induced by a rigorous strengthening intervention programme of more than 4 weeks in elderly persons (28,29) and more than 9 weeks in young persons (16,40), where significant improvements in trunk muscle strength can be expected. the precision of the tests may, however, be insufficient to identify real improvements if healthy volunteers perform a short or less rigorous exercise programme or if healthy volunteers start a training programme with an initially high trunk strength performance baseline (43). ...
Article
Objective: To determine the short- and long-term test-retest reliability of maximum isometric trunk moment measurements in healthy volunteers over 50 years of age, to compare these results with those from volunteers younger than 50 years, and to test whether volunteers' anticipatory emotional state affects the precision of these measurements. Methods: Forty-two older persons (21 females; age range 50-90 years) and 44 younger persons (19 females; age range 18-49 years) performed maximum isometric trunk extensions, flexions, and rotations using dynamometers (DAVID, Fi, David Health Solutions Ltd, Helsinki, Finland). They repeated the tests after 1-2 days (short-term) and at 6 weeks (long-term). Retest-reliability was evaluated for age- and gender-specific subgroups, with assessment of intraclass correlation coefficient (ICC2,1) , standard error of measurement, smallest real difference, and smallest real difference, in percent. Results: For the elderly group, smallest real difference, in percent values varied up to 33% and were similar to those obtained from young volunteers. Precision of the trunk rotation tests was lower than that of trunk flexion or extension. Retest agreement exceeded 0.75 (ICC2,1) for all tests, with no relevant differences observed between gender- and age-specific subgroups. Neither participants' motivation nor their anticipatory emotions correlated with the individual coefficients of variation of the trunk muscle moment measurements. Conclusion: Isometric maximum trunk extension and flexion moment measurements taken from healthy persons > 50 years old are as reliable as those from persons < 50 years old, and can be expected to enable an acceptable level of detection of expected changes in muscle strength parameters as a result of planned exercise interventions.
... Although several resistance training exercises have been proposed to improve strength and/or endurance of the back muscles, there is little agreement upon which exercises are the most effective [9,[17][18][19][20]. Extension exercises performed in prone position are frequently described in the literature [18,[21][22][23][24][25][26]. For example prone arch exercises, i.e. combined trunk and leg extension, activate the back muscles at a high level. ...
Article
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Back extension exercises are often used in the rehabilitation of low back pain. However, at present it is not clear how the posterior muscles are recruited during different types of extension exercises. Therefore, the present study will evaluate the myoelectric activity of thoracic, lumbar and hip extensor muscles during different extension exercises in healthy persons. Based on these physiological observations we will make recommendations regarding the use of extensions exercises in clinical practice. Methods: Fourteen healthy subjects performed four standardized extension exercises (dynamic trunk extension, dynamic-static trunk extension, dynamic leg extension, dynamic-static leg extension) in randomized order at an intensity of 60% of 1-RM (one repetition maximum). Surface EMG signals of Latissimus dorsi (LD), Longissimus thoracis pars thoracic (LTT) and lumborum (LTL), Iliocostalis lumborum pars thoracic (ILT) and lumborum (ILL), lumbar Multifidus (LM) and Gluteus Maximus (GM) were measured during the various exercises. Subsequently, EMG root mean square values were calculated and compared between trunk and leg extension exercises, as well as between a dynamic and dynamic-static performance using mixed model analysis. During the dynamic exercises a 2 second concentric contraction was followed by a 2 second eccentric contraction, whereas in the dynamic-static performance, a 5 second isometric interval was added in between the concentric and eccentric contraction phase. Results: In general, the muscles of the posterior chain were recruited on a higher level during trunk extension (mean +/- SD, 56.6 +/- 30.8%MVC) compared to leg extension (47.4 +/- 30.3% MVC) (p
... The data showed that progressive training of the Romanian deadlift, 1Â/ week for 10 weeks, significantly improved the 1RM performance of the Romanian deadlift, but did not significantly enhance lumbar extension torque at any of the joint angles tested on the MedX lumbar extension machine. These findings are supported by previous research, which has suggested that pelvic stabilization is necessary to optimally activate and strengthen the lumbar extensors (Da Silva et al., 2009; Graves et al., 1994; Mayer et al., 2003; San Juan et al., 2005). Indeed, other authors have suggested that where there is no pelvic stabilization it is the hamstring and gluteal muscles that are primarily acting to " de-rotate " the pelvis, rather than the lumbar muscles acting to provide lumbar extension (Graves et al., 1994). ...
