Spinal Rehabilitation.

Back2Strength uses the Medical Lumbar Extension machine developed by the MedX Corporation that holds more than 30 patents on its products, which are among the most researched in the world. The University of Florida School of Medicine and the University of California, San Diego have been involved in numerous studies to validate the MedX products.

For over 20 years, medical research has been conducted on patients with low back or neck pain to demonstrate the clinical efficacy of the treatment protocols using the MedX Medical Lumbar and Cervical Extension equipment. Research indicates a growing number of medical experts are favoring aggressive exercise (strengthening) therapy over traditional rehabilitation or surgery to help patients with chronic back and neck pain.

More than 75 peer-reviewed medical journal articles have been published to confirm spinal strengthening using MedX Medical equipment’s ability to materially decrease spine-related pain issues, restore spinal function, improve patient quality of life and independence, and decrease or eliminate the need for ongoing spinal care. Patients found success even after multiple failed attempts at other forms of treatment.

The following are highlights of selected research articles that confirm the benefits of spinal strengthening using MedX Medical equipment:

STUDIES ON CHRONIC LOWER BACK AND SPINAL PAIN

The Clinical Effects of Intensive Specific Exercise on Chronic Low Back Pain:
A Controlled Study of 895 Consecutive Patients With 1-Year Follow Up
Orthopedics October 1995 Volume 18, Number 10
Brian W. Nelson, MD, Elizabeth O’Reilly, RN, Mark Miller, PT,
Mike Hogan, PT, Charles E. Kelly, MD, Joseph A Wegner, MD
Physicians Neck and Back Clinics, Minneapolis, Minnesota
Study Outcomes & Clinical Relevance:
• 76 percent had good or excellent results
• Patients with either radicular or referred leg pain (over half of all patients) responded
just as well as patients with isolated low back pain
• Prior to evaluation at PNBC, patients had seen on average three physicians and had
failed six different treatment options, including chiropractic, epidural injections, facet
injections, ultrasound, traction, medication, electrical stimulation and low tech exercise.
• Results were independent of diagnosis. Spinal fitness was crucial, regardless of
underlying condition.
• Patients completing the PNBC program had dramatically less (67 percent) medical
reutilization in the year after discharge than comparable control group patients treated
elsewhere with passive modalities.

Low Back Strengthening for the Prevention and Treatment of Low Back Pain
Medicine and Science in Sports and Exercise 1999 Volume 31, Number 1
David M. Carpenter and Brian W. Nelson
Study Outcomes & Clinical Relevance: Isolated lumbar extension exercise with the pelvis stabilized using specialized equipment (MedX) elicits the most favorable improvements in low back strength muscle cross-sectional area, and vertebral bone mineral density. Improvements occur independent of diagnosis, are long-lasting, and appear to result in less re-reutilization of the health care system than other more passive treatments.

Can Spinal Surgery Be Prevented by Aggressive Strengthening Exercise? A Prospective Study of Cervical and Lumbar Patients
Archives of Physical Medicine & Rehabilitation January 1999 Volume 80, Number 1
Brian W. Nelson, MD, David M. Carpenter, MS, Thomas E.
Dreisinger, PhD., Michelle Mitchell, PTA, Charles E. Kelly, MD,
Joseph A Wegner, MD
Study Outcomes & Clinical Relevance: Forty-six of the 60 participants completed the (MedX based) program. At an average of 16 months after completion, 38 patients were available for follow-up while 8 patients could not be located or contacted. Of these 38 patients only three required surgery after completing the program. In other words, patients who were informed they required back or neck surgery had a 92% chance of avoiding surgery with aggressive spinal strengthening on the MedX Medical Machines.

Physiological and Psychological Benefits: Lumbar Strengthening in Chronic Back Pain Patients
Spine February 1993 Volume 18, Number 2
Sherry V. Risch, PhD, Michael L. Pollock, PhD, Howard Langer,
RPT, James E. Graves, PhD, Nancy K. Norvell, PhD, Edward D.
Risch, MD, Michael Fulton, MD, Scott H. Leggett, MS
Study Outcomes & Clinical Relevance: Lumbar extension exercise (MedX) is beneficial for strengthening the lumbar extensors and results in decreased pain and improved perceptions of physical and psychological functioning in chronic back pain patients.