Article
This paper discusses research findings relating of the use of the machine that provides isolated, specific exercise and testing for the muscles that extend the lumbar spine (lumbar extension machine, MedX, Ocala , FL ). The function of the machine is explained, and its reliability and validity examined. The effects of various lumbar extension training protocols on lumbar strength and low back pain are then explored, and practical implications and future research directions discussed. We conclude that that the lumbar extension machine provides reliable and accurate measures of lumbar extension strength and can produce very large increases in low back strength in a relatively short time period. Perhaps more importantly given the huge costs of low back problems, it is a very effective tool for preventing or eliminating low back pain in most chronic patients.
... Thus, in that study, the subjects performed tests at maximal ability for fewer repetitions, and this was noted to be as reliable as isometric testing in a Roman Chair device. 35 However, most studies have focused on isometric contractions. ...
Article
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Muscle fatigue has high relevance in human performance yet little research has evaluated how it should be assessed. To perform a pilot study to identify suitable methods of generating and assessing fatigue of the trunk flexor and extensor muscles. Sixteen university rugby players (mean (SEM) age 21.9 (0.2) years) were recruited and subjected to four protocols (A, B, C, D), separated by a week to allow recovery, with peak torque being recorded during each test: A, isokinetic measurements before and after fatigue, with a 10 repetition isokinetic fatigue period; B, isokinetic measurements before and after fatigue with a 45 second isometric fatigue period; C, isometric measurements before and after fatigue with a 10 repetition isokinetic fatigue period; D, isometric measurements before and after fatigue with a 45 second isometric fatigue period. All were conducted during flexion and extension of the trunk on the Cybex Norm Isokinetic Dynamometer trunk flexion-extension unit. All subjects completed all four protocols. Fatigue induction appeared more effective in flexion than extension. Significant differences in mean peak torque before and after fatigue were seen in protocols A, B, and D in flexion and only in protocol D for extension. In flexion, protocol D produced the greatest fatigue, peak torque being 16.2% less after than before fatigue, suggesting greatest sensitivity. Protocol D, which incorporates isometric testing and fatigue protocols, appears to be able to produce fatigue most effectively, and therefore may provide the most valid assessment of fatigue in the trunk flexor and extensor muscles.
Isometric exercise can be used for strength training. Generally, strength training requires heavy weights to be lifted on large pieces of gym equipment. However, the use of co-contraction of agonist and antagonist muscle pairs while the subject is standing has been suggested as a means of isometric strength training. In the present investigation, the muscle activity, as assessed by the electromyogram, was examined in 6 male and 11 female subjects aged 22 to 28 years old to compare isometric exercise induced by co-contraction of muscles in 3 areas of the body to the muscle use with exercise on commercial weight lifting equipment. The areas of the body undergoing isometric exercise were the arm, trunk, and leg muscles. Subjects exercised these areas for 25 seconds compared to 3 loads on a commercial TuffStuff Apollo 5900 gym system (TuffStuff Inc, Pomona, CA). The results of the experiments showed that isometric co-contraction of muscle while the subjects were standing still resulted in 5 times greater work then exercise on a commercial exercise gym for the muscle groups. Thus isometric exercise against agonist and antagonist pairs provides a good exercise regime.