Restorative Exercise for Clinical Low Back Pain (A Prospective Two-Center Study With 1-Year Follow Up)
Spine November 1999 Volume 24, Number 9
Scott Leggett, MS, Vert Mooney, MD, Leonard N.
Matheson, PhD, Brian Nelson, MD, Ted Dreisinger, PhD,
Jill Van Zytveld, BA and L. Vie, BA
Physicians Neck and Back Clinic, Minneapolis, Minnesota
University of California, San Diego
Study Outcomes & Clinical Relevance: A combined study between Physicians Neck and Back Clinic (PNBC) and the University of California at San Diego, using similar exercise-only protocols (MedX) were able to achieve comparable excellent results with comparable spine patients. Health care reutilization was dramatically reduced at both clinics to almost identical levels, thus validating the results of each. In the year after completion of treatment, only 12% of PNBC patients needed to re-enter the health care system for spinal problems and 10% at UCSD.

Changes in Isometric Strength and Range of Motion of the Isolated Cervical Spine After Eight Weeks of Clinical Rehabilitation
Spine 1992 Volume 17, Number 68
Thomas R. Highland, MD, Thomas E. Dreisinger, PhD, Laura L.
Vie, BEd, Garth S. Russell, MD
Study Outcomes & Clinical Relevance: This study was one of the first studies to objectively measure changes in strength and range of motion in patients with non-spinal cord injuries of the cervical spine. Significant gains were seen in strength as well as range of motion and perceived pain was significantly reduced. This study showed that testing and training of the isolated cervical spine (MedX) is a safe and viable method of clinical assessment and treatment of a variety of cervical spine disorders.

A Randomized Clinical Trial of Exercise and Spinal Manipulation for Patients with Chronic Neck Pain
Spine April 2001 Volume 26, Number 7
Bronfort G, Evans R, Nelson B, Aker PD, Goldsmith CH,
Vernon H
Northwestern Health Sciences University
Bloomington, Minnesota
Study Outcomes & Clinical Relevance: For chronic neck pain, the use of strengthening exercise, whether in combination with spinal manipulation or in the form of a high-technology MedX program, appears to be more beneficial to patients with chronic neck pain than the use of spinal manipulation alone. An additional finding was that 85% of the patients with chronic neck pain were able to engage in MedX therapy with no exacerbation of head or neck pain, and the remaining patients experienced only transient, self-limited discomfort.

Two-year Follow-up of a Randomized Clinical Trial of Spinal Manipulation and Two Types of Exercise for Patients with Chronic Neck Pain
Spine November 2002 Volume 27, Number 21
Evans R, Bronfort G, Nelson B, Goldsmith CH
Northwestern Health Sciences University, Bloomington,
Minnesota
Study Outcomes & Clinical Relevance: There have been few randomized clinical trials of spinal manipulation and rehabilitative exercise for patients with neck pain, and most have only reported short-term outcomes. The results of this study demonstrate an advantage of spinal manipulation combined with low-tech rehabilitative exercise and MedX rehabilitative exercise versus spinal manipulation alone over two years and are similar in magnitude to those observed after one-year follow-up. These results suggest that treatments including supervised rehabilitative exercise should be considered for chronic neck pain sufferers.

Effect of Focused Strength Training After Low Back Injury
North American Spine Society 1993 Annual Meeting San Diego, California
Federation of Spine Associations’ Council of Musculoskeletal Specialists 1994 Annual Meeting New Orleans, Louisiana
V. Mooney, L. Matheson, D. Holmes, S. Leggett, J. Grant,
S. Negri, B. Holmes (University of California San Diego—
Orthomed
Study Outcomes & Clinical Relevance: Focused training (MedX) after low back injury appears to be an efficacious approach to treatment with broad effect. Not only were significant effects found with improvement in back strength, but these effects generalized to improvement in lifting capacity, self-perception, pain rating, and activity level.

A Rational Approach to the Treatment of Low Back Pain
(Most Patients Can Achieve Functional Restoration)
The Journal of Musculoskeletal Medicine May 1993 Volume 10 Number 5
Brian W. Nelson, MD
Study Outcomes & Clinical Relevance: At the initial visit of a patient with low back pain, the physician must set a positive tone, emphasizing that the problem is common in the human body and can be remedied. Initial treatment is 1-2 days of rest, a short course of analgesics, and stretches and other exercises. The 5% to 10% who do not improve within 3 months (chronic pain patients) or have a relapse frequently require an active functional rehabilitation program. Exercises are helpful only if they focus on the lumbar extensors (MedX). Patients may need encouragement at the beginning of the program to tolerate discomfort. Expensive imaging studies are reserved for patients who become disabled or show no improvement. Only when a lesion is identified in a patient who has seriously tried and failed conservative rehabilitation is surgery recommended.

Philadelphia Panel Evidence-Based Clinical Practice Guidelines on Selected Rehabilitation Interventions for Low Back Pain
Physical Therapy October, 2001 Volume 81, Number 10
Collective Name: Philadelphia Panel
Study Outcomes & Clinical Relevance: According to this expert panel, only therapeutic exercise has enough scientific support to warrant its recommendation as an intervention in the treatment of chronic, subacute, and postsurgical low back pain. These recommendations essentially match other national and international practice guidelines. Advantages of an active approach to physical rehabilitation include empowering the patient, decreasing dependency on the health care provider, and impacting other health-related risk factors of secondary interest. Of interest to practitioners working in MedX-equipped facilities, this review did include a randomized controlled trial by Risch et al. (1993) that utilized MedX as an effective, high-technology intervention in the treatment of chronic low back pain.

The Effect of Trunk Muscle Exercises in Patients Over 40 Years of Age with Chronic Low Back Pain
Journal of Orthopedic Science 2000 Volume 5, Number 3
Department of Orthopaedic Surgery, Kochi Medical School,
Kohasu, Oko-cho, Nankoku, Kochi 783, Japan
Study Outcomes & Clinical Relevance: Like many other recent studies, this study confirms the importance of strengthening the lumbar extensors to improve symptoms in patients with chronic low back pain. Rectus abdominis strength is not compromised to the same degree in such patients and thus should be prioritized accordingly. Other contemporary studies fail to support the outdated notion that weak abdominals are of primary concern in the cause or treatment of low back pain.

Comparison of Female Geriatric Lumbar Extension Strength: Asymptomatic Versus Chronic Low Back Pain Patients and Their Response to Active Rehabilitation
Journal of Spinal Disorders 1996 Volume 9, Number 1
Bryon Holmes, Vert Mooney, Scott Negri, Scott Leggett,
Jean Nichols, An Hoeyberghs
Study Outcomes & Clinical Relevance: This study confirmed that many back pain sufferers have weaker lumbar extension strength and that some symptomatic geriatric women can increase strength with progressive resistance exercise (MedX), which leads to a decrease in low back pain.

The Effect of Workplace Based Strengthening on Low Back Injury Rates: A Case Study in the Strip Mining Industry
Journal of Occupational Rehabilitation 1995 Volume 5, Number 3
Vert Mooney, Marvin Kron, Patrick Rummerfield, Bryon Holmes
Study Outcomes & Clinical Relevance: The purpose of this study was to demonstrate the effect of a once a week exercise program (MedX) focused specially at lumbar extensor strengthening. There was a 54% to 104% increase in strength during the 20 week program. The average workers’ compensation liability dropped from $14,430 per month to $380 per month for the study year. The significant increase in strength associated with the exercise program correlated with the greatly reduced incidence of back claims.