Article
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To review the specificity of exercises designed to condition the lumbar extensor musculature (ie, lumbar erector spinae and multifidus). A review of studies examining effects of exercises designed to condition the lumbar extensors was conducted. Included were studies that examined the acute activation and chronic adaptation of the lumbar extensor musculature in response to benches and roman chair trunk extensions, free weights exercises (ie, deadlifts, squats, good-mornings, etc), floor and stability ball exercise (ie, trunk extensions, bridging, four-point kneeling, etc) and resistance machines (ie, those with and without pelvic restraints). Evidence suggests that the reviewed exercises designed to condition the lumbar extensors all may result in significant activation of this musculature during their performance. However, examination of training studies shows that for benches and roman chair trunk extensions, free weights exercises, floor and stability ball exercise and resistance machines without appropriate pelvic restraints, evidence suggests that they may be less effective for inducing chronic adaptations in the lumbar extensors as a result of their performance. Contrastingly, resistance machines that employ appropriate pelvic restraint to isolate lumbar extension are better evidenced to confer specific adaptations to the lumbar extensors. Numerous exercise approaches have been designed with the intention of conditioning the lumbar extensors. Those examined appear to activate the lumbar extensors; however, the specificity of many of these exercises for producing chronic adaptations may be questionable, potentially due to the compound nature of them allowing involvement of other musculature such as the hip extensors. Many of the reviewed exercises offer potential to condition the lumbar extensors, however, isolation of lumbar extension through appropriate pelvic restraint appears important for optimising specific adaptations in the lumbar extensors.
Chapter
Resistance exercise has long been used to promote musculoskeletal health with the application of training regimens for the clinical treatment and prevention of low back pain growing in popularity over the last couple of decades. A variety of exercise modes have been utilized in an attempt to stimulate and promote increases in muscle function of the lumbar extensors. This chapter examines the current state of knowledge regarding the application of external pelvic fixation during trunk extension exercise and its importance on the concomitant increase of functional outcomes such as muscle strength, muscle activation patterns and compensatory muscle growth.
Article
To identify sports medicine-related clinical trial research articles in the PubMed MEDLINE database published between 1996 and 2005 and conduct a review and analysis of topics of research, experimental designs, journals of publication and the internationality of authorships. Sports medicine research is international in scope with improving study methodology and an evolution of topics. Structured review of articles identified in a search of a large electronic medical database. PubMed MEDLINE database. Sports medicine-related clinical research trials published between 1996 and 2005. Review and analysis of articles that meet inclusion criteria. Articles were examined for study topics, research methods, experimental subject characteristics, journal of publication, lead authors and journal countries of origin and language of publication. The search retrieved 414 articles, of which 379 (345 English language and 34 non-English language) met the inclusion criteria. The number of publications increased steadily during the study period. Randomised clinical trials were the most common study type and the "diagnosis, management and treatment of sports-related injuries and conditions" was the most popular study topic. The knee, ankle/foot and shoulder were the most frequent anatomical sites of study. Soccer players and runners were the favourite study subjects. The American Journal of Sports Medicine had the highest number of publications and shared the greatest international diversity of authorships with the British Journal of Sports Medicine. The USA, Australia, Germany and the UK produced a good number of the lead authorships. In all, 91% of articles and 88% of journals were published in English. Sports medicine-related research is internationally diverse, clinical trial publications are increasing and the sophistication of research design may be improving.
Article
Methods for detecting recruitment patterns of the lumbar muscles during exercise in patients with chronic low back pain are limited. This article discusses the use of magnetic resonance imaging with Roman chair extension exercise to examine lumbar muscle usage in five normal volunteers, five chronic low back pain patients without surgery, and five chronic low back pain patients with surgery.Changes in signal intensities of psoas, multifidus, and longissimus/iliocostalis with graded exercise were measured at three lumber disc levels. At rest, there was a difference between multifidus and longissimus/iliocostalis signal intensity in chronic low back pain subject without surgery(P=0.0162) and in chronic low back pain subjects with surgery (P=0.0036), but not in normal subjects. At peak exercise, there was a defference in signal intensities between multifidus and longissimus/iliocostalis in all groups (normal volunteers, P=0.0069; chronic low back pain patients without surgery, P=0.0125; chronic low back pain patients with surgery, P=0.0060). The exercise response was attenuated in chronic low back pain patients with surgery. Thus, MRI demonstrates static and dynamic differences in lumbar paraspinal musculature in chronic low back pain subjects compared to normal subjects.
Article
The purpose of this study was to evaluate the reliability and variability of repeated measurements of isometric (IM) lumbar extension (LB EXT) strength made at different joint angles. Fifty-six men (age, 29.4 +/- 10.7 years) and 80 women (age, 24.3 +/- 9.1 years) completed IM LB EXT strength tests on 3 separate days (D1, D2, and D3). On D1 and D2, subjects completed two tests (T1 and T2) separated by a 20- to 30-minute rest interval. For each test, IM LB EXT strength was measured at 72, 60, 48, 36, 24, 12, and 0 degrees of lumbar extension. Mean IM strength values, within-day reliability coefficients, and test variability over the seven angles improved from D1 to D2 (D1: mean, 160.0 to 304.1 N.m, r = 0.78 to 0.96, SEE = 37.6 to 46.9 N.m; D2: mean, 176.3 to 329.1 N.m, r = 0.94 to 0.98, SEE = 29.0 to 34.4 N.m). Mean strength values leveled off by D3 (174.5 to 317.0 N.m). The most reliable test results showed that the IM LB EXT strength curves were linear and descending from flexion to extension and ranged from 235.8 +/- 85.2 to 464.9 +/- 150.7 N.m for men (extension to flexion) and from 134.6 +/- 53.2 to 237.3 +/- 71.9 N.m for women. Lumbar extension strength was clearly greatest in full flexion, which is in contrast to previously reported results. One practice test was required to attain the most accurate and reliable results. These data indicate that repeated measures of IM LB EXT strength are highly reliable and can be used for the quantification of IM LB EXT strength through a range of motion.
Article
To investigate the effects of training frequency and specificity of training on isolated lumbar extension strength, 72 men (age = 31 +/- 9 years) and 42 women (age = 28 +/- 9 years) were tested before and after 12 weeks of training. Each test involved the measurement of maximum voluntary isometric torque at 72 degrees, 60 degrees, 48 degrees, 36 degrees, 24 degrees, 12 degrees, and 0 degrees of lumbar flexion. After the pretraining tests, subjects were randomly stratified to groups that trained with variable resistance dynamic exercise every other week (1X/2 weeks, n = 19), once per week (1X/week, n = 22), twice per week (2X/week, n = 23) or three times per week (3X/week, n = 21); a group that trained isometrically once per week (n = 14); or a control group that did not train (n = 15). Analysis of covariance showed that all training groups improved their ability to generate isometric torque at each angle measured when compared with controls (P less than 0.05). There was no statistical difference in adjusted posttraining isometric torques among the groups that trained (P greater than 0.05), but dynamic training weight increased to a lesser extent (P less than 0.08) for the 1X/2 weeks group (26.6%) than for the groups that trained 1X/week, 2X/week, and 3X/week (37.2 to 41.4%). These data indicate that a training frequency as low as 1X/week provides an effective training stimulus for the development of lumbar extension strength. Improvements in strength noted after isometric training suggest that isometric exercise provides an effective alternative for developing lumbar strength.
Article
Development of a new testing machine, which stabilizes the pelvis, allowed us to evaluate the lumbar extensor muscles before and after training. Fifteen healthy subjects (29.1 +/- 8 years of age) trained 1 day per week for 10 weeks and 10 healthy subjects (33.7 +/- 16 years of age) acted as controls. Training consisted of 6 to 15 repetitions of full range of motion variable resistance lumbar extension exercise to volitional fatigue and periodic maximal isometric contractions taken at seven angles through a full range of motion. Before and after the 10 week training period, subjects completed a maximum isometric strength test at seven angles through a 72 degrees range of motion (0 degrees, 12 degrees, 24 degrees, 36 degrees, 48 degrees, 60 degrees, and 72 degrees of lumbar flexion). The training group significantly improved in lumbar extension strength at all angles (P less than or equal to 0.01). The result at 0 degrees (full extension) showed an increase from 180.0 +/- 25 Nm to 364.1 +/- 43 Nm (+102%) and at 72 degrees (full flexion) from 427.4 +/- 44.1 to 607.4 +/- 68 (+42%) Nm. Results from the control group showed no change (P greater than or equal to 0.05). The magnitude of gain shown by the training group reflects the low initial trained state of the lumbar extensor muscles. These data indicate that when the lumbar area is isolated through pelvic stabilization, the isolated lumbar extensor muscles show an abnormally large potential for strength increase.