STUDIES ON DISC HERNIATIONS/POST SURGICAL PROGRAMS

Can Exercise Therapy Improve the Outcome of Microdiscectomy?
Spine June 2000 Volume 15, Number 25
Dolan P, Greenfield K, Nelson RJ, Nelson IW
Department of Anatomy, University of Bristol, United Kingdom
Study Outcomes & Clinical Relevance: A 4-week postoperative exercise program can improve pain, disability, and spinal function in patients who undergo microdiscectomy. : A brief course of active-based therapy (MedX) provided long-term (up to one year) benefits to patients following microdiscectomy. These exercise-induced benefits augmented the outcomes provided by surgery. The authors expound on the long-term deconditioning that likely precedes surgery. A follow up study should thus include a pre-surgical exercise group. If properly applied, aggressive spinal strengthening performed pre-surgically may have not only improved surgical outcomes, but helped many patients avoid surgery altogether—as previous research has suggested.

The Effect of Early Isolated Lumbar Extension Exercise Program for Patients with Herniated Disc Undergoing Lumbar Discectomy
Neurosurgery October 2005 Volume 57, Number 4
Choi G, Raiturker PP, Kim MJ, Jin CD, Chae YS
Wooridul Spine Hospital, Seoul, South Korea
Study Outcomes & Clinical Relevance: This study examined the effects of a postoperative early isolated lumbar extension muscle-strengthening program (MedX) on pain, disability, return to work, and power of back muscle after operation for herniated lumbar disc. Significant improvements were observed in the exercise group versus the control group for lumbar extensor power, the cross-sectional area of multifidus and longissimus muscle, and the visual analog scale score. The percentages of returning to work within 4 months after surgery were significantly greater in the exercise group than in the control group (87% versus 24%, respectively). These results support the positive effects of the postoperative early lumbar extension muscle-strengthening program on pain, return to work, and strength of back muscles in patients after operation of herniated lumbar disc.

Early Aggressive Exercise for Postoperative Rehabilitation After Discectomy
Spine April 2000 Volume 25, Number 8
Danielsen JM; Johnsen R; Kibsgaard SK; Hellevik E
Institute of Manual Therapy, Mo i Rana; the Institute of
Community Medicine, University of Tromso, and Rana Hospital,
Mo i Rana, Norway
Study Outcomes & Clinical Relevance: Vigorous medical exercise therapy (MedX), started 4 weeks after surgery for lumbar disc herniation, reduced disability and pain after surgery. Because no differences in clinical end points were observed, there is hardly any danger associated with early and vigorous training after operation for disc herniation. As has been demonstrated again and again, active therapy prevails over passive or no therapy. In this study, surgery alone was insufficient to optimize outcomes, even when supplying patients with a few home exercises. Furthermore, several studies indicate spine patients (non-surgical and post-surgical) can tolerate very intensive conditioning programs. Given the present body of evidence, surgeons should be strongly encouraged to refer postoperative spine patients for supervised therapy by skilled professionals to ensure the best possible outcomes.

An Intensive, Progressive Exercise Program Reduces Disability and Improves Functional Performance in Patients After Single-Level Lumbar Microdiscectomy
Physical Therapy November 2009 Volume 89 Number 11
Kulig, K, Beneck, GJ, Selkowitz,DM, et.al.
Study Outcomes & Clinical Relevance: 12 weeks of progressive back extensor strength training (MedX) combined with education reduces disability and improves function in patients who have undergone a single-level lumbar microdiskectomy.
Serial Changes in Trunk Muscle Performance after Posterior Lumbar Surgery
Spine May 1999 Volume 15, Number 24
Department of Orthopaedic Surgery, Toyama Medical and
Pharmaceutical University, Japan
Study Outcomes & Clinical Relevance: Back muscle injury was directly related to the muscle retraction time during surgery. The damage to the multifidus muscle was more severe and the recovery of extensor muscle strength was delayed in the long-retraction-time group. In addition, the incidence of postoperative low back pain was significantly higher in the long-retraction-time group. Although lumbar surgery is often thought to fix whatever is broken, it can introduce new dysfunction such as injury to the multifidi musculature. An active course of spinal therapy to specifically retrain the multifidi may decrease postoperative low back pain resulting from weakness associated with muscular insult.