Article
The purpose of this study was to evaluate the effectiveness of resistance training performed either 2 days/week or 3 days/week. One hundred and seventeen sedentary volunteers were randomly assigned to one of the two training groups or a control group. Twenty-two men (27 +/- 5 years) and 22 women (26 +/- 5 years) trained for 10 weeks. Twenty-five men (26 +/- 5 years) and 22 women (24 +/- 5 years) trained for 18 weeks. Twenty-six subjects served as controls and did not train. Training consisted of a single set of variable resistance bilateral knee extensions performed to volitional fatigue with a weight load that allowed seven to ten repetitions. Prior to and immediately following training, isometric strength was evaluated at 70, 85, 100, 115, 130, 145, 160, and 171 degrees of knee extension with a Nautilus knee extension tensiometer. All groups who trained showed a significant increase in peak isometric strength when compared with controls (P less than 0.01). Groups that trained 3 days/week increased peak isometric strength (10 weeks = 21.2%; 18 weeks = 28.4%) to a greater extent (P less than 0.05) than groups that trained 2 days/week (10 weeks = 13.5%; 18 weeks = 20.9%). We conclude that resistance training 2 days/week significantly improves knee extension isometric strength; however, the magnitude of strength gain is greater when training is performed 3 days/week. These data indicate that the adult exerciser (18 to 38 years) training 2 days/week may derive approximately 80% of the isometric strength benefits achieved by those training 3 days/week.
Article
Of all 30-, 40-, 50-, and 60-year-old inhabitants of Glostrup, a suburb of Copenhagen, 82% (449 men and 479 women) participated in a general health survey, which included a thorough physical examination relating to the lower back. The examination was constituted of anthropometric measurements, flexibility/elasticity measurements of the back and hamstrings, as well as tests for trunk muscle strength and endurance. The reproducibility of the tests was found to be satisfactory. Twelve months after the physical examination 99% of the participants completed a questionnaire sent by mail concerning low back trouble (LBT) in the intervening period. The prognostic value of the physical measurements was evaluated for first-time experience and for recurrence or persistence of LBT by analyses of the separate measurements and discriminant analyses. The main findings were that good isometric endurance of the back muscles may prevent first-time occurrence of LBT in men and that men with hypermobile backs are more liable to contract LBT. Recurrence or persistence of LBT was correlated primarily to the interval since last LBT-episode: the more LBT, the shorter the intervals had been. Weak trunk muscles and reduced flexibility/elasticity of the back and hamstrings were found as residual signs, in particular, among those with recurrence or persistence of LBT in the follow-up year.
Article
P6new physiological criterion for muscular load sharing is developed. The criterion is based on the assumption that the endurance time of muscular contractions is maximized, hence muscular fatigue is minimized. The optimization problem is cast in the form of a linearly constrained, non-linear MINIMAX optimization. The new method predicts that: (1) there is synergistic muscle action, (2) muscle force increases non-linearly with external force (load), (3) relatively more force is allocated to muscles that have a large maximum force (large muscles), (4) relatively more force is allocated to muscles with a high percentage of slow-twitch fibers (muscles that are fatigue-resistant), (5) the load sharing does not depend on the moment arm of the muscles (although the absolute force levels do depend on this variable). The predicted load sharing between two cat muscles during standing and walking is in good agreement with direct force measurement data from the literature.
Article
The purpose of this study was to examine muscular strength responses to five different weight training frequencies per week. 75 male volunteer high school subjects were randomly assigned to train either 1 day, 2 days, 3 days, 4 days, or 5 days per week. All groups trained on an identical program of 18 sets of 1 maximum repetition in the bench press lift for 9 weeks. Significantly greater muscular strength improvement was observed in the group that trained 5 days per week than groups training with fewer frequencies per week. Sequential strength improvements resulted from increased frequency of training. It was concluded that the more frequent the stress the greater the adaptation.
Article
Isometric and isokinetic trunk flexion-extension strengths were studied among 73 subjects (41 males and 32 females) and 10 patients (9 males and 1 female). The isometric strengths were measured in four postures of trunk flexion. The isokinetic trunk strengths were measured through the range of these postures. The study had two objectives: to develop a database for isometric flexion-extension strength at different levels of trunk flexion and isokinetic strength at corresponding angles and to determine the decrement in strength characteristics among patients of idiopathic low back pain. Though flexion-extension strength among normal subjects and patients has been studied, its variation due to standardized postural change has not been reported extensively. The influence of postural deviation on flexion-extension ratios are also largely unknown. To achieve the objectives of the study, a device flexion-extension-lateral flexion tester (FELT) was designed and fabricated. The male and female subjects performed isometric flexion and extension at 0 degree, 20 degrees, 40 degrees and 60 degrees of trunk flexion; and isokinetic flexion starting at neutral posture, and isokinetic extension starting at 60 degrees of trunk flexion. The patients performed isometric flexion and extension in neutral posture only; and isokinetic flexion-extension similar to normal sample. The average strength in each activity was between 70 and 80% of the corresponding peak strength. The isokinetic activity strengths ranged between 60 and 70% of the corresponding isometric activities in each group. The strength of females ranged between 60 and 70% of males. The ANOVA revealed that posture had a significant effect on strength. The multiple regression explained 73% of variance in isometric and 34% in isokinetic modes. A patient's strength profile should be determined in a posture that simulates activities of daily living to determine impairment and plan rehabilitation.
Article
This study compared isokinetic and non-dynamometric tests for their correlation with subjective low back pain symptoms. A total of 185 patients with chronic low back pain were examined. The repetitive arch-up and sit-up tests correlated significantly with pain and disability (Million index) both in men and women (r ranged from -0.39 to -0.46; P < 0.001). In women, the isokinetic trunk flexion and extension tests and the non-dynamometric tests correlated equally well with the Million index. In men, the isokinetic flexion and extension tests had weaker correlations. Overall, the isokinetic lifting tests showed lower correlations than did the isokinetic trunk extension tests. In the isokinetic flexion and extension tests, fast testing speeds (120 degrees/sec and 150 degrees/sec) correlated somewhat better with the subjective symptoms than did the lowest speed (30 degrees/sec). The non-dynamometric tests are still useful in clinical practice in spite of the development of more accurate muscle strength evaluation methods.
Article
The effect of low back pain on the size of the lumbar multifidus muscle was examined using real-time ultrasound imaging. Bilateral scans were performed in 26 patients with acute unilateral low back pain (LBP) symptoms (aged 17-46 years) and 51 normal subjects (aged 19-32 years). In all patients, multifidus cross-sectional area (CSA) was measured from the 2nd to the 5th lumbar vertebrae (L2-5) and in six patients, that of S1 was also measured. In all normal subjects, CSA was measured at L4 and in 10 subjects measurements were made from L2-5. Marked asymmetry of multifidus CSA was seen in patients with the smaller muscle being on the side ipsilateral to symptoms (between-side difference 31 +/- 8%), but this was confined to one vertebral level. Above and below this level of wasting, mean CSA differences were < 6%. In normal subjects, the mean differences were < 5% at all vertebral levels. The site of wasting in patients corresponded to the clinically determined level of symptoms in 24 of the 26 patients, but there was no correlation between the degree of asymmetry and severity of symptoms. Patients had rounder muscles than normal subjects (measured by a shape ratio index), perhaps indicating muscle spasm. Linear measurements of multifidus cross-section were highly correlated with CSA in normal muscles but less so in wasted muscles, so CSA measurements are more accurate than linear dimensions. The fact that reduced CSA, i.e., wasting, was unilateral and isolated to one level suggests that the mechanism of wasting was not generalized disuse atrophy or spinal reflex inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)
Article
The effects of exercise for isolated lumbar extensor muscles were examined in 54 chronic low-back pain patients. Subjects were randomly assigned to a 10-week exercise program (N = 31) or a wait-list control group (N = 23). Results indicated a significant increase in isometric lumbar extension strength for the treatment group and a significant reduction in reported pain compared with the control group (P 0.05). Treated subjects reported less physical and psychosocial dysfunction whereas the control group increased in pain, and physical and psychosocial dysfunction. There were no concomitant changes in reported daily activity levels. These results show that lumbar extension exercise is beneficial for strengthening the lumbar extensors and results in decreased pain and improved perceptions of physical and psychosocial functioning in chronic back pain patients. However, these improvements were not related to changes in activities or psychological distress.