STUDIES ON SCOLIOSIS

The Role of Measured Resistance Exercises in Adolescent Scoliosis
Orthopedics February 2003 Volume 26, Number 2
Vert Mooney, MD and Allison Brigham, BS
Study Outcomes & Clinical Relevance: Twenty adolescent patients (18 girls and 2 boys) with scoliosis ranging from 15-41 degrees in their major curve were treated with a progressive resistive training program for torso rotation. All patients demonstrated an asymmetry of rotation strength measured on specialized equipment, and surface electrode electromyograms showed inhibition of lumbar paraspinal muscles. Sixteen of 20 patients demonstrated curve reduction, and no patient showed an increase in curve.

A Preliminary Report on the Effect of Measured Strength Training in Adolescent Idiopathic Scoliosis
Journal of Spinal Disorders 2000, Volume 13, Number 2
Vert Mooney, Jennifer Gulick, Robert Pozos
US Spine & Sport Center, Worldwide Clinical Trials, and
San Diego State University
Study Outcomes & Clinical Relevance: The authors studied 12 adolescent patients with scoliosis (10 girls and 2 boys) who were 11 to 16 years old and had curvatures ranging from 20 to 60 degrees. When tested on the MedX Rotary Torso Machine, both sides were unequal in their torso rotation strength in all patients. These asymmetries were correct completely with torso rotation, which was associated with significant strength gains. Strength gains ranged from 12% to 40%. A 16 year old girl with a 60 degree lumbar curve progressed and had surgery. None of the remaining patients progressed and 4 of the 12 had decreases in their curvatures from 20 to 28 degrees. These results are equal to or better than 23 hour per day bracing. None of the patients used braces during this study.

DIFFERENTIATION BETWEEN MEDX MEDICAL LUMBAR MACHINE AND OTHER COMMERCIALLY AVAILABLE “LOW BACK EXERCISE MACHINES”

Effect of Resistance Training on Lumbar Extension Strength
American Journal of Sports Medicine 1989 Volume 17, Number 5
Michael L. Pollock, PhD, Scott H. Leggett, MS, James E.
Graves, PhD, Arthur Jones, Michael Fulton MD, and
Joe Cirulli
Study Outcomes & Clinical Relevance: This study demonstrates that healthy normal individuals show a significant increase in lumbar extension strength when these muscles are effectively isolated and trained. The magnitude of strength gained over the 10 week period is much greater than strength increases found with the average muscle group within the same period, and indicates that the lumbar extensor muscles were in a deconditioned state prior to training. In addition, 10 of the 15 subjects that trained had reported using the Nautilus low back machine on a regular basis prior to the study period. This supports the concept that commercially-available “low back” machines do not isolate the lumbar muscles and that the lumbar extensor muscles must be effectively isolated through pelvic stabilization in order to elicit a training response from progressive resistance exercise.

Effects of Pelvic Stabilization on Lumbar Muscle Activity During Dynamic Exercise
Journal of Strength and Conditioning Research 2005 Volume 19 Number 4
Jun G. San Juan, James A. Yaggie, Susan Levy, Vert Mooney,
Brian Udermann, and John M. Mayer
Study Outcomes & Clinical Relevance: Pelvic stabilization is necessary to achieve optimal recruitment of the lumbar extensor muscles during dynamic extension exercises on a lumbar extension machine. Therefore, if the goal is to strengthen the muscles of the low back, it is necessary to stabilize the pelvis with a clinically proven restraint system (found on MedX).

Pelvic Stabilization During Resistance Training: Its Effect on the Development of Lumbar Extension Strength
Archives of Physical Medicine and Rehabilitation 1994 Volume 75
James, E. Graves, PhD, Michael L. Pollock, PhD, Scott
Leggett, MS, Dan Foster, Dina C. Webb, PT, Jan Matkozich,
David M. Carpenter, MS, Joseph Cirulli
Study Outcomes & Clinical Relevance: The “No Stabilization” and the “Stabilization” groups showed significant and similar increases in the weight load for training. However, the post-training isometric torque values describing isolated lumbar extension strength improved only for the “Stabilization” group. Therefore, pelvic stabilization is required to effectively train the lumbar extensor muscles. The increased load for the “No Stabilization” group is attributed to increases in strength of the hamstring and buttock muscles.