Article
This study investigated the level of resistance and the level of muscle activation of the prone back exercise. Fifteen male subjects with no previous history of low back injury performed two repetitions of seven exercises. These consisted of four maximal isometric voluntary contractions (MVC) and three prone back extension (PBE) exercises. The subject was lying prone on a table, the upper body was suspended off the end of the table and the legs and thighs were secured to the table with straps. Three starting positions from the horizontal were investigated, 0 degree, 30 degrees and 60 degrees, and were compared with MVC to quantify the level of effort needed to perform the task. The results showed that the three PBE exercises require a level of resistance and a level of muscle activation generally under 40% of the maximum capacity of healthy subjects. Muscle activity of the erector spinae (ES) was slightly greater when the exercise started at 60 degrees, compared to 0 degree and 30 degrees. During the static phase of the PBE exercises, the level of resistance remained at 40% relative to the peak reaction moment of the MVC, but muscular activity of ES tended to work at a lower activity level. In conclusion, since for healthy subjects PBE exercises are low resistance exercises, they seem to be more specifically designed to develop muscular endurance of the back muscles.
Article
To evaluate the effects of angle and hand position during variable-angle Roman chair (VARC) back extension exercise on lumbar paraspinal electromyographic (EMG) activity. Descriptive, repeated measures. University-based musculoskeletal research laboratory. Two female and eight male volunteers recruited from a university setting. INTERVENTION AND OUTCOME MEASURES: Surface integrated EMG activity was recorded from the L3-L4 paraspinal region during 24 10-second repetitions of dynamic back extension exercise, each consisting of a unique VARC angle (six total) and subject hand position (four total). Lumbar paraspinal surface integrated EMG activity measured in millivolts per repetition was used for analysis. Significant lumbar paraspinal EMG activity was evident during each of the 24 repetitions (p < or = .05), with a 104% increase in activity noted between the lowest and highest. EMG activity increased progressively among hand positions and as the VARC angle became more horizontal. VARC angle affected EMG activity more than hand position, but the greatest impact on EMG activity was produced by modifying both angle and hand position. Lumbar paraspinal EMG activity can be altered during VARC back extension exercise by changing angle and hand position. Clinicians can use these data to develop progressive resistance exercise programs using the VARC apparatus.
Article
To evaluate the effect of hip position and lumbar posture on the surface electromyographic activity of the trunk extensors during Roman chair exercise. Descriptive, repeated measures. University-based musculoskeletal research laboratory. Twelve healthy volunteers (7 men, 5 women; age range, 18-35y) without a history of low back pain were recruited from a university setting. Not applicable. Surface electromyographic activity was recorded from the lumbar extensor, gluteal, and hamstring musculature during dynamic Roman chair exercise. For each muscle group, electromyographic activity (mV/rep) was compared among exercises with internal hip rotation and external hip rotation and among exercises by using a typical lumbar posture (nonbiphasic) and a posture that accentuated lumbar lordosis (biphasic). For the lumbar extensors, electromyographic activity during exercise was 18% greater with internal hip rotation than external hip rotation (P< or =.05) and was 25% greater with a biphasic posture than with a nonbiphasic posture (P< or =.05). For the gluteals and hamstrings, there was no difference in electromyographic activity between internal and external hip rotation or between biphasic and nonbiphasic postures (P >.05). The level of recruitment of the lumbar extensors can be modified during Roman chair exercise by altering hip position and lumbar posture. Clinicians can use these data to develop progressive exercise protocols for the lumbar extensors with a variety of resistance levels without the need for complex equipment.