Comparison of Two Restraint Systems for Pelvic Stabilization during Isometric Lumbar Extension Strength Testing
Journal of Orthopedic & Sports Physical Therapy January 1992 Volume 15, Number 1
James E. Graves, PhD, Cecily K. Fix, MS, Michael L.
Pollock, PhD, Scott H. Leggett, MS, Dan N. Foster, MS,
David M. Carpenter, MS
Study Outcomes & Clinical Relevance: The researchers examined the difference in two different stabilization methods (knee and foot restraints). Due to the differences in results, standardization of the restraint system used is important for comparative purposes.

THE INEFFECTIVENESS OF TRADITIONAL LOW BACK EXERCISES

Electromyographic Activity of Selected Trunk Muscles during Dynamic Spine Stabilization Exercises
Archives of Physical Medicine & Rehabilitation November 2001 Volume 82, Number 11
Souza GM, Baker LL, Powers CM
Study Outcomes & Clinical Relevance: Spine Stabilization Exercises (traditional back exercises taught in therapy and home exercise programs) produced low levels of electromyographic activity (41% of maximum voluntary isometric contraction). Healthy persons may not receive a significant strengthening effect from common, low-technology trunk extensions.

Effect of Roman Chair Exercise Training on the Development of Lumbar Extension Strength
Journal of Strength & Conditioning Research May 2003 Volume 17, Number 2
Mayer, JM, Udermann, BE, Graves, JE, Ploutz-Snyder LL
Department of Exercise Science, Syracuse University,
Syracuse, New York 13244.
Study Outcomes & Clinical Relevance: Following training, peak isometric lumbar extension torque did not increase for the group training on the Roman Chair. It was determined that the Roman Chair primarily strengthened the hamstrings and gluteal muscles.

Effects of Three Different Training Modalities on the Cross Sectional Area of the Lumbar Multifidus Muscle in Patients with Chronic Low Back Pain
British Journal of Sports Medicine 2001 Volume 35
L A Danneels, G G Vanderstraeten, D C Cambier, E E
Witvrouw, J Bourgois, W Dankaerts and H J De Cuyper
Department of Rehabilitation Sciences and Physical Therapy,
Faculty of Medicine, Ghent University, Belgium; Centre of
Sports Medicine, Ghent University Hospital, Belgium;
Department of Physical Medicine and Rehabilitation, Hospital
Jan Palfijn-Campus Gallifort, Antwerp, Belgium
Study Outcomes & Clinical Relevance: Multifidus muscle wasting appears to be reversible if given the proper intervention. But, spinal stabilization training does not restore atrophied multifidi in the absence of progressive resistance exercises for the low back musculature. The most effective resistance exercise routine in this study used a concentric-eccentric protocol with a 5- second isometric pause with the muscles in their most contracted position.

Differences in Electromyographic Activity in the Multifidus Muscle and the Iliocostalis Lumborum between Healthy Subjects and Patients with Sub-Acute and Chronic Low Back Pain
European Spine Journal February 2002 Volume 11, Number 1
Danneels LA, Coorevits PL, Cools AM, Vanderstraeten
GG, Cambier DC, Witvrouw EE, De CH
University Hospital, Department of Rehabilitation Sciences
and Physiotherapy, Ghent, Belgium
Study Outcomes & Clinical Relevance: Back pain patients have a reduced capacity to voluntarily recruit the multifidus in order to obtain a neutral lordosis. Pain, pain avoidance and deconditioning may have contributed to these lower levels of EMG activity during intensive back muscle contraction. This study reaffirms the involvement of the multifidi in the possible pathogenesis of low back pain. In this study, low load activity (lumbar stabilization exercises) was insufficient to challenge the multifidi during “stabilization” exercises. This is in agreement with another study previously reviewed in this column that concluded stabilization exercises do not recruit the paraspinal musculature at a level high enough to stimulate strength adaptations. One of the most researched means of accomplishing this spinal overload is via the MedX lumbar extension machine.

THE RELATIONSHIP BETWEEN WEAK LOW BACK AND NECK MULTIDIFUS MUSCLES AND PAIN

Correlation Between the MRI Changes in the Lumbar Multifidus Muscles and Leg Pain
Clinical Radiology February 2000 Volume 55, Number 2
Kader DF, Wardlaw D, Smith FW
Department of Radiology, Woodend Hospital
Aberdeen, United Kingdom
Study Outcomes & Clinical Relevance: This study found multifidi muscle atrophy in 80% ofpatients with low back pain. Interestingly, clinical research using MedX to rehabilitate lumbar spine dysfunction boasts nearly an 80% success rate. Perhaps these figures are coincidentally similar. It is, however, tempting to speculate that the widespread multifidi muscle atrophy in this study and the targeted multifidi training afforded by MedX explain in part the widespread success of MedX therapy across diagnoses. That is, it is possible that various spinal pathologies share at least one common symptom generator: multifidi dysfunction. Thus, addressing this dysfunction should improve a majority of low back pain patients owing to their common trait of aberrant multifidi function. From these data, it can be argued that most patients with lumbar pain should receive physical therapy directed at reconditioning the multifidi.

CT Imaging of Trunk Muscles in Chronic Low Back Pain Patients and Healthy Control Subjects
European Spine Journal August 2000 Volume 9, Number 4
Danneels LA, Vanderstraeten GG, Cambier DC,
Witvrouw EE, De Cuyper HJ
Department of Rehabilitation Sciences and Physical Therapy,
Faculty of Medicine, Ghent University, Belgium
Study Outcomes & Clinical Relevance: This research on non-operative persons adds to the impressive body of evidence regarding a relationship between multifidi dysfunction and low back pain. It is not known if muscle weakness and atrophy are the cause or the result of chronic low back pain. It is possible that this relationship may depend upon the particular case. Weakness represents an abnormality that requires intervention in the form of isolated spinal strengthening to optimize spinal function.

Surface Electromyography-Verified Muscular Damage Associated with the Open Dorsal Approach to the Lumbar Spine
European Spine Journal October 2001 Volume 10, Number 5
Kramer M, Katzmaier P, Eisele R, Ebert V, Kinzl L, Hartwig E
Study Outcomes & Clinical Relevance: The dorsal approach for surgeries to repair vertebral fractures causes damage patterns in the muscles that are caused by the surgery. This approach may disrupt normal function of the multifidi, which can contribute to chronic pain and dysfunction. This supports the rationale for concerted spinal strengthening in such post-operative patients.

Cross-sectional Area of Cervical Multifidus Muscle in Females with Chronic Bilateral Neck Pain Compared to Controls
J. Orthop. Sports Phys Ther. 2008;38(4): 175-180, published online 7 December 2007.
Cesar Fernandez-de-las-Penas, Joan C. Albert-Sanchis, Miguel Buil, Jose C. Benitez, Francisco Alburquerque-Sendin
Study Outcomes & Clinical Relevance: Females with bilateral chronic neck pain had generalized smaller CSA of the cervical multifidus muscles compared to healthy females.
Strength Testing Can Identify Malingering
The Journal of Workers Compensation 1992 Volume 2, Number 1
Vert Mooney, MD, Scott H. Leggett, MS, Bryon L. Holmes, MS,
Scott Negri, MD
Study Outcomes & Clinical Relevance: Consistent sub-maximal efforts with visual feedback can be achieved by a subject anxious to deceive the tester. However, with reliable equipment (MedX) and the potential to manipulate the test circumstances, the apparent consistent performance can document a patient’s willful deception.

With such a body of knowledge documenting that the results of a good Chiropractor and MedX equipment, why doesn’t every spinal clinic offer it? It is largely about cost. These are very expensive tools. Insurance companies usually pay for ‘physical therapy’ at a fixed rate… it doesn’t matter to them that the machine used is proven to have dramatically better results and costs more than most people make in a year… or if the provider uses a stretchy rubber band whose outcomes pale in comparison.

We made the choice to buy the very best equipment to help our patients get their lives back. Not to get them ‘ok’ or ‘good enough’. To give them the very best opportunity to be well. We’re proud of that choice. It was the right one. If you have back pain come see us and see why. Call 541-484-0360 today.